2-year review of a novel vestibular rehabilitation program in Montreal and Laval, Quebec.

Abstract

To evaluate the benefits of a vestibular rehabilitation program (VRP) in the Montreal-Laval area. The VRP was conceptualized by a panel of experts including otolaryngologists, physiotherapists, and researchers from McGill University and its teaching hospitals. From February 1999 to December 2001, 117 patients were seen, and 88 of them completed the VRP. The VRP has been established at the Jewish Rehabilitation Hospital in Laval, PQ, to provide specialized rehabilitation to clients suffering from vertigo, dizziness, and/or impaired balance owing to lesions or disorders of the vestibular system. Presence or absence of nystagmus or vertigo during the Dix-Hallpike test, Dizziness Handicap Inventory (DHI), and Dynamic Gait Index (DGI). Thirty-five patients with benign paroxysmal positional vertigo of the posterior canal were treated with canalith repositioning manoeuvres. All of the patients (100%) had absence of nystagmus or vertigo after one to four treatment sessions. Forty-six patients with vestibular deficits or dizziness-disequilibrium completed the VRP, which consisted mainly of individualized eye-head and balance home exercise programs. At the end of the VRP, there was a significant decrease in DHI score (31 vs 57; p < .01) and a significant increase in DGI score (18.4 vs 22.6; p < .01). A range of modest to major improvements was shown by comparing initial and discharge scores of patients who had completed vestibular rehabilitation. The VRP appears to be beneficial for patients with a variety of vestibular disorders. Further research is needed to continue optimizing vestibular rehabilitation.