Effect of a vestibular rehabilitation protocol to improve the health-related quality of life and postural balance in patients with peripheral vertigo

Abstract

To determine the effect of completing a vestibular rehabilitation treatment protocol on postural balance, dizziness and quality of life in patients with peripheral vertigo. A prospective study concerning patients with instability due to unilateral peripheral vestibular disorder. The patients were evaluated with a clinical examination and a test of static and dynamic balance on the Satel ® platform in which length, mediolateral (LongX) and anterior-posterior deviations (long Y) were monitored. Information regarding vertigo symptoms and quality of life were assessed through the vertigo symptom Scale (VSS) and the Dizziness Handicap Inventory (DHI). Patients were treated in two sessions per week for two months by a custom protocol. The rehabilitation program included substitutional and/or habitudinal exercises, exercises on a stability platform, and optokinetic stimulation. Thirty patients with mean age of 52.26 ± 8.45 years were included: 7 men and 23 women. Twelve patients had vestibular neuritis sequelae (46,7%), 10 otolith disorders (33,33%),and 6 Meniere's disease (20%). An improvement in the intensity of dizziness, postural parameters and quality of life was considered (0.01) with the intervention. The main balance parameters (Long X and Long Y) have decreased after the rehabilitation protocol. This improvement was significant in the static condition eyes closed. The mean of Long X decreased from 489.05 ± 327.07 to 365.09 ± 268.82 mm ( P < 0.001). The average Y Long decreased from 853.49 ± 734.19 to 569.08 ± 530.55 ( P < 0.001). We noted an improvement of vertigo condition (the mean total score of VSS decreased from 22.2 ± 6.74 to 10.86 ± 3.54 ( P < 0.001)) and the quality of life (the mean total score DHI has decreased from 37.6 ± 8.35 to 18.1 ± 5.56 ( P < 0.01). Postural balance and quality of life improve with postural rehabilitation and optokinetic stimulation in patients with peripheral vertigo. This technique must be applied as early as possible by a specialized physiotherapist to promote the elimination of the unpleasant symptoms related to this dysfunction.