Abstract
Vestibular rehabilitation (VR) has been shown to be effective for many vestibular disorders. This review focuses on the current evidence on the effects of physical therapy in the management of vestibular symptoms in individuals with a vestibular migraine (VM). The individuals with a history of a migraine tend to have a high incidence of vestibular symptoms with some or all of their headaches. A total of six included studies investigated the effects of VR in the management of VM. The critical review form for quantitative studies was used to appraise quality assessment and risk of bias in the selected studies. Previous studies validated the use of VR in the treatment of vestibular symptoms for individuals with a VM to include improved headache and migraine-related disability in patients with a VM. From the current evidence, it is difficult to provide conclusive evidence regarding the efficacy of VR to minimize vestibular symptoms in patients with VM. Therefore, more randomized controlled studies are required to make firm evidence on the effect of VR in reducing vestibular symptoms in patients with VM. The future prospective, blinded, randomized controlled studies may help to isolate possible therapeutic effects of VR and other general effects.
Highlights
Migraine is the most prevalent neurological disorder affecting about 1 out of every 7 Americans annually, and results in numerous emergency department and outpatient visits [1]
We reviewed five studies [23, 25, 69,70,71] that investigated the effectiveness of Vestibular rehabilitation (VR) for migraine related vestibular symptoms (Table 3)
Mean Dizziness Handicap Inventory (DHI) improvement was 12 points (P < 0.01); Activitiesspecific Balance Confidence Scale (ABC) improvement was 14 points (p < 0.01); Dynamic Gait Index (DGI) was 4 points (P < 0.01). 78% decrease in >1 fall was reported at discharge (P < 0.05)
Summary
Scores of 19 or less indicate increased risk of falling in older people [64] Other outcome measures such as vestibular symptom index (VSI), vestibular rehabilitation benefit questionnaire (VRBQ), and the vertigo symptom scale (VSS) were used to assess the effects of VR in patients with VM. Whitney et al [23] reported significant improvement in functional outcomes in vestibular physical therapy in patients with migraine headaches. The results of the study reported significant improvement in all outcome measures following “vestibular rehabilitation” in patients with MRV or a migraine headache. They studied the effects of anti-migraine medications along with physical therapy intervention in those patients. Patients with migrainerelated vestibulopathy (MRV) or vestibular dysfunction with a history of migraine headache
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