Abstract
Background: Dizziness is a non-specific term used by patients to describe several symptoms ranging from true vertigo, light headedness, disorientation or sense of imbalance. Vestibular rehabilitation (VR) is a specific form of exercise-based therapy programme aimed at alleviating the primary and secondary problems of a vestibular pathology. The aim of this study was to investigate the effectiveness of exercise-based vestibular rehabilitation in adult patients with chronic dizziness. Methods: The following five databases were searched: the Cochrane Central Register of Controlled Trials (CENTRAL, the Cochrane Library), MEDLINE, PubMed, the Physiotherapy Evidence Database (PEDro) and Scopus (Elsevier). Two investigators independently reviewed all articles and a systematic review of literature was performed using the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The articles were included if they met the following inclusion criteria: (1) randomised controlled trial, (2) people with chronic dizziness, (3) adults aged 18 or over, (4) exercise-based VR, (5) VR exercises compared with sham or usual care, non-treatment or placeboand (6) only studies published full text in English. Results:The initial search identified 304 articles,fourof whichmet the criteria for analysis.All studies involved some form ofvestibular rehabilitation, includingvestibular compensation,vestibular adaptation and substitution exercises. These exercises were compared with usual medical care (threestudies) or placebo eye exercise (onestudy). The Vertigo Symptom Scalewas the most commonly usedoutcome measureto assess subjective perception of symptoms of dizziness (threestudies).According to thePEDroscale, threestudies were considered to be of highquality,and one was rated as fair. Conclusions: This review suggests that exercise-based vestibular rehabilitation shows benefits for adult patients with chronic dizziness with regard to improvement in the vertigo symptom scale, fall risk, balance and emotional status.
Highlights
This review suggests that exercise-based vestibular rehabilitation shows benefits for adult patients with chronic dizziness with regard to improvement in the vertigo symptom scale, fall risk, balance and emotional status
Dizziness is a non-specific term used by patients to describe several symptoms ranging from true vertigo, light headedness, disorientation or sense of imbalance[1]
Changes in symptoms All the included studies[18,19,20,21] assessed whether there was an improvement in dizziness symptoms, as measured by the Vertigo Symptom Scale[19,20,21], the Visual Analogue Scale (VAS)[18] or the Disability Rating Scale[18]
Summary
Dizziness is a non-specific term used by patients to describe several symptoms ranging from true vertigo, light headedness, disorientation or sense of imbalance[1]. Tinetti et al.[3] reported adverse health, functional and psychological consequences due to chronic dizziness in patients aged 72 years or older. It was concluded over one year of follow-up that chronic dizziness was associated with increased risk of falling, worsened depressive symptoms, self-reported health and decreased confidence in performing social activities. The articles were included if they met the following inclusion criteria: (1) randomised controlled trial, (2) people with chronic dizziness, (3) adults aged 18 or over, (4) exercise-based VR, (5) VR exercises compared with sham or usual care, non-treatment or placebo and (6) only studies published full text in English. According to the PEDro scale, three studies were considered to be of high quality, and one was rated as fair
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