Variables Associated With Outcome in Patients With Unilateral Vestibular Hypofunction

Abstract

Background. Not all individuals with unilateral vestibular hypofunction (UVH) have fewer subjective complaints and improved function after vestibular rehabilitation. Objective. To identify factors and/or combinations of factors that are strongly associated with rehabilitation outcome in patients with UVH and that ultimately can be used to develop models to predict outcome. Methods. Data from 209 patients with UVH were analyzed. All patients participated in similar vestibular rehabilitation (5 weeks of home exercises and once-weekly clinic visits). Outcome measures included intensity of oscillopsia and dysequilibrium, balance confidence, perceived disability, percentage of time symptoms interfered with activities, gait speed, fall risk, and dynamic visual acuity (DVA). Bivariate correlation and regression analysis were used to determine relationships between baseline (pretherapy) measures and outcome at discharge. Results. No baseline measure of subjective complaints (eg, symptom intensity) predicted improvement of physical function (eg, gait speed). Similarly, no baseline measure of physical function predicted improvement of subjective complaints. Certain patient characteristics, such as gender and time from onset, were not related to any outcomes. Most comorbidities did not affect outcome; however, anxiety and/or depression were associated with lower balance confidence and higher percentage of time for which symptoms interfered with activities at discharge. Baseline DVA and gait speed were associated with DVA and gait speed at discharge, respectively. Dynamic gait index (DGI) at discharge was affected by age, baseline DGI, and history of falls. Conclusion. These results provide insight into recovery of patients with UVH. Therapists can use this information in the development of expectations for patient outcome and treatment priorities.