Vestibular rehabilitation for individuals with mal de debarquement syndrome: a systematic review

Abstract

Background Mal de debarquement syndrome (MdDS) is a pathological condition characterized by rocking, swaying, and/or a sense of imbalance. The two types of MdDS are known as motion triggered MdDS and spontaneous or other onset MdDS. Objectives The purpose of this systematic review was to evaluate the effectiveness of vestibular rehabilitation on individuals experiencing the symptoms of MdDS using valid and reliable outcome measures. Methods MEDLINE, ProQuest Medical Database, and Web of Science were the databases utilized in the search process. The search terms included ‘mal de debarquement’ AND ‘intervention’ OR ‘management’ OR ‘rehabilitation’ OR ‘therapy’ OR ‘treatment’. The Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence was utilized in evaluating the evidence level for all of the included articles, and a 10-item tool created by Medlicott and Harris was utilized in evaluating the methodological rigor for all of the included articles. Results Seven articles met the eligibility requirements based upon the inclusion and exclusion criteria, and these articles were qualitatively analyzed. The intervention focused on traditional vestibular rehabilitation in two of the studies and on optokinetic stimulation in the other five studies. Optokinetic stimulation is designed to induce re-adaptation of the vestibulo-ocular reflex. This systematic review found that optokinetic stimulation required a much shorter treatment duration than traditional vestibular rehabilitation to significantly improve the balance and decrease the symptoms of individuals affected with MdDS. Conclusions Clinicians should consider using optokinetic stimulation when treating individuals diagnosed with MdDS, especially those with the motion-triggered subtype.