Vestibular Rehabilitation Therapy Outcome In Patients with Unilateral Peripheral Vestibular Disorders

Abstract

Objective: To study the efficacy of the rotational chair (RC) testing versus the self-assessment questionnaire (Dizziness Handicap Inventory = DHI)) in monitoring the vestibular rehabilitation therapy in patients with unilateral peripheral vestibular disorders. Study Design: Prospective Study. Setting: Clinical tertiary care vestibular function test centre. Patients: 20 patients (9 male and 11 females with documented unilateral peripheral vestibular lesion evaluated with history taking, bedside examination, Electronystagmography (ENG) and rotational chair testing tests. Intervention: Clinical, DHI, Caloric and RC tests, vestibular rehabilitation therapy (VORX1 and VORX2) Materials and Methods: Two groups: control and study groups; Study group was selected according to the following criteria: Recent onset of vertigo spells (2-10 months prior to the enrolment in this study), documented unilateral caloric weakness. Patients suffering from Diabetes Mellitus, hypertension and neurological deficits were excluded. DHI which designed to evaluate the patient's functional, physical and emotional status was conducted by the entire study group. Caloric testing was performed with standard bithermal irrigations of 30°C and 44°C for 45 seconds. The rotational chair testing paradigms used in this study were: A): The Rotational Sinusoidal Harmonic Acceleration (SHA) Test and; B): The Rotational Velocity Step (RVS) Test. Customized vestibular rehabilitation therapy program in the form of VORX1 and VORX2 was given to 15 patients out of 20 patients. Results: In terms of demographic characteristics of the study group (20 patients), the age range was 23 - 54 years, and the gender distribution was 9 males and 11 females, the most common cause of dizziness was Vestibular Neuritis (30 %), followed by Meniere's Disease (25 %). DHI demonstrated that most of patients showed moderate to moderatlysevere degree of handicap; furthermore, most of patients showed moderate handicap as regard functional, physical and emotional status. Caloric test results revealed that all patients had abnormal caloric test. There was insignificant correlation between the rotational chair test findings and the self-assessment questionnaire (DHI) findings, but the DHI showed a significant improvement in patients received vestibular rehabilitation therapy as regard physical, functional and emotional scores Conclusion: In summary, Rotational Chair testing is sensitive measure to quantify the presence of dysequilibrium; moreover, vestibular rehabilitation therapy is an effective line of treatment in patients with peripheral vestibular disorders.