Effects Of Vestibular Rehabilitation Research Articles

Effectiveness of vestibular rehabilitation on postural balance in Parkinson’s disease: a systematic review and meta-analysis of randomized controlled trials

IntroductionPostural balance impairment can affect the quality of life of patients with Parkinson’s disease. Previous studies have described connections of the vestibular system with postural functions, suggesting a potential participation of the basal ganglia in receiving vestibular stimuli. This systematic review aims to summarize the evidence on the effectiveness of vestibular rehabilitation on postural balance in patients with Parkinson’s disease.MethodsA systematic review was conducted using the electronic databases: PubMed, Embase, Scopus and PEDro. The study selection was independently conducted by two reviewers, and disagreements were evaluated by a third reviewer. The included studies had no restrictions on publication dates or languages and the last update occurred in July 2023.ResultsFrom the 485 studies found in the searches, only 3 studies were deemed eligible for the systematic review involving a total of 130 participants. The Berg Balance Scale was described as the tool for evaluation of postural balance in all studies. The meta-analysis showed statistically significant results in favor of vestibular rehabilitation (MD = 5.35; 95% CI = 2.39, 8.31; P < 0.001), regardless of the stage of Parkinson’s disease. Although the effect size was suggested as a useful functional gain, the analysis was done with caution, as it only included 3 randomized controlled trials. The risk of bias using the RoB-2 was considered as being of “some concern” in all studies. Furthermore, the quality of the evidence based on the Grading of Recommendations Assessment Development and Evaluation system, produced by pooling the included studies was considered very low.ConclusionCompared to other interventions, vestibular rehabilitation has potential to assist the postural balance of patients with Parkinson’s disease. However, the very low quality of the evidence demonstrates uncertainty about the impact of this clinical practice. More robust studies are needed to confirm the benefits of this therapy in patients with Parkinson’s disease. This study was prospectively registered in PROSPERO: CRD42020210185.

Effectiveness of vestibular rehabilitation in children and adolescents post concussion: A systematic review

Effectiveness of vestibular rehabilitation in children and adolescents post concussion: A systematic review

Effect of vestibular rehabilitation on trunk kinetic and kinematic parameters in patients with multiple sclerosis

PurposeTo investigate the effect of the Cawthorne Cooksey exercise protocol on trunk kinetic and kinematic parameters in MS patients.MethodsUsing a randomised controlled study design, 30 ambulatory patients with MS (aged 35–55 years) with relapsing/ remitting disease, hemiparesis, and minimal disability were recruited. Patients were split into two equal groups to undergo four weeks of vestibular rehabilitation. Group I received conventional vestibular rehabilitation along with the Cawthorne Cooksey exercise protocol, and group II (control group) received only conventional vestibular rehabilitation. Patients were assessed using an isokinetic dynamometer (average power, acceleration, and deceleration time) before and after the treatment.ResultsThe current study found that there was a significant improvement in the trunk flexors’ average power and a decrease (enhancement) in the acceleration and deceleration times after the treatment (p &lt; 0.05). The effect was more pronounced in group I than in group II.ConclusionsCawthorne Cooksey exercise protocol may be an effective way to help people with MS improve their dynamic trunk stability by facilitating trunk movements and muscle power.

Effect of Vestibular Rehabilitation on Postural Stability in Children with Visual Impairment

Background and Aim: Postural stability is monitored by a circuitous system, particularly visual perception, vestibular apparatus, and somatosensory organs. The ability to maintain balance is significantly compromised in children with visual impairment and has higher risks of falls than the normal sighted children. Children with visual disability reported delayed motor dexterity such as eye-hand coordination, gross and fine motor control involving struggle in gait procurement and postural control. Vestibular rehabilitation is the relevant therapy to restitute for maintaining postural control in the absence of visual information. This study aimed to find the effect of vestibular rehabilitation on postural stability in children with visual impairment.&#x0D; Methods: A quasi-experimental study was done in pre and post-test type design on 30 boys in the age group of 7-16 years’ children with visual impairment. Vestibular rehabilitation therapy was used as the exercise protocol to improve functional balance and reduction of falls in children with visual impairment for six weeks.&#x0D; Results: Statistical analysis was done between pre-test and post-test readings with SPSS 20 and there is a significant difference between the pre-test and post-test of total score and individual scores of Pediatric Balance Scale (PBS) after the intervention, since (p&lt;0.05).&#x0D; Conclusion: Vestibular rehabilitation therapy improved the capability of postural controlling and reduces the risk of falls to an extent in children with visual impairment.&#x0D; Keywords: Visual impairment; postural stability; vestibular rehabilitation; pediatric balance scale; high risk of falls

Effect of Vestibular Rehabilitation on Dizziness and Balance Disorders in Traumatic Brain Injury Patients: A Systymatic Review

Effect of Vestibular Rehabilitation on Dizziness and Balance Disorders in Traumatic Brain Injury Patients: A Systymatic Review

Effects of vestibular rehabilitation on body composition and daily-living physical activity in chronic unilateral vestibular hypofunction.

Unilateral vestibular hypofunction (UVH) may lead to modifications on metabolism and body composition. Vestibular rehabilitation (VR) demonstrated its effectiveness in ameliorating balance function and several other daily-living aspects. The aim of this study was to evaluate metabolic composition, by means of bioelectrical impedance analysis (BIA) and daily activity, with the use of a wrist-worn movement tracker, in UVH participants before and after VR, and to compare data with a healthy control group (CG) of adults. 46 UVH and 60 CG participants underwent otoneurological testing, self-report and performance questionnaires, BIA, and wore a device tracking daily movement and energy expenditure for one full day; this was performed before and after VR. UVH participants demonstrated a significant (p = 0.008) increase in muscle mass after VR, and, when compared to CG, no differences were present with respect to visceral fat and muscle mass. UVH adults reported a significant increase in energy expenditure spent in movement (p = 0.008) and during the day (p = 0.009), daily number of strides (p = 0.009) and calories spent in sweeping (p = 0.009) and stairing (p = 0.008). Results from this study show that VR provided an improvement of metabolic function and body composition of people with UVH, possibly by contrasting structural modifications in neural pathways stemming from the vestibular nuclei and connected to autonomous function.

Effects of vestibular rehabilitation in patients with unilateral vestibular hypofunction

Purpose: To investigate the effect of physiotherapy on the balance parameters and fall risk in patients with unilateral vestibular hypofunction (UVH). Patients and Methods: Thirty patients diagnosed with UVH were included in the study. The number of falls, Visual Analog Scale, Modified Clinical Test for Sensory Interaction in Tandem and Balance, and dynamic visual acuity assessments was performed before and after treatment. The patients were included in an individual treatment program for 8 weeks. Physiotherapy sessions were given at 2-week intervals. Along with the level of development of the treatment applied to the patients, it was requested perform a home exercise program with ten repetitions three times a day. Results: After 8 weeks of vestibular rehabilitation, it was observed that the balance parameters of the participants improved and the number of falls decreased. Statistically significant results were obtained in the Eyes-closed Tandem test (P = 0.001). Significant changes occurred in the modified Clinical Test results for Sensory Interaction in Balance from 0.37 ± 0.19 s to 0.93 ± 0.11 s (P = 0.001). Vestibular symptoms and dynamic visual acuity scores also improved after treatment (P = 0.001). Conclusion: It was concluded that the physiotherapy program applied to our patients with UVH positively affected fall risk and significantly improved balance parameters.

Effectiveness of vestibular rehabilitation on balance, dizziness, functioning, and depressive symptoms in older adults

RESUMO Objetivo Avaliar a efetividade da reabilitação vestibular na funcionalidade, ganho dos canais semicirculares ao Video Head Impulse Test (v-HIT), nas respostas ao Potencial Evocado Miogênico Vestibular (VEMP), sintomas depressivos, equilíbrio e tontura em idosos. Métodos Estudo longitudinal, quase experimental e analítico, realizado entre dezembro de 2019 e julho de 2022, com 50 idosos com disfunção vestibular, submetidos à reabilitação vestibular e à aplicação dos exames VEMP, v-HIT, dos questionários e escalas Escala Visual Analógica, Dizziness Handicap Inventory e Escala de Equilíbrio de Berg, além do Questionário de Atividades Funcionais de Pfeffer e Escala de Depressão Geriátrica. Todos os exames e questionários foram aplicados antes e após oito sessões semanais de reabilitação vestibular. A análise estatística foi realizada pelo programa SPSS, por meio do teste Wilcoxon (p&lt;0,05). Resultados Observou-se melhora do ganho do canal semicircular anterior direito (0,71/0,78), redução do incômodo da tontura (7/5), do impacto da tontura na qualidade de vida (35/15), melhora do equilíbrio (45/51), além de melhora da funcionalidade (2/1) e redução dos sintomas depressivos (5/3). Conclusão Idosos com disfunção vestibular submetidos à reabilitação vestibular apresentaram melhora do ganho do reflexo vestíbulo-ocular, do equilíbrio, da funcionalidade, redução do impacto da tontura na qualidade de vida e dos sintomas depressivos.

Effectiveness of Vestibular Rehabilitation after Concussion: A Systematic Review of Randomised Controlled Trial.

Introduction: Mild traumatic brain injury (mTBI) affects approximately 740 cases per 100,000 people. Impairments related to mTBI include vertigo, dizziness, balance, gait disorders double or blurry vision, and others. The efficacy on acute or chronic phase and dosage of vestibular rehabilitation (VR) in reducing these symptoms is not clearly stated. To clarify these points, we performed a systematic review of randomised controlled trials (RCTs). Methods: A systematic literature search was performed from 2015 to 2022 on PubMed, CINAHL, Cochrane Trial SPORTDiscus, Web of Science, and PEDRO. Eligibility criteria were RCTs which consider VR, participants with mTBI, and no gender or age restriction. Two blinded reviewers independently selected the study, and a third author was contacted in case of disagreements. Risk of bias was independently screened by two authors and successively checked by the other two authors. Results: Thirty-three full articles were read for potential inclusion and seven records met the inclusion criteria. The authors analysed different outcomes considering DHI, a meta-analysis was carried out, statistical difference was observed (p < 0.01), and a mean difference of −6.91 (−9.11, −4.72) in favour of VR was shown. Considering quality of life, the VR group reached a higher score on QOLIBRI. Controversial results were shown about balance and subjective symptoms questionnaire. Differently considering HiMAT, the authors showed a statistically important difference in favour of VR (p = 0.002). Conclusion: VR seems useful to reduce symptoms in patients with concussion; however, a huge heterogeneity of the studies and of the outcomes used were found. Therefore, a larger sample is necessary to assess the efficacy of VR.

Fall risk assessment and effect of vestibular rehabilitation in the elderly population

BackgroundAccidental falls in elderly represent a major healthcare problem; they are a major cause of accidental death in people above 65 years of age. They result in both physical and psychological trauma, where fear of falling is a major consequence that leads to a vicious cycle that makes elderlies more isolated and dependent, making them more vulnerable to falls. Falls are multifactorial, where dizziness is a common factor in elderlies. Thus, a multi-systemic approach is essential for the assessment of balance functions; it also serves as a guide for treatment planning, either in the presence of a cause-specific pathology or when presbyvestibulopathy is the sole issue. Vestibular rehabilitation is useful in training elderlies to improve their dizziness and balance functions.AimThe aim of the study is to assess fall risk in elderly participants and to assess the role of customized vestibular rehabilitation in decreasing dizziness and falls in elderlies identified to be at risk of falling.ResultsAll elderlies diagnosed at fall risk showed statistically significant improvement in dizziness handicap inventory, dynamic gait index, and computerized dynamic posturography after vestibular rehabilitation. As for dizziness, handicap inventory participants showed statistically significant improvement in the total score and in each of its three aspects (functional, emotional, and physical) after vestibular rehabilitation. The Dynamic Gait Index showed statistically significant improvement after vestibular rehabilitation, where they all became non-fallers. Subjects improved significantly in sensory organization test, limits of stability, vestibular stimulation test, motor control test, and faller assessment test of computerized dynamic posturography. Performance on the subjective assessment test was not significantly correlated to the objective assessment methods. The Dynamic Gait Index is sensitive in the detection of elderlies at risk of falling.ConclusionsFalls in elderlies is an important subject that must be taken seriously due to its major consequences. Full balance assessment is crucial for offering customized vestibular rehabilitation, which has proved to be useful in minimizing dizziness and fall risk in elderlies.

Effects of vestibular rehabilitation in the management of patients with and without vestibular migraine

ObjectiveVestibular Migraine (VM) is the second most common cause in patients with vertigo. Patients with VM complain about vestibular symptoms during a headache attack or during the period between attacks. Vestibular Rehabilitation (VR), an exercised based therapy to treat dizziness and balance dysfunction has been shown to be effective in vestibular diseases. In this study, we aimed to assess the effect of VR for vestibular symptoms and quality of life in VM patients, and to compare the results with patients with vestibular disorders without migraine. MethodsSixty (60) patients who received VR treatment were divided into two groups: vestibular migraine group (30 patients) and non-migraine vestibular dysfunction group (30 patients). All patients received VR for 18 sessions and the program was completed in 1.5 months. Pre- and post-treatment Dizziness Handicap Inventory (DHI) scores, Vestibular Disorders Activities of Daily Living Scale (VADL) scores, the frequency of dizziness and headache, and Computerized Dynamic Posturography (CDP) scores were assessed and compared retrospectively. ResultsWith VR in both the vestibular migraine group and vestibular dysfunction group, DHI score, VADL score, the frequency of dizziness and headache scores significantly improved. Post-treatment CDP results were higher than pre- treatment results for both patient groups. ConclusionWith VR, a significant improvement was observed in subjective and objective balance assessment measurement. Vestibular Rehabilitation must be considered in patients who do not benefit from medical therapy or have limited benefit. Level of evidenceLevel III (evidence obtained from well-designed controlled trials without randomization).

Observation on the Curative Effect of Vestibular Rehabilitation Combined Treatment for Sudden Deafness Combined with Benign Paroxysmal Positional Vertigo

Observation on the Curative Effect of Vestibular Rehabilitation Combined Treatment for Sudden Deafness Combined with Benign Paroxysmal Positional Vertigo

Effects of Vestibular Rehabilitation on Physical Activity and Subjective Dizziness in Patients With Chronic Peripheral Vestibular Disorders: A Six-Month Randomized Trial.

Introduction: The present study aimed to determine whether supervised vestibular rehabilitation therapy (VRT) by physical therapists (PTs) affects subjective dizziness in patients with chronic vestibular disorders, and whether supervised VRT-induced changes in subjective dizziness are related to the changes in physical activity levels in daily life.Methods: Patients (n = 47) with chronic peripheral vestibular disorders were randomly divided into the VRT group (n = 25) and control group (n = 22). Patients in the VRT group received weekly supervised visits from PTs for a period of 6 months. Every other month, both groups were advised by neuro-otologists to increase the amount of activity in their daily life. All patients wore an accelerometer device, which recorded their physical activity for seven successive days before the end of the intervention. Patients also completed the dizziness and unsteadiness questionnaires before and after the intervention.Results: Subjective dizziness decreased significantly regardless of whether supervised VRT was administered; however, dizziness evoked by social activity and head and body movements improved more significantly in the VRT group than in the control group. In the VRT group, there was a significant negative correlation between the increase in sedentary behavior and improvement in subjective dizziness, and a significant positive correlation between the increase in light physical activity and improvement in subjective dizziness at the second month of intervention. The VRT group showed a significantly higher rate of increase in light physical activity than the control group, after 6 months of intervention.Conclusion: Supervised VRT could be highly effective in treating subjective dizziness in patients with chronic peripheral vestibular disorders. We believe frequent (weekly) and medium-term (6 months) PT-guided interventions may be highly effective in enhancing physical activity in daily life, and may subsequently improve subjective dizziness in these patients.Trial registration: This clinical study was registered with University hospital Medical Information Network (identification number: 000028832). https://www.umin.ac.jp/

Effect of vestibular rehabilitation on change in health-related quality of life in patients with dizziness and balance problems after traumatic brain injury: A randomized controlled trial.

ObjectiveSecondary analysis, testing the effect on change in health-related quality of life of group-based vestibular rehabilitation in patients with mild-moderate traumatic brain injury, dizziness and balance problems.DesignA single-blind randomized controlled trial.SubjectsA total of 65 patients aged 16–60 years with a Rivermead Post-concussion Symptoms Questionnaire dizziness score ≥2, and DizzinessHandicap Inventory score >15 points. Data collection was performed at baseline 3.5 (standard deviation (SD) 2.1) months post-injury, end of intervention, and 4.4 (SD 1.0) months after baseline.MethodsQuality of Life after Brain Injury was the main outcome. Independent variables were demographic and injury variables, Hospital Anxiety and Depression Scale, changes on the Rivermead Post-concussion Symptoms Questionnaire (RPQ3 physical and RPQ13 psychological/cognitive), and Vertigo Symptom Scale-Short Form.ResultsMean age of participants was 39.4 years (SD 13.0); 70.3% women. Predictors of change inthe Quality of Life after Brain Injury were receiving the vestibular rehabilitation (p =0.049), baseline psychological distress (p =0.020), and changein RPQ3 physical (p =0.047) and RPQ13 psychological/cognitive (p =0.047). Adjusted R2 was 0.399,F=6.13, p < 0.001.ConclusionThere was an effect in favour of the intervention group in improvement in health-related quality of life. Changes on the Rivermead Post-concussion Symptoms Questionnaire were also associated with change on the Quality of Life after Brain Injury.LAY ABSTRACTThis paper is the first to present results of a vestibular rehabilitation intervention study on changes in health-related quality of life in patients with dizziness and balance problems after mild-to-moderate traumatic brain injury. The intervention group received exercises and guidance aimed at self-efficacy and how to cope with their dizziness and balance problems. In addition, both the intervention and control groups received treatment as usual, comprising multidisciplinary rehabilitation at a university hospital. The main result was measured as change on the Quality of Life after Brain Injury questionnaire. Post-concussion symptoms, vertigo and psychological distress were also measured. The study showed that the group receiving the vestibular rehabilitation intervention underwent more improvement in health-related quality of life than the group receiving usual treatment alone. Other factors that influenced the improvement in quality of life were psychological distress at the start of the study and fewer post-concussion symptoms.

Effects of Vestibular Rehabilitation in a Patient with Central Dizziness /vertigo and Bilateral Vestibular Disorders

Effects of Vestibular Rehabilitation in a Patient with Central Dizziness /vertigo and Bilateral Vestibular Disorders

Does vestibular rehabilitation improve postural control of subjects with chronic subjective dizziness?

Postural control is the ability to maintain equilibrium and orientation in a gravitational environment. Patients with chronic subjective dizziness have some troubles with their postural stability. The present study aimed to assess the benefit of home-based vestibular rehabilitation in patients with chronic subjective dizziness using computerized dynamic posturography. Therefore, 100 subjects, between 19 to 86 years, diagnosed with dizziness were included in the study. Computerized dynamic posturography was performed to assess postural stability. Vestibular rehabilitation programs included exercises tailored to the particular needs of each patient. After vestibular rehabilitation, patients were re-examined using the same tests. Posturographic data were analyzed and compared for before and after vestibular rehabilitation findings. The mean composite scores before the intervention (58,92 ±11,64) was significantly (p<0.01) lower than the mean composite scores after vestibular rehabilitation (73,83 ± 8,26). This result is found to be statistically significant. In conclusion it could be suggested that the effectiveness of vestibular rehabilitation could be verified by means of computerized dynamic posturography as a concrete method.

Assessments of balance-gait/fall risk and effects of vestibular rehabilitation by physiotherapist intervention in patients with unilateral peripheral vestibular hypofunction

Assessments of balance-gait/fall risk and effects of vestibular rehabilitation by physiotherapist intervention in patients with unilateral peripheral vestibular hypofunction

Effect of Vestibular Rehabilitation on Spontaneous Brain Activity in Patients With Vestibular Migraine: A Resting-State Functional Magnetic Resonance Imaging Study.

Previous studies have shown that vestibular migraine (VM) is a cerebral disease with recurrent vertigo. Vestibular rehabilitation (VR) is an effective type of physical therapy for minimizing vestibular symptoms, as it improves vestibular compensation in patients with VM. Currently, the cerebral regions that are associated with the pathogenesis of VM are largely unknown. To further understand the underlying mechanisms of VM, we performed resting-state functional magnetic resonance imaging (fMRI) before and after 1 month of VR in 14 patients with VM. The Dizziness Handicap Inventory (DHI), the 36-Item Short-Form Health Survey (SF-36), the Hamilton Depression Scale (HAMD) and the Hamilton Anxiety Scale (HAMA) scores were included as clinical outcomes. The amplitude of low-frequency fluctuation (ALFF) was assessed to characterize spontaneous brain activity. The correlations between the clinical characteristics and ALFF values were assessed. After 1 month of VR training, the DHI scores in patients with VM were significantly lower than those at baseline (p = 0.03), as were the HAMA scores (p = 0.02). We also found that the ALFF values in the left posterior cerebellum of VM patients increased significantly after 1 month of VR training. Moreover, the ALFF values in the left cerebellum were inversely correlated with the patients’ DHI scores. Overall, this study showed that VR exercise for 1 month has a positive effect on vestibular symptoms in patients with VM. Asymmetric cerebellar hyperactivity might be a functional compensation for vestibular dysfunction in patients with VM.

The Effectiveness of Vestibular Rehabilitation on Balance Related Impairments among Multiple Sclerosis Patients: A Systematic Review

Background: Balance related dysfunction remains a debilitating clinical manifestation among people with Multiple Sclerosis (pwMS) causing significant morbidity and reduced quality of life. Imbalance is found to stem primarily from neurophysiological causes. Current management strategies have shown to have small but clinically insignificant results with little consideration towards vestibular sources of postural instability. Vestibular rehabilitation (VR) provides a promising treatment strategy to mediate balance dysfunction among people with pwMS. Design: Systematic Review, guided by PRISMA guidelines and presenting a best evidence synthesis. Data sources: 10 electronic databases were searched from inception until September 2019. Eligibility criteria for study selection: Article of original research, population of patients with multiple sclerosis aged over 18, interventions detailing VR protocols, measurement of outcomes pre-VR/post-VR. Results: Seven articles satisfied the eligibility criteria. 6/7 studies were rated as high quality and regarded as level one evidence. 5 studies consisted of standardised VR protocols while 2 studies consisted of customised VR. All studies identified improvements of mixed significance in balance, fatigue and dizziness outcomes post VR. Heterogeneity among VR prescription patterns limited optimal prescription guidelines. Conclusions: The available evidence shows promise that VR is a safe and effective strategy to provide short term benefits in balance related dysfunction in pwMS. Recommendations of mixed strength are made based on the quality of current literature. Current evidence for optimal prescription and long-term effects of VR is limited. Further high-level studies evaluating the effects of VR in patients with multiple sclerosis with vestibular and/or balance dysfunction are required.

Effects of Vestibular Rehabilitation and Pharmacological Therapy in Patients with Vestibular Migraine

Objectives: The objectives of this study were to compare the results of pharmacologic management options and vestibular rehabilitation (VR) programs in the context of dizziness, balance problems, and headache in patients with vestibular migraine. Materials and Methods: Sixty patients with migraine with vestibular symptoms were evaluated in three groups in the neurology, physical medicine, and rehabilitation and otorhinolaryngology clinics of a medical school hospital. The groups were defined as routine pharmacologic therapy (PT), VR, or both. Patients were evaluated with static posturography, the Dizziness Handicap Inventory (DHI), and the Activities-Specific Balance Confidence (ABC) Scale as primary outcome measures and symptom frequency and severity (headaches and vertigo attacks) as secondary outcome measures. In-group and between-group comparisons were made using relevant statistical methods. Results: DHI scores were significantly reduced (P &lt; 0.001) in all treatment groups. ABC scores increased significantly (P &lt; 0.001) in patients taking PT and those on VR + PT. Posturographic examinations revealed that sway velocity values recorded on foam with eyes closed, which targets vestibular assessment, were significantly reduced (P &lt; 0.001) in groups taking VR either alone or with PT. VR benefited patients with migraine in terms of headaches, vertigo attack frequency, intensity, and duration. Conclusion: Patients with predominant vestibular disorders can benefit from VR alone, and patients with combined symptoms (headache and vertigo) can benefit from pharmacologic and rehabilitation therapies.