Efficacy Of Vestibular Rehabilitation Research Articles

Efficacy of vestibular rehabilitation and its facilitating and hindering factors from real-world clinical data.

Customized vestibular rehabilitation improved dizziness and imbalance in several randomized controlled trials. In the present study, we determined the efficacy of customized vestibular rehabilitation using real-world observational data. In this retrospective observational study, we recruited 64 patients (median age = 60, interquartile range = 48-66.3) who completed the customized vestibular rehabilitation from January to December 2022. The outcomes of rehabilitation were evaluated using the dizziness handicap inventory (DHI) or vestibular disorders activities of daily living scale (VADL). The factors associated with outcomes were assessed with a generalized linear model, of which covariates included patients' age, sex, duration of illness, type of vestibular disorders, initial DHI and VADL scores, exercise compliance, and initial hospital anxiety and depression scale (HADS) scores. After the median of 6 (4-6) weeks of rehabilitation, DHI and VADL scores significantly improved in patients with either peripheral or central vestibular disorders (Wilcoxon signed-rank test, p < 0.05). The initial DHI and VADL scores showed a positive while the sum of HADS scores showed a negative correlation with the outcome. In contrast, the age, sex, duration of illness, types of vestibular disorders, and exercise compliance did not affect the outcome. Customized vestibular rehabilitation is effective for central as well as peripheral disorders, especially when the symptoms are severe and the psychological distress is mild.

Efficacy of Vestibular Rehabilitation Following Acute Vestibular Neuritis: A Randomized Controlled Trial.

To investigate whether a vestibular rehabilitation program started early after diagnosis of vestibular neuritis combined with standard care reduces dizziness and improves functions of daily life more effectively than standard care alone in patients with acute vestibular neuritis. Non-blinded, randomized controlled trial with 2 parallel groups. Specialist centers in 2 university hospitals. Patients, 18-70 years, with acute vestibular neuritis confirmed by videonystagmography. Standard care was 10 days of prednisolone, general information, and counseling given to all patients. In addition to standard care, the intervention group received supervised exercise therapy (vestibular rehabilitation). Vestibular rehabilitation was given in a group format, individually tailored, and supported by home exercises. Perceived dizziness during head motion. Secondary outcomes were walking speed, standing balance, Hospital Anxiety and Depression Scale (HADS), Vertigo Symptom Scale, Visual Analog Scales (VASs), Dizziness Handicap Inventory (DHI), The University of California Los Angeles Dizziness Questionnaire. Sixty-five patients were included, 27 participated in the vestibular rehabilitation group. There was a statistically significant difference in favor of the vestibular rehabilitation group in overall perceived dizziness at 3 (p = 0.007) and 12 months (p = 0.001). No statistically significant differences were found in standing balance and walking speed. Results from self-report measures showed a statistically significant difference at 12 months in HADS (p = 0.039), DHI (p = 0.049) and VAS-C (p = 0.012). A vestibular rehabilitation program started early after confirmed vestibular neuritis diagnosis in addition to standard care reduces the perception of dizziness and improves functions of daily life more effectively than standard care alone.

Rehabilitation to improve gaze and postural stability in people with multiple sclerosis: study protocol for a prospective randomized clinical trial

BackgroundThe use of vestibular rehabilitation principles in the management of gaze and postural stability impairments in people with multiple sclerosis (PwMS) has shown promise in pilot work completed in our lab and in a recently published randomized clinical trial (RCT). However, further work is needed to fully quantify the gaze and postural impairments present in people with multiple sclerosis and how they respond to rehabilitation.Methods/designThe study is a single blind RCT designed to examine the benefit of a gaze and postural stability (GPS) intervention program compared to a standard of care (SOC) rehabilitation program in dizzy and balance impaired PwMS. Outcomes will be collected across the domains of body structure and function, activity, and participation as classified by the World Health Organization International Classification of Functioning, Disability, and Health (ICF). Our primary outcomes are the Dizziness Handicap Inventory (DHI) and the Functional Gait Assessment (FGA). Secondary outcomes include other measures of gaze and postural stability, fatigue, and functional mobility. Participants who are interested and eligible for enrollment will be consented prior to completing a baseline assessment. Following the baseline assessment each participant will be randomized to either the GPS or SOC intervention group and will complete a 6 week treatment period. During the treatment period, both groups will participate in guided exercise 3x/week. Following the treatment period participants will be asked to return for a post-treatment evaluation and again for a follow-up assessment 1 month later. We anticipate enrolling 50 participants.DiscussionThis study will be an innovative RCT that will utilize gaze and postural stability metrics to assess the efficacy of vestibular rehabilitation in PwMS. It will build on previous work by examining measures across the ICF and improve the current evidence base for treating PwMS.Trial registrationClinicalTrials.gov, May 29th 2018, NCT03521557.

Efficacy of vestibular rehabilitation on quality of life of patients with unilateral vestibular dysfunction

Objective: The aim of this study is to determine the efficacy of vestibular rehabilitation (VR) exercise of patients with uncompensated unilateral peripheral vestibular dysfunction. Materials and Methods: An intervention study was conducted on 20 patients their age ranging from 20 to 60 years. The main complaint of the participants was chronic dizziness (dizziness for >3 months). Dizzy patients were recruited from the Ear, Nose, and Throat department. The study was conducted in the audiovestibular unit. All participants in the study were subjected to basic audiological evaluation and vestibular evaluation (videonystagmography). The Dizziness handicap inventory questionnaire (DHI) was carried out twice (pre and post) rehabilitation program. The VR therapy was performed according to the protocol established by Cawthorne and Cooksey and Norre exercises. Results: All the DHI scores reduced significantly after VR. There were no differences among genders; adults and elderly patients. Conclusion: The result of this study proved the importance and the efficacy of VR. It considered a useful therapeutic approach for improvement in the quality of life of individuals with unilateral peripheral vestibular weakness. The improvement was not influenced by sex, age, or duration of disease. It considered a low-cost, short, and safe treatment technique which can be widely used in outpatients without the need for sophisticated tools.

Research progresses in vestibular rehabilitation

Vestibular rehabilitation is one of the treatments of vertigo, which major based on vestibular exercise. Unlike general exercise, it is a highly specialized designed method without medication or traumatic. Vestibular rehabilitation includes peripheral rehabilitation,central rehabilitation, alternative rehabilitation, visual conflict rehabilitation and fall prevention rehabilitation. The cross-coupling mechanism of vestibular reflex is the basis of vestibular compensation. The characteristics of visual reflex and the proprioception mediated cervical reflex are the foundation of alternative rehabilitation, and cognitive mechanism is the basis of all kinds of vestibular rehabilitation. Data about the safety and efficacy of vestibular rehabilitation are provided during the past several decades. Various tests and measures are used for examination and determine their ability to participate in their environment, as well as various treatments are described. Factors that affect recovery are noticed to prognosticate recovery. This review focuses on the rehabilitation mechanism, clinical application, related inspection and evaluation, and influence factor of vestibular rehabilitation.

The efficacy of vestibular rehabilitation in people reporting dizziness with multiple sclerosis: a systematic review and meta-analysis

Objectives Dizziness is estimated to affect 49%–75% of people with multiple sclerosis and has a significant impact on quality of life. Current management includes medications, lifestyle modifications and exercise therapies such as vestibular rehabilitation. The aim of this study was to evaluate the efficacy of vestibular rehabilitation in people reporting dizziness with multiple sclerosis. Methods Six electronic databases were searched from earliest date until October 2016. Search terms were based on three concepts; multiple sclerosis, dizziness and vestibular rehabilitation. All studies were screened independently by two authors according to pre-determined eligibility criteria. Standardised mean differences (effect sizes) and 95% CI were calculated to describe differences between groups (eg, intervention and control) and pooled in a meta-analysis where two or more studies were clinically homogeneous. The quality of evidence of the body of evidence was assessed using the GRADE approach. Results Two randomised controlled trials were identified with a total of 65 participants. In both studies, dizziness was measured using the patient reported Dizziness Handicap Inventory. Low quality evidence indicates there is no significant effect for vestibular rehabilitation on improving symptoms of dizziness compared with a control group of people with multiple sclerosis (SMD (95% CI) 0.76, (–0.19 to 1.70)). The quality of the meta-analysis was limited due to imprecision of results and risk of bias. The two studies identified only used a short period of vestibular rehabilitation (six to eight weeks). Conclusions There is low quality evidence that vestibular rehabilitation has no effect on dizziness in the multiple sclerosis population. Given the efficacy of vestibular rehabilitation in other causes of dizziness, further high quality studies with longer rehabilitation periods are required.

Efficacy of vestibular rehabilitation in management of balance deficit in Indian collegiate football players, with sport-related concussion – randomized clinical trial

Background: Football (Soccer) is a popular sport in India, next only to Cricket and is played for both professional and recreational pursuits. Football players need to be mentally and physically fit in order to cater to the imposing demands of game and training which require exceptional levels of attention, planning, memory, and other higher mental functions. Balance is an essential prerequisite to improve sport performance and to prevent lower extremity injury and concussion.

The Efficacy of Vestibular Rehabilitation in Patients with Benign Paroxysmal Positional Vertigo: A Rapid Review

To systematically review the evidence on the effectiveness of vestibular rehabilitation in addition to a canalith repositioning maneuver in patients with benign paroxysmal positional vertigo. A literature search was performed in the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and EMBASE databases. A comprehensive search was performed up to July 2013. Two authors independently scanned the search results to identify randomized controlled trials of vestibular rehabilitation in addition to a canalith repositioning maneuver in patients with benign paroxysmal positional vertigo. We included trials that were available in the English language and did not apply publication year or publication status restrictions. Studies were methodologically assessed using the Cochrane risk of bias tool. Primary outcome was the effect on vertigo attacks and balance. Of 76 identified trials, only 2 trials fulfilled our inclusion criteria and were included in this review, involving 106 patients. One study was methodologically weak, the other strong. The studies differed in type of intervention, type of outcome, and follow-up time. Both studies reported no significant difference in the vertigo intensity between groups. A small effect was found on balance. Two level II studies in benign paroxysmal positional vertigo showed no effect of vestibular rehabilitation in addition to a canalith repositioning maneuver on vertigo intensity and a small, beneficial effect on balance. We therefore conclude that there is no evidence for an effect of vestibular rehabilitation in addition to a canalith repositioning maneuver in patients with benign paroxysmal positional vertigo.

Vestibular substitution: comparative study

To determine the efficacy of vestibular rehabilitation with the electrotactile vestibular substitution system, as a new treatment modality in patients with bilateral vestibular disorders. Nineteen patients with bilateral, chronic, idiopathic vestibulopathy were studied prospectively. Patients were divided to two groups. Patients in the first group were rehabilitated with the electrotactile vestibular substitution system, while patients in the second group were treated with standard vestibular rehabilitation therapy. The sensory organisation test and dizziness handicap inventory were used to compare the pre- and post-training results of both rehabilitative treatments. All group one patients in the standardised testing subset demonstrated improved results for both the composite sensory organisation test and for the functional transfer aspect of the dizziness handicap inventory, after five days' training with the electrotactile vestibular substitution system. In contrast, group two patients showed no significant improvement in their composite sensory organisation test or dizziness handicap inventory scores after eight weeks of therapy, compared with pre-treatment levels. These preliminary results indicate the efficacy of the electrotactile vestibular substitution system in improving patients' symptoms of vestibulopathy, and constitute evidence of successful sensory substitution.

The Efficacy of Vestibular Rehabilitation for Patients with Head Trauma

Head injury patients often develop vertigo and imbalance. The mechanisms of these symptoms include unilateral or bilateral vestibular hypofunction, benign paroxysmal positioning vertigo (BPPV), and central vestibular dysfunction. Vestibular rehabilitation techniques have developed over the past 50 years to help patients compensate for these deficits. Liberatory maneuvers effectively treat BPPV. Rotational head movements with visual fixation (ie, vestibulo-ocular reflex [VOR] exercises) may enhance compensation for vestibular hypofunction. Motion habituation may decrease dizziness associated with head movements. Balance retraining can improve stability during ambulation. While few controlled studies have been performed, results suggest fair to good efficacy for most vestibular diagnoses, especially BPPV.

Prolonged dysequilibrium in three cases with vestibular neuronitis: efficacy of vestibular rehabilitation.

The clinical course of acute unilateral vestibular disturbance in 3 cases with vestibular neuronitis and a case with labyrinthine destruction was surveyed for a long-term period. Vestibular training with a modified Cawthorne-Cooksey's exercise was done in 2 of 3 cases with vestibular neuronitis and a case of labyrinthine destruction. All had no severe troubles in activities of their daily lives over one year after the onset of the disease, but the central compensation was not completed, even in a young patient, in a case of labyrinthine destruction and in a well trained case. Spontaneous nystagmus to the affected side and increase of body sway with eyes closed were revealed by examinations in all cases. Physical exercise was found to be effective for relief from vestibular ataxia, but it was difficult to keep the effect even after training.