Only a few studies in the literature demonstrate the effect of vestibular rehabilitation (VR) on all vestibular receptor organs. Furthermore, very little evidence of the effect of VR on isolated otolith dysfunction (IOD) is available.
OBJECTIVE:
The study aimed to investigate the effect of VR on all vestibular receptor organs in patients with different types of unilateral vestibular hypofunction (UVH).
METHODS:
We enrolled 80 patients with three different types of UVH; combined and isolated loss of semicircular canal and otolith organ function. All patients performed a 12-week customized program of VR and received a full battery of vestibular function tests, before and after the VR. The DHI and SF-36 were performed before, after 6 weeks, and 12 weeks of the VR.
RESULTS:
Parameters of the caloric test, video head impulse test, ocular and cervical vestibular evoked myogenic potentials were significantly improved after VR. A total of 59 (74%) patients fully recovered, with no significant difference in recovery regarding the type (p = 0.13) and stage of UVH (p = 0.13). All patients reported significantly lower disability and a better quality of life after the VR based on the DHI and SF-36 score.
CONCLUSIONS:
Vestibular rehabilitation has a positive effect on the recovery of all vestibular receptor organs and it should be used in patients with IOD.
Arnold,S. A, Stewart,A. M, Moor,H. M, Karl,R. C, & Reneker,J. C. (2017). The Effectiveness of Vestibular Rehabilitation Interventions in Treating Unilateral Peripheral Vestibular Disorders: A Systematic Review. Physiother Res Int22(3).
2.
Basta,D, Singbartl,F, Todt,I, Clarke,A, & Ernst,A. (2008). Vestibular rehabilitation by auditory feedback in otolith disorders. Gait Posture28(3), 397–404.
3.
Brodovsky,J. R, & Vnenchak,M. J. (2013). Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Physical Ther93, 293–296.
4.
Enticott,J. C, O’leary,S. J, & Briggs,R. J. (2005). Effects of vestibulo-ocular reflex exercises on vestibular compensation after vestibular schwannoma surgery. Otol Neurotol26(2), 265–269.
5.
Farrell,L, & Rine,R. (2006). Increased symptom severity and persistence of postural control deficits in patients with otolith versus canal vestibular dysfunction. J Neurol Phys Ther30, 214–215.
6.
Furman,J. M, Lempert,T. (Eds.). (2016). Neuro-otology. Shirley Decker-lucke: Elsevier.
7.
Grill,E, Heuberger,M, Strobl,R, Saglam,M, Holle,R, Linkohr,B, Ladwig,K. H, Peters,A, Schneider,E, Jahn,K, & Lehnen,N. (2018). Prevalence, Determinants, and Consequences of Vestibular Hypofunction. Results From the KORA FF Survey. Front Neurol9, 1076.
8.
Hall,C. D, Herdman,S. J, Whitney,S. L, Cass,S. P, Clendaniel,R. A, Fife,T. D, Furman,J. M, Getchius,T. S, Goebel,J. A, Shepard,N. T, & Woodhouse,S. N. (2016). Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Evidence-Based Clinical Practice Guideline: From the american physical therapy association neurology section. J Neurol Phys Ther40(2), 124–155.
9.
Han,B. I, Song,H. S, & Kim,J. S. (2011). Vestibular rehabilitation therapy: review of indications, mechanisms, and key exercises. J Clin Neurol7, 184–196.
10.
Herdman,S. J, Clendaniel,R. A, Mattox,D. E, Holliday,M. J, & Niparko,J. K. (1995). Vestibular adaptation exercises and recovery: acute stage after acoustic neuroma resection. Otolaryngol Head Neck Surg113(1), 77–87.
11.
Jeong,J, Jung,J, Lee,J. M, Suh,M. J, Kwak,S. H, & Kim,S. H. (2017). Effects of Saccular Function on Recovery of Subjective Dizziness After Vestibular Rehabilitation. Otol Neurotol38, 1017–1023.
12.
Karapolat,H, Celebisoy,N, Kirazli,Y, Ozgen,G, Gode,S, Gokcay,F, Bilgen,C, & Kirazli,T. (2014). Is vestibular rehabilitation as effective in bilateral vestibular dysfunction as in unilateral vestibular dysfunction?Eur J Phys Rehabil Med50, 657–63.
13.
Kim,H. A, Hong,J. H, Lee,H, Yi,H. A, Lee,S. R, Lee,S. Y, Jang,B. C, Ahn,B. H, & Baloh,R. W. (2008). Otolith dysfunction in vestibular neuritis: recovery pattern and a predictor of symptom recovery. Neurology70(6), 449–453.
14.
Krebs,D. E, Gill-Body,K. M, Parker,S. W, Ramirez,J. V, & Wernick-Robinson,M. (2003). Vestibular rehabilitation: useful but not universally so. Otolaryngology-Head and Neck surgery128, 240–250.
15.
Maire,R, & van Melle,G. (2000). Dynamic asymmetry of the vestibulo-ocular reflex in unilateral peripheral vestibular and cochleovestibular loss. Laryngoscope110, 256–263.
Mossman,B, Mossman,S, Purdie,G, & Schneider,E. (2015). Age dependent normal horizontal VOR gain of head impulse test as measured with video-oculography. J Otolaryngol Head Neck Surg4, 44–29.
18.
Murray,K. J, Hill,K. D, Phillips,B, & Waterston,J. (2007). The influence of otolith dysfunction on the clinical presentation of people with a peripheral vestibular disorder. Phys Ther87(2), 143–152.
19.
Neuhauser,H. K. (2016). The epidemiology of dizziness and vertigo. Handb Clin Neurol137, 67–82.
Petri,M, Chirilă,M, Bolboacă,S. D, & Cosgarea,M. (2017). Health-related quality of life and disability in patients with acute unilateral peripheral vestibular disorders. Braz J Otorhinolaryngol83(8), 611–618.
22.
Redondo-Martínez,J, Bécares-Martínez,C, Orts-Alborch,M, García-Callejo,F. J, Pérez-Carbonell,T, & Marco-Algarra,J. (2016). Relationship between video head impulse test (vHIT) and caloric test in patients with vestibular neuritis. Acta Otorrinolaringol Esp67(3), 156–161.
23.
Rosengren,S. M, Colebatch,J. G, Young,A. S, Govender,S, & Welgampola,M.S. (2019). Vestibular evoked myogenic potentials in practice: Methods, pitfalls and clinical applications. Clin Neurophysiol Pract26, 47–68.
Szturm,T, Reimer,K. M, & Hochman,J. (2015). Home-Based Computer Gaming in Vestibular Rehabilitation of Gaze and Balance Impairment. Games Health J4(3), 211–220.
26.
Vereeck,L, Wuyts,F. L, Truijen,S, De Valck,C, & Van de Heyning,P. H. (2008). The effect of early customized vestibular rehabilitation on balance after acoustic neuroma resection. Clin Rehabil22, 698–713.
27.
Yılmaz,O, Öztürk,S. T, & Serbetçioglu,M. B. (2019). Isolated otolithic dysfunction and vestibular rehabilitation results: A case report. The Turkish Journal of Ear Nose and Throat29, 107–110.
28.
Young,Y, Wu,C, & Wu,C. (2002). Augmentation of vestibular evoked myogenic potentials: An indication for distended saccular hydrops. Laryngoscope112, 509–512.
