ASSESSING THE EFFICACY OF VESTIBULAR REHABILITATION IN THE TREATMENT OF VERTIGO

Main Article Content

Dr. Pinky
Tahira Channa
Dr. Shamshad Zahra
Dr. Samar Anwar Memon
Dr. Ghazala Langah
Dr. Komal Ramnani
Dr. Sumreen Mujahid

Keywords

Exercises, rehabilitation, postural balance, quality of life, vestibular disorders

Abstract

Introduction: Vertigo Symptoms associated with vertigo gradually decrease with vestibular rehabilitation.


Objective: To assess the efficacy of vestibular rehabilitation in the treatment of vertigo.


Material and Methods: A total of 32 patients, aged 40–60. Out of which 21 were females and 11 were males, who had been hospitalized for chronic vertigo. The patients were randomized into two groups. Six weeks were allotted for the study's execution. Patients in Group I received individualized group vestibular rehabilitation in an outpatient environment almost weekly for one and a half hours under the supervision of a physiotherapist. On the contrary Group II was directed to complete basic balancing exercises twice a week for approximately 15 minutes.


Results: For group I, the Dynamic Gait Index results showed a statistically significant improvement. Quality of life and dizziness intensity improved after the intervention. Through functional testing, a postural balance improvement was noted.


Conclusion: A customized, supervised outpatient rehabilitation program, exceeded the outcome as compared to home-based, balance exercises. Intervention improves postural balance and quality of life. Nevertheless, pharmaceutical treatment is not linked to this improvement.

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References

1. Tramontano M, Russo V, Spitoni GF, Ciancarelli I, Paolucci S, Manzari L, Morone G. Efficacy of vestibular rehabilitation in patients with neurologic disorders: a systematic review. Archives of physical medicine and rehabilitation. 2021 Jul 1;102(7):1379-89.
http://doi:10.1016/j.apmr.2020.11.017. Epub 2020 Dec 28. PMID: 33383031
2. Smółka W, Smółka K, Markowski J, Pilch J, Piotrowska-Seweryn A, Zwierzchowska A. The efficacy of vestibular rehabilitation in patients with chronic unilateral vestibular dysfunction. International journal of occupational medicine and environmental health. 2020 Apr 30;33(3):273-82. http://doi:10.13075/ijomeh.1896.01330. Epub 2020 Mar 26. PMID: 32235946.
3. Ruthberg JS, Rasendran C, Kocharyan A, Mowry SE, Otteson TD. The economic burden of vertigo and dizziness in the United States. Journal of Vestibular Research. 2021 Jan 1;31(2):81-90. http://doi:10.3233/VES-201531. PMID: 33285661.
4. Neuhauser HK. The epidemiology of dizziness and vertigo. Handbook of clinical neurology. 2016 Jan 1;137:67-82. http://doi:10.1016/B978-0-444-63437-5.00005-4. PMID: 27638063.
5. Dommaraju S, Perera E. An approach to vertigo in general practice. Australian family physician. 2016 Apr;45(4):190-4. PMID: 27052132.
6. Barkwill D, Arora R. Continuing Education Activity.
7. Regauer V, Seckler E, Müller M, Bauer P. Physical therapy interventions for older people with vertigo, dizziness and balance disorders addressing mobility and participation: a systematic review. BMC geriatrics. 2020 Dec;20(1):1-2. http://doi:10.1186/s12877-020-01899-9. PMID: 33228601; PMCID: PMC7684969.
8. Cohen HS. A review on screening tests for vestibular disorders. Journal of Neurophysiology. 2019 Jul 1;122(1):81-92. http://doi:10.1152/jn.00819.2018. Epub 2019 Apr 17. PMID: 30995137; PMCID: PMC6689777.
9. Meldrum D, Burrows L, Cakrt O, Kerkeni H, Lopez C, Tjernstrom F, Vereeck L, Zur O, Jahn K. Vestibular rehabilitation in Europe: a survey of clinical and research practice. Journal of Neurology. 2020 Dec;267:24-35. http://doi:10.1007/s00415-020-10228-4. Epub 2020 Oct 13. PMID: 33048219; PMCID: PMC7552585
10. Sharma K, Verma S, Sharma S, Jat M. Neurorehabilitation Techniques. Chief Editor Prof. Rajesh Kumar. 2023:41.
11. Deveze A, Bernard-Demanze L, Xavier F, Lavieille JP, Elziere M. Vestibular compensation and vestibular rehabilitation. Current concepts and new trends. Neurophysiologie Clinique/Clinical Neurophysiology. 2014 Jan 1;44(1):49-57. http://doi:10.1016/j.neucli.2013.10.138. Epub 2013 Nov 6. PMID: 24502905.
12. Regauer V, Seckler E, Grill E, Ippisch R, Jahn K, Bauer P, Müller M. Development of a complex intervention to improve mobility and participation of older people with vertigo, dizziness, and balance disorders in primary care: a mixed methods study. BMC Family Practice. 2021 Dec;22(1):1-5. http://doi:10.1186/s12875-021-01441-9. PMID: 33980155; PMCID: PMC81 17292.
13. Ribeiro KM, Freitas RV, Ferreira LM, Deshpande N, Guerra RO. Effects of balance vestibular rehabilitation therapy in elderly with benign paroxysmal positional vertigo: a randomized controlled trial. Disability and rehabilitation. 2017 Jun 5;39(12):1198-206. http://doi:10.1080/09638288.2016.1190870. Epub 2016 Jun 24. PMID: 27340939.
14. Grill E, Müller M, Brandt T, Jahn K. Vertigo and dizziness: challenges for epidemiological research. OA Epidemiology. 2013 Aug;1(2):12.
15. Jafarzadeh S, Pourbakht A, Bahrami E, Jalaie S, Bayat A. Effect of early vestibular rehabilitation on vertigo and unsteadiness in patients with acute and sub-acute head trauma. Iranian journal of otorhinolaryngology. 2018 Mar;30(97):85. PMID:29594074; PMCID:PMC5866486.
16. Teggi R, Colombo B, Bernasconi L, Bellini C, Comi G, Bussi M. Migrainous vertigo: results of caloric testing and stabilometric findings. Headache: The Journal of Head and Face Pain. 2009 Mar;49(3):435-44. http://doi:10.1111/j.1526-4610.2009.01338.x. Epub 2009 Feb 11. PMID: 19220504.
17. Tsukamoto HF, Costa VD, Silva Junior RA, Pelosi GG, Marchiori LL, Vaz CR, Fernandes KB. Effectiveness of a vestibular rehabilitation protocol to improve the health-related quality of life and postural balance in patients with vertigo. International archives of otorhinolaryngology. 2015 Jul;19:238-47. http://doi:10.1055/s-0035-1547523. Epub 2015 May 6. PMID: 26157499; PMCID: PMC4490916.
18. Moffat BG. Psychological consequences of vertigo and the effectiveness of vestibular rehabilitation for brain injury patients. Brain Injury. 2001 Jan 1;15(5):387-400. http://doi:10.1080/02699050010005904. PMID: 11350653.
19. Cohen HS, Kimball KT. Increased independence and decreased vertigo after vestibular rehabilitation. Otolaryngology—Head and Neck Surgery. 2003 Jan;128(1):60-70.). http://doi:10.1067/mhn.2003.23. PMID: 12574761.
20. Hall CD, Herdman SJ, Whitney SL, Cass SP, Clendaniel RA, Fife TD, Furman JM, Getchius TS, Goebel JA, Shepard NT, Woodhouse SN. Vestibular rehabilitation for peripheral vestibular hypofunction: an evidence-based clinical practice guideline: from the American Physical Therapy Association Neurology Section. Journal of Neurologic Physical Therapy. 2016 Apr;40(2):124. http://doi:10.1097/NPT.0000000000000120. PMID: 26913496; PMCID: PMC4795094.
21. Lacour M, Bernard-Demanze L. Interaction between vestibular compensation mechanisms and vestibular rehabilitation therapy: 10 recommendations for optimal functional recovery. Frontiers in neurology. 2015 Jan 6;5:285. http://doi:10.3389/fneur.2014.00285. PMID: 25610424; PMCID: PMC4285093.
22. Eleftheriadou A, Skalidi N, Velegrakis GA. Vestibular rehabilitation strategies and factors that affect the outcome. European Archives of oto-rhino-laryngology. 2012 Nov;269:2309-16). http://doi:10.1007/s00405-012-2019-2. Epub 2012 Apr 21. PMID: 22526580.