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Kunelskay NL, Ivanova GE, Baybakova EV, Guseva AL, Parfenov VA, Zamergrad MV, Zaitseva OV, Melnikov OA, Shmonin AA, Maltseva MN. [Vestibular rehabilitation for peripheral vestibular hypofunction: an interdisciplinary consensus]. Vestn Otorinolaringol 2024; 89:52-63. [PMID: 38506027 DOI: 10.17116/otorino20248901152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
The literature review presents approaches to the management of patients with vestibular disorders. The principles of organization of vestibular rehabilitation in peripheral vestibular hypofunction, indications for appointment, factors influencing its implementation, technique, methods of evaluating effectiveness are considered in detail. Attention is drawn to the fact that the selection of exercises and the duration of vestibular rehabilitation is carried out individually and depends on many factors, including the nature of vestibular deficiency and the specific characteristics of the patient. The possibilities of using additional pharmacological therapy with histamine preparations, which can accelerate the onset of vestibular compensation, are shown. It is noted that vestibular rehabilitation is a safe and effective method of treating peripheral vestibular hypofunction and should be recommended to patients of all ages with vestibular disorders leading to limited social and physical activity.
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Affiliation(s)
- N L Kunelskay
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - G E Ivanova
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - E V Baybakova
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - A L Guseva
- Pirogov Russian National Research Medical University, Moscow, Russia
- Pirogov Municipal Clinical Hospital No. 1, Moscow, Russia
| | - V A Parfenov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - M V Zamergrad
- Pirogov Russian National Research Medical University, Moscow, Russia
- Russian Medical Academy for Continuous Professional Education, Moscow, Russia
| | - O V Zaitseva
- National Medical Research Center for Otorhinolaryngology of the FMBA of Russia, Moscow, Russia
| | | | - A A Shmonin
- Pavlov First St. Petersburg State Medical University, St. Petersburg, Russia
| | - M N Maltseva
- Pavlov First St. Petersburg State Medical University, St. Petersburg, Russia
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Ding CR, Gao YQ, Zhou YJ, Gu J, Wang J. Advantages of Short-term Personalized Vestibular Rehabilitation at Home Guided by Professional Therapist for Treatment of Decompensated Vestibular Vertigo. Curr Med Sci 2021; 41:687-694. [PMID: 34403093 DOI: 10.1007/s11596-021-2420-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/18/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Patients suffered a lot from decompensated vestibular vertigo. Pharmacotherapy and vestibular rehabilitation training have been proven to be effective in prompting vestibular compensation. Routine rehabilitation training is faced with the challenges of patients' compliance, completion, the average recuperation time and so on. This study is aimed to investigate advantages of short-term personalized vestibular rehabihitation at home guided by professional therapist. METHODS A short-term personalized vestibular rehabilitation program (ST-PVR) was designed for patients with decompensated vestibular vertigo in this study. RESULTS Patients experiencing the ST-PVR program showed significant improvement of Self-Rating Anxiety Scale (SAS), Dizziness Handicap Inventory (DHI), Activities-Specific Balance Confidence Scale (ABC) scores by the second follow-up (at 2nd week after treatment, P<0.05). However-improvement in the medication group occurred slightly later, DHI for 1 month and SAS for 2 months after treatment (P<0.05). Also, the improvement in the onset time of unilateral weakness (UW) at 2nd week after treatment in the personalized vestibular rehabilitation (PVR) group was faster than that in the medication group. CONCLUSION In general, the short-term PVR program showed great advantages by prompting vestibular compensation quickly and putting forward future direction for clinical treatment on decompensated vestibular vertigo.
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Affiliation(s)
- Chen-Ru Ding
- Department of Otology and Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, 200031, China.,Shanghai Auditory Medical Center, Shanghai, 200031, China.,Key laboratory of Hearing Science, Ministry of Health, Shanghai, 200031, China
| | - Ying-Qi Gao
- Department of Otology and Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, 200031, China.,Shanghai Auditory Medical Center, Shanghai, 200031, China.,Key laboratory of Hearing Science, Ministry of Health, Shanghai, 200031, China
| | - Yu-Juan Zhou
- Department of Otology and Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, 200031, China.,Shanghai Auditory Medical Center, Shanghai, 200031, China.,Key laboratory of Hearing Science, Ministry of Health, Shanghai, 200031, China
| | - Jun Gu
- Department of Otology and Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, 200031, China.,Shanghai Auditory Medical Center, Shanghai, 200031, China.,Key laboratory of Hearing Science, Ministry of Health, Shanghai, 200031, China
| | - Jing Wang
- Department of Otology and Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, 200031, China. .,Shanghai Auditory Medical Center, Shanghai, 200031, China. .,Key laboratory of Hearing Science, Ministry of Health, Shanghai, 200031, China.
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Alessandrini M, Viziano A, Roselli L, Micarelli A. Surgical treatment of otosclerosis leading to changes in postural control and quality of life. Laryngoscope 2019; 130:2448-2454. [PMID: 31804726 DOI: 10.1002/lary.28438] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/31/2019] [Accepted: 11/09/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Evaluating postural function in patients with otosclerosis by assessing otoneurological function and balance-related quality of life before and 6 weeks after surgical treatment. Correlations between and clinical features were investigated. METHODS Thirty-three patients affected by otosclerosis underwent otoneurological examination, video Head Impulse Test (vHIT), and static posturography before and after stapedotomy. Quality of life and dizziness-related handicap were screened by means of validated questionnaires. Correlation analysis was performed in order to discover possible relations with audiological pre- and postoperative parameters. RESULTS A significant improvement in posturographic parameters was found. Correlation analysis yielded a negative correlation between preoperative bone conduction auditory threshold and both vHIT scores and postural performance improvement, evaluated by spectral analysis. Moreover, a positive correlation was also found between improvements in posturographic scores and quality-of-life questionnaires. CONCLUSION The study results demonstrated an improvement in postural function and self-reported measures in a cohort of patients with otosclerosis 6 weeks after stapedotomy. The inverse correlation with preoperative auditory levels may reflect lesser chance for balance restoration in cases with worse sensorineural function. Possible implications for daily activities and overall quality of life were suggested by improved self-report questionnaire results. LEVEL OF EVIDENCE 4 Laryngoscope, 130:2448-2454, 2020.
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Affiliation(s)
- Marco Alessandrini
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Italy
| | - Andrea Viziano
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Italy
| | - Lucrezia Roselli
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Italy
| | - Alessandro Micarelli
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Italy.,ITER Center for Balance and Rehabilitation Research (ICBRR), Rome, Italy.,Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
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Vestibular rehabilitation in older adults with and without mild cognitive impairment: Effects of virtual reality using a head-mounted display. Arch Gerontol Geriatr 2019; 83:246-256. [DOI: 10.1016/j.archger.2019.05.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/23/2019] [Accepted: 05/09/2019] [Indexed: 11/21/2022]
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Sim T, Yoo H, Lee D, Suh SW, Yang JH, Kim H, Mun JH. Analysis of sensory system aspects of postural stability during quiet standing in adolescent idiopathic scoliosis patients. J Neuroeng Rehabil 2018; 15:54. [PMID: 29929530 PMCID: PMC6013903 DOI: 10.1186/s12984-018-0395-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 06/11/2018] [Indexed: 12/20/2022] Open
Abstract
Background The aim of this study was to quantitatively analyze quite standing postural stability of adolescent idiopathic scoliosis (AIS) patients in respect to three sensory systems (visual, vestibular, and somatosensory). Method In this study, we analyzed the anterior-posterior center of pressure (CoP) signal using discrete wavelet transform (DWT) between AIS patients (n = 32) and normal controls (n = 25) during quiet standing. Result The energy rate (∆EEYE%) of the CoP signal was significantly higher in the AIS group than that in the control group at levels corresponding to vestibular and somatosensory systems (p < 0.01). Conclusions This implies that AIS patients use strategies to compensate for possible head position changes and spinal asymmetry caused by morphological deformations of the spine through vestibular and somatosensory systems. This could be interpreted that such compensation could help them maintain postural stability during quiet standing. The interpretation of CoP signal during quiet standing in AIS patients will improve our understanding of changes in physical exercise ability due to morphological deformity of the spine. This result is useful for evaluating postural stability before and after treatments (spinal fusion, bracing, rehabilitation, and so on).
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Affiliation(s)
- Taeyong Sim
- Department of Bio-Mechatronic Engineering, College of Biotechnology and Bioengineering, Sungkyunkwan University, Natural Sciences Campus, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do, 16419, South Korea
| | - Hakje Yoo
- Department of Bio-Mechatronic Engineering, College of Biotechnology and Bioengineering, Sungkyunkwan University, Natural Sciences Campus, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do, 16419, South Korea
| | - Dongjun Lee
- Department of Bio-Mechatronic Engineering, College of Biotechnology and Bioengineering, Sungkyunkwan University, Natural Sciences Campus, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do, 16419, South Korea
| | - Seung-Woo Suh
- Department of Orthopedics, Scoliosis Research Institute, Korea University Medical College, Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 08308, South Korea
| | - Jae Hyuk Yang
- Department of Orthopedics, Scoliosis Research Institute, Korea University Medical College, Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 08308, South Korea
| | - Hyunggun Kim
- Department of Bio-Mechatronic Engineering, College of Biotechnology and Bioengineering, Sungkyunkwan University, Natural Sciences Campus, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do, 16419, South Korea.
| | - Joung Hwan Mun
- Department of Bio-Mechatronic Engineering, College of Biotechnology and Bioengineering, Sungkyunkwan University, Natural Sciences Campus, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do, 16419, South Korea.
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Vestibular rehabilitation strategies and factors that affect the outcome. Eur Arch Otorhinolaryngol 2012; 269:2309-16. [PMID: 22526580 DOI: 10.1007/s00405-012-2019-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Accepted: 03/27/2012] [Indexed: 12/20/2022]
Abstract
Ever since the introduction of Cawthorne-Cooksey exercises, vestibular rehabilitation (VR) has been gaining popularity in the treatment of the dizzy patient. Numerous studies support the effectiveness of VR in improving balance/walking skills, eye-head coordination and the quality of life of the patient. Different rehabilitation protocols have been used to treat patients with peripheral and central vestibular disorders. Assessment of the patients' progress is based on the patients' selfperception of dizziness and their functional skills. Factors such as age, medication, time of onset of vertigo and home based VR have been evaluated on their effect on the rehabilitation's outcome. The aim of this review is to evaluate rehabilitation strategies and discuss the factors that affect the outcome.
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