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Akdal G, Tanrıverdizade T, Koçoğlu K, Özçelik P, Halmagyi GM, Güneri A, Kırkım G. Menière's disease with migraine, Menière's disease without migraine and Vestibular migraine: clinical differences. J Neurol 2023; 270:5635-5638. [PMID: 37453948 DOI: 10.1007/s00415-023-11866-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Affiliation(s)
- Gülden Akdal
- Department of Neurology, Faculty of Medicine, Dokuz Eylül University, İzmir, Türkiye
- Department of Neuroscience, Institute of Health Sciences, Dokuz Eylül University, İzmir, Türkiye
| | - Tural Tanrıverdizade
- Department of Neuroscience, Institute of Health Sciences, Dokuz Eylül University, İzmir, Türkiye
| | - Koray Koçoğlu
- Department of Neuroscience, Institute of Health Sciences, Dokuz Eylül University, İzmir, Türkiye
| | - Pınar Özçelik
- Department of Neuroscience, Institute of Health Sciences, Dokuz Eylül University, İzmir, Türkiye
- Department of Neurology, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Türkiye
| | - Gabor Michael Halmagyi
- Department of Neurology, Royal Prince Alfred Hospital, Sydney, Australia.
- Central Clinical School, University of Sydney, Sydney, Australia.
| | - Alpin Güneri
- Department of Otolaryngology, Faculty of Medicine, Dokuz Eylül University, İzmir, Türkiye
| | - Günay Kırkım
- Department of Otolaryngology, Unit of Speech, Hearing and Balance, Faculty of Medicine, Dokuz Eylül University, İzmir, Türkiye
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Hoppes CW, Anson ER, Carender WJ, Marchetti GF, Hall CD, Whitney SL, Keinath C, Herdman SJ. Type, dose, and outcomes of physical therapy interventions for unilateral peripheral vestibular hypofunction: protocol for a systematic review. Syst Rev 2023; 12:164. [PMID: 37710291 PMCID: PMC10503155 DOI: 10.1186/s13643-023-02328-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 08/18/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Unilateral peripheral vestibular hypofunction can result in symptoms of dizziness, gaze and gait instability, and impaired navigation and spatial orientation. These impairments and activity limitations may negatively impact an individual's quality of life, ability to perform activities of daily living, drive, and work. There is strong evidence supporting vestibular physical therapy for reducing symptoms, improving gaze and postural stability, and improving function in individuals with vestibular hypofunction. However, there is great variability in clinical practice with regard to the type of interventions and only weak evidence to guide optimal exercise dosage. It is important to identify the most appropriate interventions and exercise dosage to optimize and accelerate recovery of function and to decrease distress. The objective of this systematic review is to determine which interventions and which doses are most effective in decreasing dizziness or vertigo, improving postural control, and improving quality of life in adults with unilateral peripheral vestibular hypofunction. METHODS The literature will be systematically searched using the following online databases: PubMed/MEDLINE, EMBASE, Web of Science (Science and Social Science Citation Index), Cumulative Index for Nursing and Allied Health Literature (CINAHL), and The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials [CENTRAL], Cochrane Methodology Register). The review will include randomized controlled trials (RCTs), including cluster RCTs, to assess the beneficial effects of the interventions. Assessment of methodological quality and risk of bias will be performed by two independent, blinded reviewers using the PEDro scale and Cochrane Risk of Bias version 2, respectively. The primary outcome measure will be change in self-perceived handicap related to dizziness from baseline to the end of the study, measured using the Dizziness Handicap Inventory. Other relevant outcome measures will include self-reported change in symptoms (to include severity, frequency, and duration) such as verbal or visual analog scales for dizziness. Tertiary outcome measures will include questionnaires related to disability and/or quality of life. DISCUSSION This systematic review will identify, evaluate, and integrate the evidence on the effectiveness of physical therapy interventions for unilateral peripheral vestibular hypofunction in an adult population. We anticipate our findings may inform individualized treatment and future research. Clinical recommendations generated from this systematic review may inform vestibular physical therapy treatment of individuals with unilateral peripheral vestibular hypofunction. TRIAL REGISTRATION In accordance with the guidelines, our systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 06 August 2021 (registration number CRD42021266163 ). In the event of protocol amendments, the date of each amendment will be accompanied by a description of the change and the rationale.
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Affiliation(s)
- Carrie W Hoppes
- Army-Baylor University Doctoral Program in Physical Therapy, Joint Base San Antonio-Fort Sam Houston, TX, USA.
| | - Eric R Anson
- Department of Otolaryngology, University of Rochester, Rochester, NY, USA
| | - Wendy J Carender
- Department of Otolaryngology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | | | - Courtney D Hall
- Hearing and Balance Research Program, Mountain Home VAMC, Mountain Home, TN, USA
- Department of Rehabilitative Sciences, Physical Therapy Program, East Tennessee State University, Johnson City, TN, USA
| | - Susan L Whitney
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Christiana Keinath
- Library, Quillen College of Medicine, East Tennessee State University, Johnson City, TN, USA
| | - Susan J Herdman
- Department of Physical Medicine and Rehabilitation, School of Medicine (Emerita), Emory University, Atlanta, GA, USA
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Rüth M, Schmelzer M, Burtniak K, Kaspar K. Commercial exergames for rehabilitation of physical health and quality of life: a systematic review of randomized controlled trials with adults in unsupervised home environments. Front Psychol 2023; 14:1155569. [PMID: 37333591 PMCID: PMC10272737 DOI: 10.3389/fpsyg.2023.1155569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/02/2023] [Indexed: 06/20/2023] Open
Abstract
Background Commercial exergames are widely available tools that can support physical rehabilitation at home. However, the effects of the unsupervised use of commercial exergames in home environments are not yet clear. Hence, we provide a systematic review on the effects of unsupervised commercial exergaming at home on adults' physical health (RQ1) and quality of life (RQ2). We also scrutinize adults' experiences with exergaming at home regarding participant support, adherence, and adverse outcomes (RQ3). Methods We searched Web of Science, PsycINFO, PubMed, Embase, and CINAHL for peer-reviewed randomized controlled trials with adults in need of rehabilitation. Overall, 20 studies (1,558 participants, 1,368 analyzed) met our inclusion criteria. The quality of evidence was assessed with the Cochrane risk of bias tool. Results Effects of unsupervised commercial exergaming at home on physical health were higher in seven studies and similar in five studies regarding the respective comparison or control conditions; eight studies reported non-significant findings. Of the 15 studies that also examined effects on quality of life, improvements were higher in seven studies and similar in two studies regarding the respective comparison or control conditions; results were non-significant in six studies. Participant support consisted of setup of the exergaming system, instructions, training, and contact with participants. Adherence was high in eight studies, moderate in six studies, and low in one study. Adverse outcomes related to exergaming were found in four studies and were at most moderate. Concerning the quality of evidence, six studies were related to a high risk of bias due to outcome reporting bias or ceiling effects in the primary outcome. Additionally, 10 studies yielded some concerns, and four studies were related to a low risk of bias. Discussion This systematic review summarizes promising evidence that the unsupervised use of commercial exergames can support and complement rehabilitation measures in home environments. Still, future studies based on larger samples and using more recent commercial exergames are needed to obtain more high-quality evidence on the effects of different exercise prescriptions. Overall, considering the necessary precautions, the unsupervised use of commercial exergames at home can improve the physical health and quality of life in adults with needs for physical rehabilitation. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022341189, identifier: PROSPERO, Registration number: CRD42022341189.
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Schneider KJ, Critchley ML, Anderson V, Davis GA, Debert CT, Feddermann-Demont N, Gagnon I, Guskiewicz KM, Hayden KA, Herring S, Johnstone C, Makdissi M, Master CL, Moser RS, Patricios JS, Register-Mihalik JK, Ronksley PE, Silverberg ND, Yeates KO. Targeted interventions and their effect on recovery in children, adolescents and adults who have sustained a sport-related concussion: a systematic review. Br J Sports Med 2023; 57:771-779. [PMID: 37316188 DOI: 10.1136/bjsports-2022-106685] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2023] [Indexed: 06/16/2023]
Abstract
OBJECTIVES We evaluated interventions to facilitate recovery in children, adolescents and adults with a sport-related concussion (SRC). DESIGN Systematic review including risk of bias (modified Scottish Intercollegiate Guidelines Network tool). DATA SOURCES MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Embase, APA PsycINFO, Cochrane Central Register of Controlled Trials, CINAHL Plus with Full Text, SPORTDiscus and Scopus searched until March 2022. STUDY ELIGIBILITY CRITERIA (1) Original research including randomised controlled trials (RCTs), quasi-experimental designs, cohort, comparative effectiveness studies; (2) focus on SRC; (3) English; (4) peer-reviewed and (5) evaluated treatment. RESULTS 6533 studies were screened, 154 full texts reviewed and 13 met inclusion (10 RCTs, 1 quasi-experimental and 2 cohort studies; 1 high-quality study, 7 acceptable and 5 at high risk of bias). Interventions, comparisons, timing and outcomes varied, precluding meta-analysis. For adolescents and adults with dizziness, neck pain and/or headaches >10 days following concussion, individualised cervicovestibular rehabilitation may decrease time to return to sport compared with rest followed by gradual exertion (HR 3.91 (95% CI 1.34 to 11.34)) and when compared with a subtherapeutic intervention (HR 2.91 (95% CI 1.01 to 8.43)). For adolescents with vestibular symptoms/impairments, vestibular rehabilitation may decrease time to medical clearance (vestibular rehab group 50.2 days (95% CI 39.9 to 60.4) compared with control 58.4 (95% CI 41.7 to 75.3) days). For adolescents with persisting symptoms >30 days, active rehabilitation and collaborative care may decrease symptoms. CONCLUSIONS Cervicovestibular rehabilitation is recommended for adolescents and adults with dizziness, neck pain and/or headaches for >10 days. Vestibular rehabilitation (for adolescents with dizziness/vestibular impairments >5 days) and active rehabilitation and/or collaborative care (for adolescents with persisting symptoms >30 days) may be of benefit.
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Affiliation(s)
- Kathryn J Schneider
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | | | - Vicki Anderson
- Child Neuropsychology, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
- Psychology, University of Melbourne, Parkville, Victoria, Australia
| | - Gavin A Davis
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Cabrini Health, Malvern, Victoria, Australia
| | - Chantel T Debert
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Nina Feddermann-Demont
- Department of Neurology, University Hospital Zurich, Zurich Switzerland Sports Neuroscience, University of Zurich, Zurich, Switzerland
| | - Isabelle Gagnon
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Kevin M Guskiewicz
- Sports Medicine Research Laboratory, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - K Alix Hayden
- Libraries and Cultural Resources, University of Calgary, Calgary, Alberta, Canada
| | - Stanley Herring
- Departments of Rehabilitation Medicine, Orthopaedics and Sports Medicine and Neurological Surgery, University of Washington, Seattle, Washington, USA
| | | | - Michael Makdissi
- Florey Institute of Neuroscience and Mental Health - Austin Campus, Heidelberg, Victoria, Australia
- Australian Football League, Melbourne, Victoria, Australia
| | - Christina L Master
- Pediatrics and Sports Medicine, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | | | - Jon S Patricios
- Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Johna K Register-Mihalik
- Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Paul E Ronksley
- Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Noah D Silverberg
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Keith Owen Yeates
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Psychology, University of Calgary, Calgary, Alberta, Canada
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Lilios A, Chimona T, Papadakis C, Chatziioanou I, Nikitas C, Skoulakis C. Different Vestibular Rehabilitation Modalities in Unilateral Vestibular Hypofunction: A Prospective Study. Otol Neurotol 2023; 44:e246-e255. [PMID: 36946364 DOI: 10.1097/mao.0000000000003836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
OBJECTIVE To assess the effectiveness of three vestibular rehabilitation protocols in patients with chronic unilateral vestibular hypofunction. STUDY DESIGN Prospective randomized trial. SETTING Audiology-neurootology laboratory in a general public hospital. PATIENTS Eighty-one patients were randomly allocated into three groups: adaptation exercises (AEs), habituation exercises (HEs), and combined exercises (AE-HEs). INTERVENTIONS Each patient completed an 8-week vestibular rehabilitation program with exercise, depending on their allocation group. MAIN OUTCOME MEASURES Evaluations performed at baseline, 4 weeks, and 8 weeks with (a) Functional Gait Assessment (FGA), (b) Mini-BESTest, (c) Vestibular Rehabilitation Benefit Questionnaire, and (d) Dizziness Handicap Inventory. RESULTS FGA and Mini-BESTest scores showed significant improvement between the baseline and 8-week scores in all groups (p < 0.001), except for the FGA score in the HE group. The AE-HE group showed better scores for all measurements at 4 weeks and had significantly better FGA and Mini-BESTest scores than the AE group and better FGA scores than the HE group. The Vestibular Rehabilitation Benefit Questionnaire and Dizziness Handicap Inventory scores in the AE-HE group were significantly better (p ≤ 0.001) than those in the HE group at 8 weeks. CONCLUSIONS The AE-HE group showed faster improvement and significantly better outcomes for static balance, dynamic postural stability, and self-perceived disability than the single-exercise protocols in chronic unilateral vestibular hypofunction.
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Affiliation(s)
| | - Theognosia Chimona
- Otolaryngology, Head & Neck Surgery Department, Chania General Hospital, Chania, Greece
| | - Chariton Papadakis
- Otolaryngology, Head & Neck Surgery Department, Chania General Hospital, Chania, Greece
| | - Ioannis Chatziioanou
- Otolaryngology, Head & Neck Surgery Department, University Hospital of Larisa, Larisa, Greece
| | - Christos Nikitas
- 1st Department of Otorhinolaryngology, Head and Neck Surgery, National and Kapodistrian University of Athens, Hippocrateion General Hospital, Athens, Greece
| | - Charalambos Skoulakis
- Otolaryngology, Head & Neck Surgery Department, University Hospital of Larisa, Larisa, Greece
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Webster KE, Kamo T, Smith L, Harrington-Benton NA, Judd O, Kaski D, Maarsingh OR, MacKeith S, Ray J, Van Vugt VA, Burton MJ. Non-pharmacological interventions for persistent postural-perceptual dizziness (PPPD). Cochrane Database Syst Rev 2023; 3:CD015333. [PMID: 36912784 PMCID: PMC10011873 DOI: 10.1002/14651858.cd015333.pub2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
BACKGROUND Persistent postural-perceptual dizziness (PPPD) is a chronic balance disorder, which is characterised by subjective unsteadiness or dizziness that is worse on standing and with visual stimulation. The condition was only recently defined and therefore the prevalence is currently unknown. However, it is likely to include a considerable number of people with chronic balance problems. The symptoms can be debilitating and have a profound impact on quality of life. At present, little is known about the optimal way to treat this condition. A variety of medications may be used, as well as other treatments, such as vestibular rehabilitation. OBJECTIVES: To assess the benefits and harms of non-pharmacological interventions for persistent postural-perceptual dizziness (PPPD). SEARCH METHODS: The Cochrane ENT Information Specialist searched the Cochrane ENT Register; Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE; Ovid Embase; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 21 November 2022. SELECTION CRITERIA We included randomised controlled trials (RCTs) and quasi-RCTs in adults with PPPD, which compared any non-pharmacological intervention with either placebo or no treatment. We excluded studies that did not use the Bárány Society criteria to diagnose PPPD, and studies that followed up participants for less than three months. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methods. Our primary outcomes were: 1) improvement in vestibular symptoms (assessed as a dichotomous outcome - improved or not improved), 2) change in vestibular symptoms (assessed as a continuous outcome, with a score on a numerical scale) and 3) serious adverse events. Our secondary outcomes were: 4) disease-specific health-related quality of life, 5) generic health-related quality of life and 6) other adverse effects. We considered outcomes reported at three time points: 3 to < 6 months, 6 to ≤ 12 months and > 12 months. We planned to use GRADE to assess the certainty of evidence for each outcome. MAIN RESULTS: Few randomised controlled trials have been conducted to assess the efficacy of different treatments for PPPD compared to no treatment (or placebo). Of the few studies we identified, only one followed up participants for at least three months, therefore most were not eligible for inclusion in this review. We identified one study from South Korea that compared the use of transcranial direct current stimulation to a sham procedure in 24 people with PPPD. This is a technique that involves electrical stimulation of the brain with a weak current, through electrodes that are placed onto the scalp. This study provided some information on the occurrence of adverse effects, and also on disease-specific quality of life at three months of follow-up. The other outcomes of interest in this review were not assessed. As this is a single, small study we cannot draw any meaningful conclusions from the numeric results. AUTHORS' CONCLUSIONS: Further work is necessary to determine whether any non-pharmacological interventions may be effective for the treatment of PPPD and to assess whether they are associated with any potential harms. As this is a chronic disease, future trials should follow up participants for a sufficient period of time to assess whether there is a persisting impact on the severity of the disease, rather than only observing short-term effects.
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Affiliation(s)
- Katie E Webster
- Cochrane ENT, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Tomohiko Kamo
- Department of Physical Therapy, Faculty of Rehabilitation, Gunma Paz University, Gunma, Japan
| | - Laura Smith
- School of Psychology, University of Kent, Canterbury, UK
| | | | - Owen Judd
- ENT Department, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Diego Kaski
- National Hospital for Neurology and Neurosurgery, London, UK
| | - Otto R Maarsingh
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of General Practice, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Samuel MacKeith
- ENT Department, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | - Vincent A Van Vugt
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of General Practice, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
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Sedeño-Vidal A, Hita-Contreras F, Montilla-Ibáñez MA. The Effects of Vestibular Rehabilitation and Manual Therapy on Patients with Unilateral Vestibular Dysfunction: A Randomized and Controlled Clinical Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15080. [PMID: 36429797 PMCID: PMC9690966 DOI: 10.3390/ijerph192215080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/05/2022] [Accepted: 11/12/2022] [Indexed: 06/16/2023]
Abstract
(1) Objective: To determine the effect of a directed vestibular rehabilitation therapy (VRT) program with manual therapy (MT) on dizziness-related disability and imbalance symptoms among patients with peripheral unilateral vestibular dysfunction. (2) Methods: Eighty patients (54.75 ± 1.34 years) were allocated either to a control group (n = 40), who underwent a directed VRT program, or to an experimental group (n = 40), who received the same program plus MT once a week/4 weeks. We assessed their level of disability (Dizziness Handicap Inventory, DHI), balance confidence (the Activities-specific Balance Confidence scale-16 items), postural balance (resistive multisensor platform), and the frequency and intensity of dizziness symptoms (visual analog scale). (3) Results: Post-intervention between-group improvements were observed regarding DHI total score and intensity in the experimental group (p < 0.001), as well as four weeks later. Six months after, the experimental group exhibited improvements in the center of pressure velocity with eyes open (p = 0.019), DHI total score (p = 0.001) and subscales (all p < 0.05), and intensity (p = 0.003) and frequency (p = 0.010) of dizziness. Balance confidence improvements were observed 1 month (p = 0.035) and 6 months (p = 0.038) post-intervention. (4) Conclusions: Directed VRT plus MT is a safe and beneficial intervention that speeds up recovery for patients suffering from dizziness and instability derived from unilateral vestibular dysfunction.
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Affiliation(s)
- Ana Sedeño-Vidal
- Department of Health Sciences, Faculty of Health Sciences, University of Jaen, 23071 Jaen, Spain
| | - Fidel Hita-Contreras
- Department of Health Sciences, Faculty of Health Sciences, University of Jaen, 23071 Jaen, Spain
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Ogihara H, Kamo T, Tanaka R, Azami M, Kato T, Endo M, Tsunoda R, Fushiki H. Factors affecting the outcome of vestibular rehabilitation in patients with peripheral vestibular disorders. Auris Nasus Larynx 2022; 49:950-955. [PMID: 35307238 DOI: 10.1016/j.anl.2022.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/10/2022] [Accepted: 03/04/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Previous studies have reported that developmental, environmental, medical, psychological, visual, and other sensory-related factors can influence the outcome of vestibular rehabilitation. However, only a few studies have used patient's daily lives as the main outcome. In addition, in some studies, rehabilitation was not supervised by a physical therapist. This study aimed to determine the factors associated with the outcome of physical-therapist-supervised vestibular rehabilitation in patients with peripheral vestibular disorders, with the impact of dizziness on quality of life as the main outcome. METHODS This retrospective cohort study included 47 patients with peripheral vestibular disorders. A physical therapist provided 40 min of vestibular rehabilitation once a week for 4 weeks. Age, sex, disease duration, Dizziness Handicap Inventory (DHI), Timed Up-and-Go test (TUG), Dynamic Gait Index (DGI), Functional Gait Assessment (FGA), Activity-Specific Balance Confidence Scale (ABC scale), and Hospital Anxiety and Depression Scale (HADS) were investigated. Multiple regression analysis was performed, with the DHI rate of change before and after the intervention as the objective variable. RESULTS Vestibular rehabilitation improved all outcomes. In the multiple regression analysis, the ABC scale was identified as a factor that significantly influenced the DHI rate of change (β = -0.428, p < 0.01). CONCLUSION A higher ABC scale score was associated with a lower DHI rate of change (i.e., better improvement). Therefore, it may be important to assess psychological aspects, especially confidence in balance, when implementing vestibular rehabilitation in patients with peripheral vestibular disorders.
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Affiliation(s)
- Hirofumi Ogihara
- Division of Physical Therapy, Department of Rehabilitation, Faculty of Health Sciences, Nagano University of Health and Medicine, 11-1, Imaihara, Kawanakajima-machi, Nagano-City, Nagano, 381-2227 Japan; Otolaryngology, Mejiro University Ear Institute Clinic, 320, Ukiya, Iwatsuki, Saitama-City, Saitama, 339-8501 Japan.
| | - Tomohiko Kamo
- Otolaryngology, Mejiro University Ear Institute Clinic, 320, Ukiya, Iwatsuki, Saitama-City, Saitama, 339-8501 Japan; Department of Physical Therapy, School of Health Sciences, Japan University of Health Sciences, 2-555, Hirasuka, Satte-city, Saitama, 340-0145 Japan
| | - Ryozo Tanaka
- Otolaryngology, Mejiro University Ear Institute Clinic, 320, Ukiya, Iwatsuki, Saitama-City, Saitama, 339-8501 Japan; Department of Physical Therapy, Faculty of Health Sciences, Mejiro University, 320, Ukiya, Iwatsuki, Saitama-City, Saitama, 339-8501 Japan
| | - Masato Azami
- Otolaryngology, Mejiro University Ear Institute Clinic, 320, Ukiya, Iwatsuki, Saitama-City, Saitama, 339-8501 Japan; Department of Physical Therapy, School of Health Sciences, Japan University of Health Sciences, 2-555, Hirasuka, Satte-city, Saitama, 340-0145 Japan
| | - Takumi Kato
- Otolaryngology, Mejiro University Ear Institute Clinic, 320, Ukiya, Iwatsuki, Saitama-City, Saitama, 339-8501 Japan
| | - Mayumi Endo
- Otolaryngology, Mejiro University Ear Institute Clinic, 320, Ukiya, Iwatsuki, Saitama-City, Saitama, 339-8501 Japan
| | - Reiko Tsunoda
- Otolaryngology, Mejiro University Ear Institute Clinic, 320, Ukiya, Iwatsuki, Saitama-City, Saitama, 339-8501 Japan
| | - Hiroaki Fushiki
- Otolaryngology, Mejiro University Ear Institute Clinic, 320, Ukiya, Iwatsuki, Saitama-City, Saitama, 339-8501 Japan
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