Efficacy of vestibular rehabilitation on chronic unilateral vestibular dysfunction

Abstract

Objective: To assess the efficacy of vestibular rehabilitation exercises on patients with chronic unilateral vestibular dysfunction. Design: Prospective study. Setting: Physical Medicine and Rehabilitation Clinic and Otolaryngology Clinic of a tertiary referral hospital. Subjects: One-hundred and twenty-five patients with unilateral chronic vestibular dysfunction were included in the study. Interventions: Eight-week, two-staged (clinic and home) vestibular rehabilitation programme with components of Cawthorne-Cooksey and Norre exercises was applied. Main outcome measures: Dizziness Handicap Inventory (DHI) and visual analogue scale (VAS) were completed three times (at the beginning, end of the second week and end of the treatment). Results: Data for 112 patients in the first stage and 93 patients in the second stage were evaluated because of insufficient compliance of the other patients. The mean DHI score was decreased from 50.42 ± 24.12 points to 21.21 ± 15.97 points (p < 0.001) at the end of first two weeks, and to 19.93 ± 19.33 points at the end of the whole treatment. The mean VAS score was decreased from 5.87 ± 2.27 to 2.02 ± 1.75 (p < 0.001) at the end of second week, and to 1.51 ± 1.29 at the end of eighth week. In respect to both VAS and DHI scores, improvement was noted in 67 patients (77.4%). Age, gender and disability level had no predictive value about therapy outcome. Conclusions: There was a fast recovery in the supervised exercise session, whereas there was no significant difference in the home exercise session. These findings suggest that either supervised exercise is better than home exercise or that 10 supervised sessions are sufficient to get the end result.