MEND Therapy: A Home-Based Option for Persistent Postural-Perceptual Dizziness

Abstract

Objective: Persistent postural-perceptual dizziness (PPPD) is a chronic functional disorder where treatment should be tailored to the individual needs. While customized therapy with a physiotherapist has evidence-based benefits, it comes at a cost and the facility may not be available to some, especially in rural areas. An alternative option is a home-based treatment called MEND (Move, Eye, Neck stretching, and Deep breathing exercises) therapy. This study aimed to assess the efficacy of MEND therapy in PPPD compared to the hospital-based vestibular rehabilitation therapy (VRT). Methods: 59 PPPD patients completed the randomized-controlled study comparing MEND therapy (intervention) and hospital-based VRT (control). EuroQOL Group quality of life questionnaire (EQ-5D), Dizziness Handicap Inventory (DHI), and 21-question Depression, Anxiety, and Stress Scale (DASS-21) were monitored at baseline, 4 weeks, and 12 weeks. Results: At the end of the study, 100% patients on MEND therapy found it beneficial compared to 79.3% in the control group. The MEND therapy provided significant improvements in the physical (P = .007), functional (P=.0006), emotional (P=.0003), and total DHI (P=.0003) with a medium to large effect size. The control group showed significant improvement only in the functional elements of DHI (P=.04), and total DHI (P=.04) with a small to medium effect size. Conclusion: The MEND therapy is an effective option that incorporates all elements of therapy for PPPD. Keywords: Persistent postural-perceptual dizziness, vestibular rehabilitation therapy, home-based therapy, customized VRT, chronic dizziness.