Effectiveness of vestibular rehabilitation in patients with vestibular dysfunction

Abstract

Background Vertigo and instability due to vestibular dysfunction have been a frequent cause of work absence, with a clearly upward tendency observed in recent years. Uncompensated vestibular hypofunction requires vestibular rehabilitation, but access to this form of treatment remains limited. Therefore, innovative methods of rehabilitation utilizing new technologies, which could promote this therapy, are searched for. Virtual reality (VR) is becoming a popular method of rehabilitation used, for example, in the treatment of stroke or schizophrenia. The aim of this study was to compare and evaluate 2 methods of vestibular rehabilitation in patients with unilateral vestibular disorders. Material and Methods Forty-three patients with unilateral vestibular disorders diagnosed at the Balance Disorders Unit, 1st Otolaryngology Department of the Medical University of Lodz, were included in this study. The patients, divided into 2 groups, received 10 sessions of rehabilitation. Group 1 (N = 22) was rehabilitated using a VR unit consisting of a forceplate and a motion sensor, while Group 2 (N = 21) performed training on a static posturography platform under physiotherapist supervision. The patients were examined at the baseline, 1 month and 3 months after rehabilitation. During each assessment, posturography was performed which recorded the center of pressure (CoP) displacement. The patients also filled out a questionnaire to quantify vertigo symptoms. Results The CoP parameters decreased in both groups, with no superiority of either form of training. Analysis of the subjective symptoms reduction revealed a decrease in the Vertigo Syndrome Scale – short form (VSS-sf) score in the second evaluation in both groups, which was slightly greater in the VR group. The improvement remained stable 3 months after rehabilitation. Conclusions Both forms of rehabilitation are effective in increasing postural stability and reducing subjective symptoms. Virtual reality training achieves a slightly greater subjective improvement. Med Pr. 2019;70(5):545–53

Keywords

• rehabilitation
• vertigo
• postural stability
• loss of balance
• virtual reality
• center of pressure