Vestibular rehabilitation outcomes and follow-up
Abstract Introduction and objective: Vestibular rehabilitation (VR) typically consists of the provision of a customized exercise program targeted toward the patient’s specific needs. Patient education and psychological support are also key elements to optimal recovery. The techniques have evolved over the past few decades, and there is reliable research into the efficacy of vestibular exercises. We will try to be presented throughout this chapter.Method: Narrative review.Results: VR is a safe and effective treatment. Early intervention is advised for falls prevention and symptom management; however, symptomatic patients with chronic vestibular disorders may still demonstrate benefit. Persons with both central and peripheral vestibular disorders improve with VR. The frequency, optimal treatment duration, and total number of physical therapy visits for best results are unknown. Exercise programs must be regulated and dosed based on the response of the patient. No one-exercise program is effective for all persons with vestibular disorders.Conclusion: Vestibular rehabilitation now is the standard of care for many types of vestibular pathology and we believe should be provided by physical and occupational therapists who have specialized training beyond the entry-level degree.
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Alahmari KA, Sparto PJ, Marchetti GF, Redfern MS, Furman JM, Whitney SL. Comparison of virtual reality based therapy with customized vestibular physical therapy for the treatment of vestibular disorders. IEEE Trans Neural Syst Rehabil Eng. 2014 Mar;22(2):389-99.
Alghadir AH, Anwer S. Effects of Vestibular Rehabilitation in the Management of a Vestibular Migraine: A Review. Front Neurol. 2018 Jun 12;9:440.
Best C, Tschan R, Stieber N, Beutel ME, Eckhardt-Henn A, Dieterich M. STEADFAST: Psychotherapeutic Intervention Improves Postural Strategy of Somatoform Vertigo and Dizziness. Behav Neurol. 2015;2015:456850.
Cabrera Kang CM, Tusa RJ. Vestibular rehabilitation: rationale and indications. Semin Neurol. 2013 Jul;33(3):276-85.
Cawthorne T. The physiological basis for head exercises. J Chart Soc Physiother. 1944;3:106–7.
Cooksey FS. Rehabilitation in vestibular injuries. Proc R Soc Med. 1946;39.
Denham T, Wolf A. Vestibular rehabilitation. Rehab Manag. 1997 Apr-May;10(3):93-4, 144.
Dieterich M, Obermann M, Celebisoy N. Vestibular migraine: the most frequent entity of episodic vertigo. J Neurol. 2016 Apr;263 Suppl 1:S82-9.
Dunlap PM, Holmberg JM, Whitney SL. Vestibular rehabilitation: advances in peripheral and central vestibular disorders. Curr Opin Neurol. 2019 Feb;32(1):137-44.
Eleftheriadou A, Skalidi N, Velegrakis GA. Vestibular rehabilitation strategies and factors that affect the outcome. Eur Arch Otorhinolaryngol. 2012 Nov;269(11):2309-16.
Essery R, Geraghty AW, Kirby S, Yardley L. Predictors of adherence to home-based physical therapies: a systematic review. Disabil Rehabil. 2017 Mar;39(6):519-534.
Hall CD, Herdman SJ, Whitney SL, Cass SP, Clendaniel RA, Fife TD, et al. Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Evidence-Based Clinical Practice Guideline: from the American Physical Therapy Association Neurology Section. J Neurol Phys Ther. 2016 Apr;40(2):124-55.
Herdman SJ, Hall CD, Maloney B, Knight S, Ebert M, Lowe J. Variables associated with outcome in patients with bilateral vestibular hypofunction: Preliminary study. J Vestib Res. 2015;25(3-4):185-94.
Klatt BN, Carender WJ, Lin CC, Alsubaie SF, Kinnaird CR, Sienko KH, et al. A Conceptual Framework for the Progression of Balance Exercises in Persons with Balance and Vestibular Disorders. Phys Med Rehabil Int. 2015;2(4).
Krpi? A, Savanovi? A, Cikajlo I. Telerehabilitation: remote multimedia-supported assistance and mobile monitoring of balance training outcomes can facilitate the clinical staff’s effort. Int J Rehabil Res. 2013 Jun;36(2):162-71.
Kundakci B, Sultana A, Taylor AJ, Alshehri MA. The effectiveness of exercise-based vestibular rehabilitation in adult patients with chronic dizziness: A systematic review. F1000Res. 2018 Mar 5;7:276.
Lacour M, Bernard-Demanze L. Interaction between Vestibular Compensation Mechanisms and Vestibular Rehabilitation Therapy: 10 Recommendations for Optimal Functional Recovery. Front Neurol. 2015 Jan 6;5:285.
Lauritsen CG, Chua AL, Nahas SJ. Current Treatment Options: Headache Related to Menopause-Diagnosis and Management. Curr Treat Options Neurol. 2018 Mar 6;20(4):7.
McDonnell MN, Hillier SL. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev. 2015 Jan 13;1:CD005397.
Meldrum D, Herdman S, Vance R, Murray D, Malone K, Duffy D, et al. Effectiveness of conventional versus virtual reality-based balance exercises in vestibular rehabilitation for unilateral peripheral vestibular loss: results of a randomized controlled trial. Arch Phys Med Rehabil. 2015 Jul;96(7):1319-1328.e1.
Neuhauser HK, Radtke A, von Brevern M, Lezius F, Feldmann M, Lempert T. Burden of dizziness and vertigo in the community. Arch Intern Med. 2008 Oct 27;168(19):2118-24. doi: 10.1001/archinte.168.19.2118. Erratum in: Arch Intern Med. 2009 Jan 12;169(1):89.
Nevoux J, Barbara M, Dornhoffer J, Gibson W, Kitahara T, Darrouzet V. International consensus (ICON) on treatment of Ménière’s disease. Eur Ann Otorhinolaryngol Head Neck Dis. 2018 Feb;135(1S):S29-S32.
Pardal-Refoyo J, Batuecas-Caletrío Á. Revisión sobre los instrumentos de evaluación de la discapacidad en patología vestibular. Revista ORL [Internet]. 30 Ene 2018 [citado 29 Jun 2019]; 9(2): 145-164. Disponible en: http://revistas.usal.es/cinco/index.php/2444-7986/article/view/17700.
Porciuncula F, Johnson CC, Glickman LB. The effect of vestibular rehabilitation on adults with bilateral vestibular hypofunction: a systematic review. J Vestib Res. 2012;22(5-6):283-98.
Pérez N, Garmendia I, Martín E, García-Tapia R. Adaptación cultural de dos cuestionarios de medida de la salud en pacientes con vértigo. Acta Otorrinolaringol Esp. 2000 Oct;51(7):572-80.
Saber Tehrani AS, Coughlan D, Hsieh YH, Mantokoudis G, Korley FK, Kerber KA, et al. Rising annual costs of dizziness presentations to U.S. emergency departments. Acad Emerg Med. 2013 Jul;20(7):689-96.
Schaaf H, Hesse G. Patients with long-lasting dizziness: a follow-up after neurotological and psychotherapeutic inpatient treatment after a period of at least 1 year. Eur Arch Otorhinolaryngol. 2015 Jun;272(6):1529-35.
Sienko KH, Balkwill MD, Oddsson LI, Wall C 3rd. The effect of vibrotactile feedback on postural sway during locomotor activities. J Neuroeng Rehabil. 2013 Aug 9;10:93.
Staab JP, Eckhardt-Henn A, Horii A, Jacob R, Strupp M, Brandt T, et al. Diagnostic criteria for persistent postural-perceptual dizziness (PPPD): Consensus document of the committee for the Classification of Vestibular Disorders of the Bárány Society. J Vestib Res. 2017;27(4):191-208.
Sulway S, Whitney SL. Advances in Vestibular Rehabilitation. Adv Otorhinolaryngol. 2019;82:164-9.
Tinetti ME, Williams CS, Gill TM. Health, functional, and psychological outcomes among older persons with chronic dizziness. J Am Geriatr Soc. 2000 Apr;48(4):417-21.
Tjernström F, Fransson PA, Kahlon B, Karlberg M, Lindberg S, Siesjö P, et al. PREHAB vs. REHAB - presurgical treatment in vestibular schwannoma surgery enhances recovery of postural control better than postoperative rehabilitation: Retrospective case series. J Vestib Res. 2018;27(5-6):313-25.
Van Esch BF, van der Scheer-Horst ES, van der Zaag-Loonen HJ, Bruintjes TD, van Benthem PP. The Effect of Vestibular Rehabilitation in Patients with Ménière’s Disease. Otolaryngol Head Neck Surg. 2017 Mar;156(3):426-34.
Whitney SL, Alghadir AH, Anwer S. Recent Evidence About the Effectiveness of Vestibular Rehabilitation. Curr Treat Options Neurol. 2016 Mar;18(3):13.
Wrisley DM, Pavlou M. Physical therapy for balance disorders. Neurol Clin. 2005 Aug;23(3):855-74.
Alghadir AH, Anwer S. Effects of Vestibular Rehabilitation in the Management of a Vestibular Migraine: A Review. Front Neurol. 2018 Jun 12;9:440.
Best C, Tschan R, Stieber N, Beutel ME, Eckhardt-Henn A, Dieterich M. STEADFAST: Psychotherapeutic Intervention Improves Postural Strategy of Somatoform Vertigo and Dizziness. Behav Neurol. 2015;2015:456850.
Cabrera Kang CM, Tusa RJ. Vestibular rehabilitation: rationale and indications. Semin Neurol. 2013 Jul;33(3):276-85.
Cawthorne T. The physiological basis for head exercises. J Chart Soc Physiother. 1944;3:106–7.
Cooksey FS. Rehabilitation in vestibular injuries. Proc R Soc Med. 1946;39.
Denham T, Wolf A. Vestibular rehabilitation. Rehab Manag. 1997 Apr-May;10(3):93-4, 144.
Dieterich M, Obermann M, Celebisoy N. Vestibular migraine: the most frequent entity of episodic vertigo. J Neurol. 2016 Apr;263 Suppl 1:S82-9.
Dunlap PM, Holmberg JM, Whitney SL. Vestibular rehabilitation: advances in peripheral and central vestibular disorders. Curr Opin Neurol. 2019 Feb;32(1):137-44.
Eleftheriadou A, Skalidi N, Velegrakis GA. Vestibular rehabilitation strategies and factors that affect the outcome. Eur Arch Otorhinolaryngol. 2012 Nov;269(11):2309-16.
Essery R, Geraghty AW, Kirby S, Yardley L. Predictors of adherence to home-based physical therapies: a systematic review. Disabil Rehabil. 2017 Mar;39(6):519-534.
Hall CD, Herdman SJ, Whitney SL, Cass SP, Clendaniel RA, Fife TD, et al. Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Evidence-Based Clinical Practice Guideline: from the American Physical Therapy Association Neurology Section. J Neurol Phys Ther. 2016 Apr;40(2):124-55.
Herdman SJ, Hall CD, Maloney B, Knight S, Ebert M, Lowe J. Variables associated with outcome in patients with bilateral vestibular hypofunction: Preliminary study. J Vestib Res. 2015;25(3-4):185-94.
Klatt BN, Carender WJ, Lin CC, Alsubaie SF, Kinnaird CR, Sienko KH, et al. A Conceptual Framework for the Progression of Balance Exercises in Persons with Balance and Vestibular Disorders. Phys Med Rehabil Int. 2015;2(4).
Krpi? A, Savanovi? A, Cikajlo I. Telerehabilitation: remote multimedia-supported assistance and mobile monitoring of balance training outcomes can facilitate the clinical staff’s effort. Int J Rehabil Res. 2013 Jun;36(2):162-71.
Kundakci B, Sultana A, Taylor AJ, Alshehri MA. The effectiveness of exercise-based vestibular rehabilitation in adult patients with chronic dizziness: A systematic review. F1000Res. 2018 Mar 5;7:276.
Lacour M, Bernard-Demanze L. Interaction between Vestibular Compensation Mechanisms and Vestibular Rehabilitation Therapy: 10 Recommendations for Optimal Functional Recovery. Front Neurol. 2015 Jan 6;5:285.
Lauritsen CG, Chua AL, Nahas SJ. Current Treatment Options: Headache Related to Menopause-Diagnosis and Management. Curr Treat Options Neurol. 2018 Mar 6;20(4):7.
McDonnell MN, Hillier SL. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev. 2015 Jan 13;1:CD005397.
Meldrum D, Herdman S, Vance R, Murray D, Malone K, Duffy D, et al. Effectiveness of conventional versus virtual reality-based balance exercises in vestibular rehabilitation for unilateral peripheral vestibular loss: results of a randomized controlled trial. Arch Phys Med Rehabil. 2015 Jul;96(7):1319-1328.e1.
Neuhauser HK, Radtke A, von Brevern M, Lezius F, Feldmann M, Lempert T. Burden of dizziness and vertigo in the community. Arch Intern Med. 2008 Oct 27;168(19):2118-24. doi: 10.1001/archinte.168.19.2118. Erratum in: Arch Intern Med. 2009 Jan 12;169(1):89.
Nevoux J, Barbara M, Dornhoffer J, Gibson W, Kitahara T, Darrouzet V. International consensus (ICON) on treatment of Ménière’s disease. Eur Ann Otorhinolaryngol Head Neck Dis. 2018 Feb;135(1S):S29-S32.
Pardal-Refoyo J, Batuecas-Caletrío Á. Revisión sobre los instrumentos de evaluación de la discapacidad en patología vestibular. Revista ORL [Internet]. 30 Ene 2018 [citado 29 Jun 2019]; 9(2): 145-164. Disponible en: http://revistas.usal.es/cinco/index.php/2444-7986/article/view/17700.
Porciuncula F, Johnson CC, Glickman LB. The effect of vestibular rehabilitation on adults with bilateral vestibular hypofunction: a systematic review. J Vestib Res. 2012;22(5-6):283-98.
Pérez N, Garmendia I, Martín E, García-Tapia R. Adaptación cultural de dos cuestionarios de medida de la salud en pacientes con vértigo. Acta Otorrinolaringol Esp. 2000 Oct;51(7):572-80.
Saber Tehrani AS, Coughlan D, Hsieh YH, Mantokoudis G, Korley FK, Kerber KA, et al. Rising annual costs of dizziness presentations to U.S. emergency departments. Acad Emerg Med. 2013 Jul;20(7):689-96.
Schaaf H, Hesse G. Patients with long-lasting dizziness: a follow-up after neurotological and psychotherapeutic inpatient treatment after a period of at least 1 year. Eur Arch Otorhinolaryngol. 2015 Jun;272(6):1529-35.
Sienko KH, Balkwill MD, Oddsson LI, Wall C 3rd. The effect of vibrotactile feedback on postural sway during locomotor activities. J Neuroeng Rehabil. 2013 Aug 9;10:93.
Staab JP, Eckhardt-Henn A, Horii A, Jacob R, Strupp M, Brandt T, et al. Diagnostic criteria for persistent postural-perceptual dizziness (PPPD): Consensus document of the committee for the Classification of Vestibular Disorders of the Bárány Society. J Vestib Res. 2017;27(4):191-208.
Sulway S, Whitney SL. Advances in Vestibular Rehabilitation. Adv Otorhinolaryngol. 2019;82:164-9.
Tinetti ME, Williams CS, Gill TM. Health, functional, and psychological outcomes among older persons with chronic dizziness. J Am Geriatr Soc. 2000 Apr;48(4):417-21.
Tjernström F, Fransson PA, Kahlon B, Karlberg M, Lindberg S, Siesjö P, et al. PREHAB vs. REHAB - presurgical treatment in vestibular schwannoma surgery enhances recovery of postural control better than postoperative rehabilitation: Retrospective case series. J Vestib Res. 2018;27(5-6):313-25.
Van Esch BF, van der Scheer-Horst ES, van der Zaag-Loonen HJ, Bruintjes TD, van Benthem PP. The Effect of Vestibular Rehabilitation in Patients with Ménière’s Disease. Otolaryngol Head Neck Surg. 2017 Mar;156(3):426-34.
Whitney SL, Alghadir AH, Anwer S. Recent Evidence About the Effectiveness of Vestibular Rehabilitation. Curr Treat Options Neurol. 2016 Mar;18(3):13.
Wrisley DM, Pavlou M. Physical therapy for balance disorders. Neurol Clin. 2005 Aug;23(3):855-74.
Benito-Orejas, J. I., Alonso-Vielba, J., Valda-Rodrigo, J., & Cifuentes-Navas, V. A. (2019). Vestibular rehabilitation outcomes and follow-up. Revista ORL, 11(1), 107–114. https://doi.org/10.14201/orl.21243
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