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Rehabilitation after acute vestibular disorders

Published online by Cambridge University Press:  13 June 2008

R Teggi ,
D Caldirola ,
B Fabiano ,
P Recanati  and
M Bussi
R Teggi*
Affiliation:
ENT Department, San Raffaele Hospital, Vita-Salute University, Milan, Italy
D Caldirola
Affiliation:
Anxiety Disorder Clinical and Research Unit, San Raffaele Hospital, Vita-Salute University, Milan, Italy
B Fabiano
Affiliation:
ENT Department, San Raffaele Hospital, Vita-Salute University, Milan, Italy
P Recanati
Affiliation:
ENT Department, San Raffaele Hospital, Vita-Salute University, Milan, Italy
M Bussi
Affiliation:
ENT Department, San Raffaele Hospital, Vita-Salute University, Milan, Italy
*
Address for correspondence: Dr Roberto Teggi, San Raffaele Hospital, via Olgettina 60, 20132 Milan, Italy. Fax: +39 2 26433508 E-mail: teggi.roberto@hsr.it
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Abstract

Objectives:

To assess the efficacy of rehabilitation for dizzy patients after recent acute vestibular disturbance.

Methods:

Forty patients recently hospitalised for an acute episode of rotational vertigo which lasted days were randomly divided into two groups. The first group (20 patients; group R) underwent active rehabilitation, while the second group (20 patients; group C) were told only to ‘perform their daily activities’. Group R subjects underwent a total of 10 sessions of rehabilitation, including exercises on a stabilometric platform, point de mire and a series of five exercises repeated five times daily. All patients performed static stabilometry (posturography), undertook the dynamic gait index test, and completed a dizziness handicap questionnaire and a visual analogue scale for anxiety, at baseline and on completion.

Results:

At 25 days, the rehabilitated patients obtained better results for all recorded outcomes, compared with the control group. The greatest difference in the rehabilitated subjects, compared with the control group, was for the dynamic gait index test; however, this difference was not statistically significant. The visual analogue scale anxiety score was statistically significantly more reduced in rehabilitated patients compared with control patients. Control patients maintained a higher visual dependence for postural control.

Conclusions:

These results would appear to support the effectiveness of a supervised exercise programme for patients following acute onset of vestibular disturbance. A correlation was found in both groups between dynamic gait index results and anxiety. In our experience, a rehabilitation programme seems to reduce dependence on visual cues for postural control.

Keywords

VertigoVestibular Disorders, Rehabilitation
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 4 , April 2009 , pp. 397 - 402
Copyright
Copyright © JLO (1984) Limited 2008

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References

1 Gresty, MA, Hess, K, Leech, J. Disorders of the vestibulo-ocular reflex producing oscillopsia and mechanisms compensating for loss of labyrinthine function. Brain 1977;100:693–716Google Scholar
2 Chambers, BR, Mai, M, Barber, HO. Bilateral vestibular loss, oscillopsia, and the cervico-ocular reflex. Otolaryngol Head Neck Surg 1985;93:403–7Google Scholar
3 Bhansali, SA, Stockwell, CW, Bojrab, DI. Oscillopsia in patients with loss of vestibular function. Otolaryngol Head Neck Surg 1993;109:120–5Google Scholar
4 Smith-Wheelock, M, Shepard, NT, Telian, SA. Physical therapy program for vestibular rehabilitation. Am J Otol 1991;12:218–25Google Scholar
5 Mira, E. Improving the quality of life in patients with vestibular disorders: the role of medical treatments and physical rehabilitation. Int J Clin Pract 2008;62:109–14Google Scholar
6 Cawthorne, T. The physiological basis of head exercises. J Chart Soc Physio Ter 1944;106:106–10Google Scholar
7 Cooksey, FS. Rehabilitation in vestibular injuries. Proc R Soc Med 1946;39:273–8Google Scholar
8 Cohen, HS. Disability and rehabilitation in the dizzy patient. Curr Opin Neurol 2006;19:49–54Google Scholar
9 Brandt, T, Strupp, M, Arbusow, V, Dieringer, N. Plasticity of the vestibular system: central compensation and sensory substitution for vestibular deficits. Adv Neurol 1997;73:297–309Google ScholarPubMed
10 Curthoys, IS, Halmagyi, G. Vestibular compensation. Adv Otorhinolaryngol 1999;55:82–110Google Scholar
11 Lacour, M, Toupet, M, Denise, P, Christen, Y. Vestibular Compensation. Facts, Theories and Clinical Perspectives. Amsterdam: Elsevier, 1989Google Scholar
12 Strupp, M, Arbusow, V, Maag, KP, Gall, C, Brandt, T. Vestibular exercises improve central vestibulospinal compensation after vestibular neuritis. Neurology 1998;51:838–44Google Scholar
13 Yardley, L, Masson, E, Verschuur, C, Haacke, N, Luxon, L. Symptoms, anxiety and handicap in dizzy patients: development of the vertigo symptom scale. J Psychosom Res 1992;36:731–41Google Scholar
14 Yardley, L, Vershuur, C, Masson, E, Luxon, L, Haacke, N. Somatic and psychological factors contributing to handicap in people with vertigo. Br J Audiol 1992;26:283–90Google Scholar
15 Eagger, S, Luxon, LM, Davies, RA, Coelho, A, Ron, MA. Psychiatric morbidity in patients with peripheral vestibular disorder: a clinical and neuro-otological study. J Neurol Neurosurg Psych 1992;55:383–7Google Scholar
16 Schuerger, RJ, Balaban, CD. Immunohistochemical demonstration of regionally selective projections from locus coeruleus to the vestibular nuclei in rats. Exp Brain Res 1993;92:351–9Google Scholar
17 Balaban, CD, Porter, JD. Neuroanatomic substrates for vestibulo-autonomic interactions. J Vest Res 1998;8:7–16Google Scholar
18 Pollak, L, Klein, C, Stryjer, R, Kossych, V, Rabey, JM. Anxiety in the first attack of vertigo. Otolaryngol Head Neck Surg 2003;128:829–34Google Scholar
19 Gagey, PM, Weber, B. Posturology, regulation and disorders of upright station [in French] Paris: Masson, 1999Google Scholar
20 Wrisley, DM, Walker, ML, Echternach, JL, Strasnick, B. Reliability of the dynamic gait index in people with vestibular disorders. Arch Phys Med Rehabil 2003;84:1528–33Google Scholar
21 Whitney, SL, Marchetti, GF, Schade, A, Wrisley, DM. The sensitivity and specificity of the Timed “Up & Go” and the Dynamic Gait Index for self-reported falls in persons with vestibular disorders. J Vestib Res 2004;14:397–409Google Scholar
22 Jacobson, GP, Newman, CW. The development of the Dizziness Handicap Inventory. Arch Otolaryngol Head Neck Surg 1990;116:424–7Google Scholar
23 Jacobson, GP, Newman, CW, Hunter, L, Balzer, GK. Balance function test correlates of the Dizziness Handicap Inventory. J Am Acad Audiol 1991;2:253–60Google Scholar
24 Krebs, DE, Gill-Body, KM, Riley, PO, Parker, SW. Double-blind, placebo-controlled trial of rehabilitation for bilateral vestibular hypofunction: preliminary report. Otolaryngol Head Neck Surg 1993;109:735–41Google Scholar
25 Cowland, JL, Wrisley, DM, Walker, M, Strasnick, B, Jacobson, JT. Efficacy of vestibular rehabilitation. Otolaryngol Head Neck Surg 1998;118:49–54CrossRefGoogle Scholar
26 Herdman, SJ, Clendaniel, RA, Mattox, DE, Holliday, MJ, Niparko, JK. Vestibular adaptation exercises and recovery: acute stage after acoustic neuroma resection. Otolaryngol Head Neck Surg 1995;113:77–87Google Scholar
27 Yasuda, T, Nakagawa, T, Inoue, H, Iwamoto, M, Inokuchi, A. The role of the labyrinth, proprioception and plantar mechanosensors in the maintenance of an upright posture. Eur Arch Otorhinolaryngol 1999;256:27–32Google Scholar
28 Yardley, L, Putman, J. Quantitative analysis of factors contributing to handicap and distress in vertiginous patients: a questionnaire study. Clin Otolaryngol 1992;17:231–6CrossRefGoogle ScholarPubMed