A Clinical Analysis of Vestibular Rehabilitation Therapy for Patients with Balance Disorders / 听力学及言语疾病杂志

Objective To explore the clinical outcomes of vestibular rehabilitation therapy(VRT) in the treat‐ment of patients with balance disorders .Methods Seventy -six patients were diagnosed with vertigo based on the principle of single and double side targeted rehabilitation ,and were divided into four groups randomly .Group A of 29 cases received unilateral simple drug treatment only ,group B of 29 cases received unilateral drug treatmeat com‐bined with vestibular rehabilitation therapy ;bilateral simple drug treatment for the 9 cases in group C ,group D of 9 cases accepted bilateral drug treatment combined with vestibular rehabilitation therapy .Group A and C were the control groups while B and D were experimental groups .All cases were retrospectively analyzed to compare vestibu‐lar rehabilitation therapy combined with drugs treatment with the simple drug treatment group .Results The effects in all patients were better after treatment .The VSI scores four weeks after treatment in four groups were signifi‐cantly lower than that of before treatment .The BBS score after treatment of experimental groups were significantly higher than those of in the control groups .The Fukuda step experiment effects were better than the control group . All the above comparisons had a statistical significance(P< 0 .01) .Conclusion The clinical efficacy of normative vestibular rehabilitation exercise is satisfactory .

Vestibular Rehabilitation Therapy: Review of Indications, Mechanisms, and Key Exercises

Vestibular rehabilitation therapy (VRT) is an exercise-based treatment program designed to promote vestibular adaptation and substitution. The goals of VRT are 1) to enhance gaze stability, 2) to enhance postural stability, 3) to improve vertigo, and 4) to improve activities of daily living. VRT facilitates vestibular recovery mechanisms: vestibular adaptation, substitution by the other eye-movement systems, substitution by vision, somatosensory cues, other postural strategies, and habituation. The key exercises for VRT are head-eye movements with various body postures and activities, and maintaining balance with a reduced support base with various orientations of the head and trunk, while performing various upper-extremity tasks, repeating the movements provoking vertigo, and exposing patients gradually to various sensory and motor environments. VRT is indicated for any stable but poorly compensated vestibular lesion, regardless of the patient's age, the cause, and symptom duration and intensity. Vestibular suppressants, visual and somatosensory deprivation, immobilization, old age, concurrent central lesions, and long recovery from symptoms, but there is no difference in the final outcome. As long as exercises are performed several times every day, even brief periods of exercise are sufficient to facilitate vestibular recovery. Here the authors review the mechanisms and the key exercises for each of the VRT goals.