Aquatic physiotherapy for vestibular rehabilitation in patients with unilateral vestibular hypofunction: Exploratory prospective study

2008 ◽  
Vol 18 (2-3) ◽  
pp. 139-146
Author(s):  
Yeda P.L. Gabilan ◽  
Mônica R. Perracini ◽  
Mario S.L. Munhoz ◽  
Fernando F. Gananç
Keyword(s):  
Symptom Onset ◽  
Stability Index ◽  
Vestibular Rehabilitation ◽  
Therapeutic Effects ◽  
Self Perception ◽  
Vestibular Loss ◽  
Tertiary Referral Center ◽  
Vestibular Hypofunction ◽  
Computerized Posturography ◽  
Stability Indexes

Purpose: To explore the effects of aquatic physiotherapy on individuals with unilateral vestibular hypofunction and examine the association of therapeutic effects with age, time since symptom onset and use of antivertigo medication. Study design: Exploratory study. Setting: Tertiary referral center. Patients: Twenty-one patients presenting chronic dizziness with uncompensated unilateral vestibular loss. Intervention: All patients underwent a regimen of 10 sessions of aquatic physiotherapy for vestibular rehabilitation. Main outcome measures: Patient evaluation prior to and following rehabilitation involved the application of the Brazilian version of the Dizziness Handicap Inventory (DHI), dynamic computerized posturography and the self-perception scale of dizziness intensity. Statistical analysis compared average variables prior to and following rehabilitation using the Student t test. Results: Brazilian DHI total scores were lower following rehabilitation (p = 0.001). Posturography revealed a reduction in the variation of body displacement following rehabilitation in the average stability and anterior/posterior stability indexes (p = 0.001) and in the average medial/lateral stability index (p = 0.003). Self-perception of dizziness intensity was lower following rehabilitation (p = 0.001). No association between age, time since symptom onset and use of antivertigo medication and rehabilitation therapeutic effects were found. Conclusion: Unilateral vestibular hypofunction patients undergoing aquatic physiotherapy for vestibular rehabilitation achieved an improvement in quality of life, body balance and self-perception of dizziness intensity, regardless of age, time since symptom onset, and use of antivertigo medication.

Two conditions to fully recover dynamic canal function in unilateral peripheral vestibular hypofunction patients

2021 ◽  
pp. 1-15
Author(s):  
Michel Lacour ◽  
Alain Thiry ◽  
Laurent Tardivet
Keyword(s):  
Crucial Role ◽  
Recovery Process ◽  
Head Impulse Test ◽  
Additional Parameter ◽  
Vestibular Loss ◽  
Horizontal Canal ◽  
Lateral Canal ◽  
Gaze Stability ◽  
Vestibular Hypofunction ◽  
Anterior Canal

BACKGROUND: The crucial role of early vestibular rehabilitation (VR) to recover a dynamic semicircular canal function was recently highlighted in patients with unilateral vestibular hypofunction (UVH). However, wide inter-individual differences were observed, suggesting that parameters other than early rehabilitation are involved. OBJECTIVE: The aim of the study was to determine to what extent the degree of vestibular loss assessed by the angular vestibulo-ocular reflex (aVOR) gain could be an additional parameter interfering with rehabilitation in the recovery process. And to examine whether different VR protocols have the same effectiveness with regard to the aVOR recovery. METHODS: The aVOR gain and the percentage of compensatory saccades were recorded in 81 UVH patients with the passive head impulse test before and after early VR (first two weeks after vertigo onset: N = 43) or late VR (third to sixth week after onset: N = 38) performed twice a week for four weeks. VR was performed either with the unidirectional rotation paradigm or gaze stability exercises. Supplementary outcomes were the dizziness handicap inventory (DHI) score, and the static and dynamic subjective visual vertical. RESULTS: The cluster analysis differentiated two distinct populations of UVH patients with pre-rehab aVOR gain values on the hypofunction side below 0.20 (N = 42) or above 0.20 (N = 39). The mean gain values were respectively 0.07±0.05 and 0.34±0.12 for the lateral canal (p <  0.0001), 0.09±0.06 and 0.44±0.19 for the anterior canal (p <  0.0001). Patients with aVOR gains above 0.20 and early rehab fully recovered dynamic horizontal canal function (0.84±0.14) and showed very few compensatory saccades (18.7% ±20.1%) while those with gains below 0.20 and late rehab did not improve their aVOR gain value (0.16±0.09) and showed compensatory saccades only (82.9% ±23.7%). Similar results were found for the anterior canal function. Recovery of the dynamic function of the lateral canal was found with both VR protocols while it was observed with the gaze stability exercises only for the anterior canal. All the patients reduced their DHI score, normalized their static SVV, and exhibited uncompensated dynamic SVV. CONCLUSIONS: Early rehab is a necessary but not sufficient condition to fully recover dynamic canal function. The degree of vestibular loss plays a crucial role too, and to be effective rehabilitation protocols must be carried out in the plane of the semicircular canals.

Tai Chi and vestibular rehabilitation effects on gaze and whole-body stability

2004 ◽  
Vol 14 (6) ◽  
pp. 467-478 ◽  
Author(s):  
Chris A. McGibbon ◽  
David E. Krebs ◽  
Steven L. Wolf ◽  
Peter M. Wayne ◽  
Donna Moxley Scarborough ◽  
...  
Keyword(s):  
Significant Relationship ◽  
Postural Stability ◽  
Intervention Program ◽  
Tai Chi ◽  
Vestibular Rehabilitation ◽  
Whole Body ◽  
Gaze Control ◽  
Gaze Stability ◽  
Vestibular Hypofunction ◽  
The Relationship

Tai Chi (TC) is a comparatively new intervention for peripheral vestibular hypofunction, which is often treated with vestibular rehabilitation (VR). We compared gaze stability (GZS), whole-body stability (WBS) and footfall stability (FFS) during locomotion among 26 people with vestibulopathy (VSP), randomized into two treatment arms (13 TC and 13 VR). Each intervention program was offered for 10 weeks. GZS improved more for VR than for TC, but WBS (and FFS) improved more for TC than for VR. There was a significant relationship between changes in GZS and WBS for the VR subjects (r = 0.60, p = 0.01), but not for TC subjects. There was a significant relationship between changes in WBS and FFS for both VR (r = 0.65, p < 0.01) and TC (r = 0.58, p = 0.02) groups; the relationship disappeared in the VR but not the TC group when controlling for GZS. These findings suggest that VR and TC both benefit patients with VSP but via differing mechanisms. Moreover, these data are the first to test the assumption that improving gaze control among patients with VSP perforce improves postural stability: it does not. We conclude that GZS is most improved in those who receive VR, but that TC improves WBS and FFS without improving GZS, suggesting patients with VSP can rely on non-gaze related mechanisms to improve postural control.

scholarly journals Voluntary Upper-Extremity Movements in Patients With Unilateral Peripheral Vestibular Hypofunction

2002 ◽  
Vol 82 (3) ◽  
pp. 216-227
Author(s):  
Diane F Borello-France ◽  
Jere D Gallagher ◽  
Joseph M Furman ◽  
Mark S Redfern ◽  
George E Carvell
Keyword(s):  
Reaction Time ◽  
Choice Reaction Time ◽  
Arm Movements ◽  
Arm Movement ◽  
Upper Body ◽  
Body Segment ◽  
Motor Impairments ◽  
Vestibular Loss ◽  
Head Velocity ◽  
Vestibular Hypofunction

Abstract Background and Purpose. People with peripheral vestibular pathology demonstrate motor impairments when responding and adapting to postural platform perturbations and during performance of sit-to-stand and locomotor tasks. This study investigated the influence of unilateral peripheral vestibular hypofunction on voluntary arm movement. Subjects and Methods. Subjects without known neurological impairments and subjects with vestibular impairments performed 3 voluntary arm movements: an overhead reach to a target, a sideward reach to a target, and a forward flexion movement through 90 degrees. Subjects performed these tasks under precued and choice reaction time conditions. During all tasks, body segment motion was measured. Head velocity measurements were calculated for the side task only. Results. Subjects with vestibular loss restricted upper body segment motion within the frontal and transverse planes for the 90-degree and overhead tasks. Average angular head velocity was lower for the group with vestibular hypofunction. Task uncertainty (the introduction of a choice reaction time paradigm) differentially influenced the groups regarding head velocity at target acquisition. Discussion and Conclusion. Individuals with vestibular loss altered their performance of voluntary arm movements. Such alterations may have served to minimize the functional consequences of gaze instability.

scholarly journals LIMITATIONS OF VESTIBULAR REHABILITATION THERAPY USING DYNAMIC COMPUTERIZED POSTUROGRAPHY IN PATIENTS WITH CENTRAL VESTIBULAR SYNDROME

2015 ◽  
Vol 14 (3) ◽  
pp. 140-144
Author(s):  
Anamaria Andreia Ulmeanu ◽  
◽  
Andreea Didilescu ◽  
Raluca Enache ◽  
Gabriela Musat ◽  
...  
Keyword(s):  
Postural Stability ◽  
Maximum Amplitude ◽  
Vestibular Rehabilitation ◽  
Rehabilitation Program ◽  
Time Interval ◽  
Dynamic Posturography ◽  
Computerized Posturography ◽  
Risk Of Falls ◽  
Anterior Posterior

Objectives. To evaluate the importance of computerized dynamic posturography in vestibular rehabilitation (VR) of patients with central vestibular syndrome. Methods. The study included 30 patients with central vestibular syndrome with mean age (± SD) = 72.96 ± 11.97 which benefited from VR on a posturography platform between 2012-2014. All patients were evaluated using sensory integration tests. The parameters studied were: Romberg coefficient, statokinesigram (SKG), maximum amplitude of the degree of deviation in anterior-posterior and medial-lateral planes, SKG and the time interval of the rehabilitation program. Results. All of the analyzed parameters showed statistically significant results (p <0.05). The anterior-posterior and medio-lateral balance improved significantly at the end of the vestibular rehabilitation program and the parameters decreased to values close to normal. Conclusions. For patients with central vestibular syndrome, the vestibular rehabilitation improves postural stability and quality of life by reducing the risk of falls.

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