Karla J Thompson1, Jay C Goetting1, Jeffrey P Staab2, Neil T Shepard3. 1. Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA. 2. Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA. 3. Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, USA.
Abstract
BACKGROUND: Persistent postural-perceptual dizziness (PPPD) (formerly chronic subjective dizziness) may be treated using the habituation form of vestibular and balance rehabilitation therapy (VBRT), but therapeutic outcomes have not been formally investigated. OBJECTIVE: This pilot study gathered the first data on the efficacy of VBRT for individuals with well-characterized PPPD alone or PPPD plus neurotologic comorbidities (vestibular migraine or compensated vestibular deficits). METHODS: Twenty-six participants were surveyed by telephone an average of 27.5 months after receiving education about PPPD and instructions for home-based VBRT programs. Participants were queried about exercise compliance, perceived benefits of therapy, degree of visual or motion sensitivity remaining, disability level, and other interventions. RESULTS: Twenty-two of 26 participants found physical therapy consultation helpful. Fourteen found VBRT exercises beneficial, including 8 of 12 who had PPPD alone and 6 of 14 who had PPPD with co-morbidities. Of the 14 participants who found VBRT helpful, 7 obtained relief of sensitivity to head/body motion, 5 relief of sensitivity to visual stimuli, and 4 complete remission. Comparable numbers for the 12 participants who found VBRT not helpful were 1 (head/body motion), 3 (visual stimuli), and 0 (remission). CONCLUSIONS: This pilot study offers the first data supporting the habituation form of VBRT for treatment of PPPD.
BACKGROUND: Persistent postural-perceptual dizziness (PPPD) (formerly chronic subjective dizziness) may be treated using the habituation form of vestibular and balance rehabilitation therapy (VBRT), but therapeutic outcomes have not been formally investigated. OBJECTIVE: This pilot study gathered the first data on the efficacy of VBRT for individuals with well-characterized PPPD alone or PPPD plus neurotologic comorbidities (vestibular migraine or compensated vestibular deficits). METHODS: Twenty-six participants were surveyed by telephone an average of 27.5 months after receiving education about PPPD and instructions for home-based VBRT programs. Participants were queried about exercise compliance, perceived benefits of therapy, degree of visual or motion sensitivity remaining, disability level, and other interventions. RESULTS: Twenty-two of 26 participants found physical therapy consultation helpful. Fourteen found VBRT exercises beneficial, including 8 of 12 who had PPPD alone and 6 of 14 who had PPPD with co-morbidities. Of the 14 participants who found VBRT helpful, 7 obtained relief of sensitivity to head/body motion, 5 relief of sensitivity to visual stimuli, and 4 complete remission. Comparable numbers for the 12 participants who found VBRT not helpful were 1 (head/body motion), 3 (visual stimuli), and 0 (remission). CONCLUSIONS: This pilot study offers the first data supporting the habituation form of VBRT for treatment of PPPD.
Authors: Angelique Van Ombergen; Astrid J Lubeck; Vincent Van Rompaey; Leen K Maes; John F Stins; Paul H Van de Heyning; Floris L Wuyts; Jelte E Bos Journal: PLoS One Date: 2016-04-29 Impact factor: 3.240
Authors: R E Roberts; H Ahmad; Q Arshad; M Patel; D Dima; R Leech; B M Seemungal; D J Sharp; A M Bronstein Journal: Brain Struct Funct Date: 2016-12-10 Impact factor: 3.270