Therapeutic effect of vestibular rehabilitation by physiotherapist intervention on unilateral peripheral vestibular disorders

As the aging population increases, the number of patients with complaints of dizziness is increasing. Vestibular rehabilitation (VR) therapy (VRT) is reported to be helpful for these patients, especially those with unilateral vestibular dysfunction. In Japan, VRTs are usually performed by physicians. In order to investigate the effectiveness of VRT, we used a team approach that included physicians, PTs, and laboratory technicians who cooperated to deliver VRT. Six patients with refractory dizziness due to a unilateral vestibular disorder were treated with customized VRT for approximately three months. The typical procedure for VR in the clinic consisted of medical examinations, self-reporting of symptoms using a questionnaire (Dizziness Handicap Inventory, [DHI]), a balance test using posturography, walking test (Timed Up and Go Test, [TUG]), and VRT sessions. The tests included a head and eye movement test, caloric test, and head impulse test (HIT). The range of motion in the legs, muscle strength, foot deformity, and wear on the patient's shoes were also investigated by the PT. For VR at home, customized rehabilitation programs for individual patients were created. The program was revised by the PT at the monthly follow-up visits. After three months of VRT, the indexes of the posturography balance test showed improvements on average. In particular, there were significant improvements in the balance test on the rubber foam that was performed with the eyes closed. Most of the DHI scores improved with time, but they were not statistically significant. VRT using the team approach may improve vestibular function and quality of life in patients with intractable dizziness.