Effectiveness of vestibular rehabilitation on improving the gait in patients with chronic unilateral vestibular disorder

Abstract

There are few reports in Japan of investigation of the effect of vestibular rehabilitation (VR) by physical therapists (PT). This study was aimed at examining the effectiveness of vestibular rehabilitation therapy (VRT) for patients with unilateral peripheral vestibular disorder. The subjects were nine patients with chronic unilateral peripheral vestibular disorder. PTs provided VR, consisting of eye movement exercises, body balance exercises, walking exercises, daily activity movement exercises, to the subjects once a month. The subjects were instructed to perform one to three sets of customized home exercises a day. For this study, the results of the Timed Up & Go test (TUG), Dynamic Gait Index evaluation (DGI), Functional Gait Assessment (FGA) and Activities-Specific Balance Confidence Scale evaluation (ABC) conducted before the start of the VRT and at one month, two months and three months after the start of VRT were compared. The results revealed a significant difference in the results of the DGI and FGA recorded before the start of the intervention and at three months after the start of the intervention later (p＜0.05 for both). In both the DGI and FGA, the number of subjects below the cutoff value for the risk of falls decreased after the intervention. There were no significant differences in the results of the TUG or ABC recorded before and after the start of the intervention, although the number of subjects falling below the cutoff value for the risk of falls decreased in the ABC. VR might improve the vestibular function and may need to be continued for more than three months. DGI and FGA were useful for the evaluation of patients with chronic unilateral vestibular disorder. TUG was not suitable for the evaluation of patients with chronic unilateral vestibular disorders with advanced walking ability. Further studies are needed on the usefulness of ABC for the evaluation of these patients.