Vestibular Rehabilitation Therapy Outcome In Patients with Unilateral Peripheral Vestibular Disorders

Objective:  To study the efficacy of  the  rotational  chair  (RC)  testing versus the self-assessment questionnaire (Dizziness Handicap Inventory = DHI)) in monitoring the vestibular rehabilitation therapy in patients with unilateral  peripheral  vestibular  disorders. 
Study Design:  Prospective Study.  Setting:  Clinical tertiary care vestibular  function  test  centre.
Patients: 20 patients (9 male and 11 females with documented unilateral peripheral vestibular  lesion  evaluated  with  history  taking,  bedside examination,  Electronystagmography  (ENG)  and  rotational  chair  testing tests.  Intervention:  Clinical,  DHI,  Caloric  and  RC  tests,  vestibular rehabilitation  therapy  (VORX1  and  VORX2) 
Materials and  Methods: Two  groups:  control  and  study  groups;  Study  group  was  selected according to the following criteria: Recent onset of vertigo spells (2-10 months prior to the enrolment in this study), documented unilateral caloric weakness.  Patients  suffering  from  Diabetes  Mellitus,  hypertension  and neurological deficits were excluded. DHI which designed to evaluate the patient's functional, physical and emotional status was conducted by the entire study group. Caloric testing was performed with standard bithermal irrigations of 30°C and 44°C for 45 seconds. The rotational chair testing paradigms used  in  this  study  were:  A):  The  Rotational  Sinusoidal Harmonic Acceleration (SHA) Test and; B): The Rotational Velocity Step (RVS) Test. Customized vestibular rehabilitation therapy program in the form of VORX1 and VORX2 was given to 15 patients out of 20 patients. 
Results: In terms of demographic characteristics of the study group (20 patients), the age range was 23 - 54 years, and the gender distribution was 9  males  and  11  females,  the  most  common  cause  of  dizziness  was Vestibular Neuritis (30 %), followed by Ménière's Disease (25 %). DHI demonstrated that most of patients showed moderate to moderatlysevere degree of handicap; furthermore, most  of  patients  showed  moderate handicap as regard functional, physical and emotional status. Caloric test results revealed that all patients had abnormal  caloric  test.  There was insignificant correlation between the rotational chair test findings and the self-assessment questionnaire (DHI) findings, but the DHI showed  a significant  improvement  in  patients  received  vestibular  rehabilitation therapy as regard physical, functional and emotional scores
Conclusion: In summary, Rotational Chair testing is sensitive measure to quantify  the  presence  of  dysequilibrium;  moreover,  vestibular rehabilitation  therapy  is  an  effective  line  of  treatment  in  patients  with peripheral vestibular disorders.