What is the most effective vestibular rehabilitation technique in patients with unilateral peripheral vestibular disorders?

Abstract

Vestibular rehabilitation has been found to be effective and safe in patients with instability. There is insufficient evidence, however, for distinguishing between the efficacies of different rehabilitation techniques. The objective of this study is to verify whether there are differences between two instrumental vestibular rehabilitation techniques, computerised dynamic posturography (CDP) and optokinetic stimulation (OKN), in order to establish the optimal strategy for each patient. We conducted a prospective, comparative study of the two techniques (CDP and OKN) in patients with instability due to chronic unilateral peripheral vestibular disorder. We randomly included 12 patients in each group, performing the evaluation with the Dizziness Handicap Inventory and the CDP with the sensorial organisation test (SOT), rhythmic weight shift and limits of stability (LOS). We found a statistically significant improvement in both groups in average balance score according to the SOT. In the OKN group, however, improvement was greater in visual preference. The CDP group showed greater benefits in the visual and vestibular input and LOS. Patients with poor vestibular and visual input or with reduced LOS will benefit more from an exercise protocol with CDP. Patients with poor visual preference, however, are ideal candidates for rehabilitation with OKN.