Vestibular rehabilitation: Proven benefits in enhancing balance and reducing dizziness.

Abstract

Background: Vestibular rehabilitation therapy (VRT) is widely utilized to enhance balance and mitigate dizziness in patients with vestibular disorders. However, its overall effectiveness remains to be comprehensively assessed, particularly in the context of variability among studies.

Objectives: This study aimed to address the current need for a systematic evaluation of VRT's efficacy.

Material and methods: A meta-analysis was conducted using the "meta" and "dmetar" R packages to evaluate VRT's efficacy. The analysis included statistical tools, such as Begg's test, Egger's test, Baujat plots, Galbraith plots, and influence analysis. Additionally, heterogeneity and outliers were assessed using generalized scatterplot smoothing (GOSH) diagnostics and clustering methods, including K-means, density-based spatial clustering of applications with noise (DBSCAN) and Gaussian mixture model (GMM).

Results: The meta-analysis examined the impact of VRT on the dizziness handicap inventory (DHI) and Berg balance scale (BBS). For the DHI, VRT resulted in a significant mean improvement of 7.63 points, despite high heterogeneity (I2 = 88%). Similarly, the BBS exhibited significant improvement, with a mean difference (MD) of -2.31 points in the fixed effects model, while the random effects model also suggested improvement, though with greater variability (I2 = 92%). Subgroup analysis identified outliers significantly influencing the results.

Conclusion: We showed that VRT significantly enhanced patient outcomes as measured with both the DHI and BBS. These findings provide strong evidence supporting VRT's effectiveness, though the substantial heterogeneity underscores the need for further research to refine patient selection and intervention protocols. This study advances the understanding of VRT's role in managing vestibular disorders and highlights the importance of addressing variability in future studies.