Vestibular rehabilitation in patients with stroke: A comprehensive review of past and current evidence.

Abstract

In 2016, the American Physical Therapy Association Neurology Section published clinical practice guidelines titled "Vestibular Rehabilitation (VR) for Peripheral Vestibular Hypofunction." These guidelines recommend that physicians should provide VR to individuals with peripheral vestibular hypofunction, emphasizing its importance in managing dysfunctions of the vestibular system. Previous systematic reviews or studies on vestibular function have concluded that VR has positive effects on central vestibular disorders. More recently, a systematic review has found that there are positive effects of VR on ambulatory performance in stroke patients. Evidence is consistently being added regarding the positive impact of VR in patients with a history of stroke who are currently living with dizziness, balance, and gait impairments. However, there are still many unanswered questions in this area. Most studies lack complementary quantitative vestibular function testing and uniform standards for the timing and frequency of the VR. Furthermore, the methods of VR are carried out in a general fashion without catering to the individual, resulting in a lack of understanding of the mechanisms of various VR approaches. In future, much work needs to be done to solve these questions. The objective of this review is to investigate and validate the impact of VR on stroke patients while assessing the associated methodologies for determining its effectiveness. In particular, this review aims to offer a thorough evaluation of the advantages and drawbacks of employing VR in stroke rehabilitation.