Vestibular rehabilitation in unilateral/bilateral vestibular hypofunction: a systematic review.

Abstract

Objective: The purpose of this systematic review was to investigate whether vestibular rehabilitation (VR) can improve balance, symptoms and quality of life in individuals diagnosed with unilateral or bilateral vestibular hypofunction (VH).

Methods: The methodology used to conduct this systematic review was based on the PRISMA 2020 guidelines. The first step in the methodology was to conduct a thorough literature search to identify all published studies concerning vestibular rehabilitation and bilateral VH. This search resulted in a total of 509 studies found from six different electronic databases including; PubMed, Scopus, Web of Science, Cochrane Library, Embase and Science Direct; however, to be included in the review randomized controlled trials and prospective interventional studies. Each of the randomised controlled trial's risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool.

Results: Of the 509 records identified, eight studies comprising 397 participants met the inclusion criteria. Study populations included both male and female patients with unilateral or bilateral VH, presenting in acute or chronic stages. VR was consistently associated with significant improvements in dizziness severity, balance performance, functional mobility, and quality of life, as assessed using validated outcome measures such as the Dizziness Handicap Inventory, Visual Analog Scale, Timed Up and Go, and Berg Balance Scale. Improvements were observed in both intervention and control groups; however, more pronounced improvements were observed in the intervention groups, particularly in studies utilizing virtual reality-based, head-mounted display-assisted, or gaming-supported vestibular rehabilitation programs. Due to heterogeneity in study design, intervention protocols, and outcome measures, quantitative meta-analysis was not feasible.

Conclusion: The systematic review suggests VR can be of benefit to patients with both unilateral and bilateral VH. Using technology based and/or virtual reality techniques should provide additive benefits over traditional rehabilitation techniques with respect to balance, dizziness severity, and functional outcome measures.