Objective: Many papers describe vestibular rehabilitation programmes to reduce vertigo and disequilibrium caused by peripheral vestibular disorders, but few studies have assessed performance on purposeful activities. This study determined if performance on a purposeful activity improves after vestibular rehabilitation exercises, and if the speed of treatment exercises influences performance.Setting: Medical school practice; tertiary care facility.Subjects: Fifty-three patients with chronic vertigo caused by peripheral vestibular weakness.Interventions: Subjects performed vestibular rehabilitation head movement exercises to habituate vertigo, in either slow or rapid movement groups. Main measures: Time to perform a repetitive head movement task and intensity of vertigo elicited by that task, questionnaires about independence in activities of daily living and reported usual intensity of vertigo.Results: Both groups significantly decreased the time to perform the task and the intensity of elicited vertigo. Results were related to improved independence in activities of daily living and to decreased vertigo. Conclusion: Vertigo decreases and speed of head movement improved after a programme of vestibular rehabilitation, regardless of speed of treatment exercises. A simple purposeful activity can be useful to evaluate improvements after vestibular rehabilitation.
Get full access to this article
View all access options for this article.
References
1.
Cohen HS. Specialized knowledge and skills in adult vestibular rehabilitation for occupational therapy practice. Am J Occup Ther2001; 55: 661–665.
2.
Shumway-Cook A, Horak FB. Vestibular rehabilitation: an exercise approach to managing symptoms of vestibular dysfunction. Semin Hearing1989; 10: 196–208.
3.
Cohen H. Vestibular rehabilitation reduces functional disability. Otolaryngol Head Neck Surg1992; 107: 638–643.
4.
Cohen H, Miller LV, Kane-Wineland M, Hatfield CL. Case reports of vestibular rehabilitation with graded occupations. Am J Occup Ther1995; 49: 362–367.
5.
Cohen H, Kane-Wineland M, Miller LV, Hatfield CL. Occupation and visual/vestibular interaction in vestibular rehabilitation. Otolaryngol Head Neck Surg1995; 112: 526–532.
6.
Cohen HS, Gavia JA. A task for assessing vertigo elicited by repetitive head movements. Am J Occup Ther1998; 52: 644–649.
7.
Cohen HS, Kimball KT. Development of the Vestibular Disorders Activities of Daily Living Scale. Arch of Otolaryngol Head Neck Surg2000; 126: 881–887.
8.
Cohen HS, Kimball KT, Adams AD. Application of the Vestibular Disorders Activities of Daily Living Scale. Laryngoscope2000: 1204–1209.
9.
Cohen HS, Kimball KT. Improvements in path integration after vestibular rehabilitation. J Vestib Res2002; 12: 47–51.
10.
Cohen HS, Kimball KT. Increased independence and decreased vertigo after vestibular rehabilitation. Otolaryngol Head Neck Surg2003; 128: 56–66.
11.
Snijders T, Bosker R. Multilevel analysis: an introduction to basic and advanced multilevel modeling. Thousand Oaks, CA: SAGE Publications, 1999.
12.
Cohen HS, Kimball KT, Jenkins HA. Factors affecting recovery after acoustic neuroma resection. Acta Otolaryngol2002; 122: 841–850.
13.
StataCorp. Stata Statistical Software: Release 7.0. College Station, TX: Stata Corporation, 2001.
14.
Woodhouse G, Goldstein H, Rasbash J, Yang M. A user's guide for MLn for Windows (MLwiN). London: Multilevel Models Project, University of London, Institute of Education, 2000.
