Personalized Vestibular Rehabilitation in Persistent Postural-Perceptual Dizziness (PPPD), Unilateral and Bilateral...

Area of Science:

• Neurology
• Rehabilitation Medicine
• Audiology

Background:

• Vestibular rehabilitation (VR) is established for unilateral and bilateral vestibular disorders.
• Its efficacy in Persistent Postural-Perceptual Dizziness (PPPD) remains debated.
• This study investigates VR with computerized dynamic posturography (CDP) as a standalone therapy for PPPD.

Purpose of the Study:

• To evaluate the efficacy of VR using CDP in PPPD patients.
• To compare VR outcomes in PPPD with those in unilateral vestibular vestibulopathy (UVP) and bilateral vestibular vestibulopathy (BVP).
• To define VR's role in personalized therapy for different vestibular disorders.

Main Methods:

• 44 patients with UVP (n=19), BVP (n=10), and PPPD (n=15) were assessed.
• Methods included bedside vestibular assessment, VNG, vHIT, CDP, and Dizziness Handicap Inventory (DHI).
• Patients received 5 weekly VR sessions and daily home exercises.

Main Results:

• VR significantly improved quality of life and reduced handicap in UVP and BVP patients (improved DHI and CDP).
• In PPPD patients, VR did not significantly alter CDP results.
• PPPD patients showed improved DHI functional sub-score but not overall DHI score.

Conclusions:

• VR is effective for unilateral and bilateral peripheral vestibulopathies.
• VR with CDP may offer subjective benefits for PPPD patients, improving handicap and daily functioning.
• Limitations include a small sample size and lack of a control group, precluding definitive conclusions for PPPD efficacy.