Structured habituation training for movement provoked vertigo after severe traumatic brain injury: a single-case...

The purpose of this study was to evaluate the effect of structured habituation training (HT) for movement provoked vertigo (PV) secondary to unilateral peripheral hypofunction in a 16 year old patient who had sustained a severe TBI. Treatment of PV with severe TBI patients can be quite different from other patients with vestibular deficits because of the physiological, behavioural and cognitive sequelae of brain trauma. A single-subject experimental paradigm using an ABA protocol was used to assess efficacy of HT. The data were submitted to C statistic analysis. The transformed data were submitted to combined visual and statistical analysis by the celeration line with a directional one-tailed test and the two-standard deviation band method. Significant change in duration from sitting to supine without triggering vertigo was found between baseline phase (A) and structured HT phase (B) and was maintained for 1 month after the end of treatment. This single-case experiment demonstrates successful structured HT for PV for a 16 year old severe TBI patient. Important clinical decisions (time of introduction of treatment, type of activity, pacing, frequency, intensity, repetition, support and education) necessary to achieve optimal resolution of PV with HT in severe TBI patients are discussed.