The effect of self‐management vestibular rehabilitation on persistent postural‐perceptual dizziness

Abstract

ObjectiveTo investigate the effects of self‐management vestibular rehabilitation (VR) on the subjective symptoms of dizziness and postural stability in persistent postural‐perceptual dizziness (PPPD).Study designRetrospective case review.MethodsThe medical records of 30 patients newly diagnosed with PPPD based on the Bárány Society's diagnostic criteria were reviewed. Nineteen patients (4 males and 15 females; age range 27–84 years, mean age ± standard deviation 57.4 ± 14.2 years) who was newly instructed to self‐management VR were included and instructed to perform self‐management VR for 2 months.ResultsOne patient did not visit the outpatient clinic again, and in the remaining 18 patients, 4 (22%) discontinued VR at their own discretion. In the 12 patients who completed 2 months of VR (67%), there was a significant improvement in Niigata PPPD Questionnaire (NPQ) and Dizziness Handicap Inventory (DHI) scores after VR compared to those before VR (p < .05). However, the mean velocity of center of pressure (COP) movement (velocity) and the envelopment area traced by COP movement (area), as well as the Romberg ratio and foam ratio of velocity and area, did not differ significantly after VR when compared to those before VR (p > .05).ConclusionsFor PPPD, self‐management VR improved subjective symptoms of dizziness, but not stability of standing posture. It is necessary to improve patients' adherence to the treatment.Level of evidence4.

Impact and experiences of vestibular disorders and psychological distress: Qualitative findings from patients, family members and healthcare professionals

“…Self‐management interventions were also described as an important therapeutic component. Our findings align with previous studies showing coping strategies can help patients to manage their lifestyle and gain a sense of control over their symptoms (e.g., identifying triggers, having a backup plan for unpredictable attacks) 27,70,71 . Our findings also brought another dimension to this discourse by highlighting barriers to self‐management implementation.…”

“…Our findings align with previous studies showing coping strategies can help patients to manage their lifestyle and gain a sense of control over their symptoms (e.g., identifying triggers, having a backup plan for unpredictable attacks). 27,70,71 Our findings also brought another dimension to this discourse by highlighting barriers to self-management implementation. Family members in our study thought that patients could have difficulties implementing strategies when their symptoms are severe.…”

Navigating unsteady ground: vestibular rehabilitation in postural perceptual positional dizziness: A narrative review

“…Other experiences with self-care management over a period of 2 months have been documented in a retrospective case review [14]. In this study, 67% of patients diagnosed with PPPD, who were instructed to engage in a 2-month selfmanagement vestibular rehabilitation program, successfully completed the program, while 22% chose to discontinue the vestibular rehabilitation program at their own discretion [14].…”

“…In this study, 67% of patients diagnosed with PPPD, who were instructed to engage in a 2-month selfmanagement vestibular rehabilitation program, successfully completed the program, while 22% chose to discontinue the vestibular rehabilitation program at their own discretion [14]. The authors reported that self-management vestibular rehabilitation led to a reduction in Dizziness Handicap Inventory scores and improvements in the Niigata PPPD questionnaire, which assesses subjective symptoms of dizziness [14]. However, this retrospective study indicated that patients who completed the self-care management program showed subjective improvements in dizziness symptoms but did not exhibit enhanced postural stability when objectively measured through posturography [14].…”

“…Other experiences with self-care management over a period of 2 months have been documented in a retrospective case review [14]. In this study, 67% of patients diagnosed with PPPD, who were instructed to engage in a 2-month selfmanagement vestibular rehabilitation program, successfully completed the program, while 22% chose to discontinue the vestibular rehabilitation program at their own discretion [14]. The authors reported that self-management vestibular rehabilitation led to a reduction in Dizziness Handicap Inventory scores and improvements in the Niigata PPPD questionnaire, which assesses subjective symptoms of dizziness [14].…”