Outcome analysis of individualized vestibular rehabilitation protocols

Objective: To determine the outcome of vestibular rehabilitation protocols in subjects with peripheral vestibular disorders compared with normal and a bnormal control subjects. Study Design: Prospective study using repeated measure, matched control des ign. Subjects were solicited consecutively according to these criteria: ves tibular disorder subjects who had abnormal results of computerized dynamic posturography (CDP) sensory organization tests (SOTs) 5 and 6 and underwent rehabilitation; vestibular disorder subjects who had abnormal results of S OTs 5 and 6 and did not undergo rehabilitation; and normal subjects (normal SOTs). Setting: Tertiary neurotology clinic. Subjects: Men and women over age 18 with chronic vestibular disorders and c hief complaints of unsteadiness, imbalance, and/or motion intolerance, and normal subjects. Interventions: Pre- and post-rehabilitation assessment included CDP, vestib ular disability, and activities of daily living questionnaires. Individuali zed rehabilitation plans were designed and implemented to address the subje ct's specific complaints and functional deficits. Supervised sessions were held at weekly intervals, and self-administered programs were devised for d aily home use. Main Outcome Measures: CDP composite and SOT scores, number of falls on CDP , and self-assessment questionnaire results. Results: Subjects who underwent rehabilitation (Group A) showed statistical ly significant improvements in SOTs, overall composite score, and reduction in falls compared with abnormal (Group B) control groups. Group A's perfor mances after rehabilitation were not significantly different from those of normal subjects (Group C) in SOTs 3 through 6, and close to normal on SOTs 1 and 2. Subjects in Group A also reported statistically significant sympto matic improvement. Conclusions: Outcome measures of vestibular protocol physical therapy confi rmed objective and subjective improvement in subjects with chronic peripher al vestibular disorders. These findings support results reported by other i nvestigators.