Vestibular rehabilitation for patients with agoraphobia and vestibular dysfunction - A pilot study

This study examined whether physical therapy with vestibular rehabilitation exercises would benefit patients with agoraphobia and vestibular dysfuncti on. Nine patients went through a 2-week no-treatment baseline phase, a 4-we ek behavioral treatment phase focusing on self-directed exposure, and an 8- 12-week vestibular rehabilitation phase (weekly sessions). On the main outc ome measure, clinical global impressions (CGI) ratings of severity, behavio ral treatment was accompanied by a reduction in severity (effect size d=0.8 ; P < .10). On the supplementary measures, the Hamilton Anxiety Scale (Hami lton-A) and the Chambless Mobility Inventory (Mi), no significant improveme nts were noted. After vestibular rehabilitation therapy, further improvemen t occurred in CGI severity (d=0.65; two-tailed P < .10), and significant im provements occurred in the supplementary measures. The physical therapist i dentified motion-induced dizziness and disturbances in balance in most pati ents. These improved with rehabilitation. Although the results can be attri buted to other explanations, they are not inconsistent with the hypothesis that vestibular dysfunction maintains agoraphobic symptoms in some patients . (C) 2001 Elsevier Science Inc. All rights reserved.