Physical therapy outcomes for persons with bilateral vestibular loss

Objective: The purpose of the study was to assess the efficacy of physical therapy for patients with bilateral vestibular loss. Study Design. Retrospe ctive case series. Methods: Twenty-four patients with a diagnosis of bilate ral vestibular loss were identified by a retrospective chart review. Thirte en of the 24 patients met the inclusion criteria of having a moderate or gr eater loss of vestibular function bilaterally as rated by an otoneurologist based on the patient's vestibular function tests. These patients were trea ted with a custom-designed physical therapy program for a mean of 4.6 visit s over an average period of 3.8 months. Patients completed the Dizziness Ha ndicap Inventory and the Activities-specific Balance Confidence Scale at in itial evaluation and discharge. Patients were asked to perform the balance and gait tasks of the Dynamic Gait Index, Sensory Organization Test of comp uterized dynamic posturography, and the Timed "Up and Go" test at their fir st and last physical therapy sessions. The number of falls in the previous 4 weeks and the use of an assistive device at initial evaluation and discha rge were reported. Composite score, an overall score of clinical outcome, w as calculated to determine clinically significant changes in physical perfo rmance and subjective information. Results. On a population basis, statisti cally significant improvement was observed after physical therapy for each of the outcome measures including the composite score (P < .05). Clinically significant changes were demonstrated by 33% to 55% of the patients on the various outcome measures. No change was noted in the patients' risk of fal ling, their number of falls, and the use of assistive devices. Conclusion: Many patients with bilateral vestibular loss benefit from an individualized vestibular physical therapy exercise program based on improved physical fu nction and reduced self-perceived levels of handicap.