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Evidence summaries

Vestibular Rehabilitation for Unilateral Peripheral Vestibular Dysfunction

Vestibular rehabilitation is effective for patients with unilateral peripheral vestibular dysfunction. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 39 studies with 2441 patients with unilateral peripheral vestibular disorders. Trials addressed the effectiveness of vestibular rehabilitation against control/sham interventions, medical interventions or other forms of vestibular rehabilitation.

Individual and pooled analyses of the primary outcome, frequency of dizziness, showed a statistically significant effect in favour of vestibular rehabilitation over control or no intervention (OR 2.67, 95% CI 1.85 to 3.86; four studies, 565 participants). Secondary outcomes measures related to levels of activity or participation measured, for example, with the Dizziness Handicap Inventory, which also showed a strong trend towards significant differences between the groups (SMD -0.83, 95% CI -1.02 to -0.64). The exception to this was when movement-based vestibular rehabilitation was compared to physical manoeuvres for benign paroxysmal positional vertigo (BPPV), where the latter was shown to be superior in cure rate in the short term (OR 0.19, 95% CI 0.07 to 0.49). There were no reported adverse effects.

    References

    • McDonnell MN, Hillier SL. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev 2015;1():CD005397. [PubMed]

Primary/Secondary Keywords