Vestibular Rehabilitation Using Dynamic Posturography: Objective and Patient‐Reported Outcomes from a Randomized Trial

Abstract

AbstractObjectiveBalance deficits are common and debilitating. Standard treatments have limitations in addressing symptoms and restoring dynamic balance function. This study compares a rehabilitative computerized dynamic posturography (CDP) protocol, computerized vestibular retraining therapy (CVRT), with a home exercise program (HEP) for patients with objectively confirmed unilateral vestibular deficits (UVDs).Study DesignSingle‐center, randomized, interventional trial, with 1‐sided crossover.SettingA tertiary neurotology clinic.MethodsPatients with UVDs and Dizziness Handicap Inventory (DHI) score >30 were randomized to receive either CVRT or HEP. After completion of treatment, the HEP group was crossed over to CVRT. Outcome measures were the sensory organization test (SOT) and 3 participants reported dizziness disability measures: the DHI, Activity‐Specific Balance Confidence Scale (ABC) scale, and Falls Efficacy Score—International (FES‐I).ResultsWe enrolled 37 patients: 18 participants completed CVRT and 12 completed HEP, 11 of whom completed the crossover. Seven participants withdrew. The CVRT group demonstrated a greater improvement in SOT composite score than the HEP group (P = .04). Both groups demonstrated improvement in participant‐reported measures but there were no differences between groups (DHI: P = .2604; ABC: P = .3627; FES‐I: P = .96). Following crossover to CVRT after HEP, SOT composite (P = .002), DHI (P = .03), and ABC (P = .006) improved compared to HEP alone.ConclusionCVRT and HEP were both associated with improved participant‐reported disability outcomes. CVRT was associated with greater improvement in objective balance than HEP. Adding CVRT after HEP was superior to HEP alone. Multimodal CDP‐based interventions, such as CVRT, should be considered as an adjunct to vestibular physiotherapy for patients with UVD.