Physical therapy in unilateral and bilateral vestibular hypofunction

• Main Authors: José Ignacio BENITO-OREJAS, María José AYLAGAS-ANDRÉS, Carmen MARTÍN-MORATINOS, Irene GALLARDO-CHAPARRO, Laura PÉREZ-HICKMAN, Vanesa ALADRO-ABAD, Niria PLAZA-GARCÍA, José María LÓPEZ-FRANCO, Beatriz DÍEZ-RABADÁN, Carmen GARCÍA-FRANCO, Lucía SECO-RODRÍGUEZ, Felipa PANIAGUA-SERRANO, María Elena BUSTELO-SANZ, María Teresa JIMÉNEZ-GARCÍA, Diana ALONSO-TOBALINA, Serán Tamara GARCÍA-SOMOZA, Ana Isabel GÓMEZ-TEJERO, Inés ALONSO-RODRÍGUEZ, María Jesús COLLAZOS-VILLAFÁFILA, Irene GARCÍA-MARTÍNEZ, María Teresa BAZ-HERRERO, Laura Alejandra MARTÍN-GUTIÉRREZ, Cristina MARTÍN-TUDA, Inés Flavia DE LA CAL-GÓMEZ, Ana SÁNCHEZ-MARTÍNEZ
• Format: Article
• Language: Spanish
• Published: Ediciones Universidad de Salamanca 2020-02-01
• Series: Revista ORL
• Subjects: mareo; equilibrio; rehabilitación vestibular; estabilidad de la mirada; estabilidad postural; habituación
• Online Access: https://revistas.usal.es/index.php/2444-7986/article/view/21022

Introduction: The vestibular rehabilitation is an exercise-based method, aiming to maximize central nervous system (CNS) compensation at vestibular nuclear and other CNS levels for vestibular pathology. Vestibular rehabilitation includes exercises to habituate symptoms, exercises to promote vestibular adaptation and substitution, exercises to improve balance and dynamic postural control, and exercises to improve general conditioning. Recent advances in balance and gait training, gaze stability training, habituation training, are discussed in this chapter in the context of unilateral and bilateral vestibular disorders. Method: Narrative review. Results: Exercises are prescribed that address VOR adaptation, habituation, sensory substitution, gait and posture, strengthening, flexibility, and endurance to maximize functioning. Customized exercise programs have been shown to be more effective than providing a patient with a generic exercise program. It is thought that compliance is enhanced with customization and with follow-up visits with a physical therapist. Discussion/ conclusions: VR therapy is effective in improving functional deficits and subjective symptoms resulting from unilateral and bilateral peripheral vestibular hypo function, as well as from central balance disorders. The goals of vestibular rehabilitation are to reduce subjective symptoms, to improve gaze and postural stability (particularly during head movements), and to return the individual to normal activities, including regular physical activity, driving, and work. Clinicians should offer vestibular rehabilitation to persons with impairments and functional limitations related to the vestibular deficit. Vestibular rehabilitation is now considered the standard of care for persons with peripheral vestibular dysfunction.