Vestibular Compensation PDF Download

ABSTRACT: Background: Vestibular neuritis (VN) is a common unilateral vestibular disorder. VN may result in a decreased or altered function of the vestibular system, called vestibular hypofunction, which results in symptoms of dizziness, nausea, and imbalance. Treatment for vestibular hypofunction has been largely pharmaceutical with minimal improvements in symptoms. Vestibular rehabilitation, with a focus on compensation of the vestibular system, is an alternative form of treatment for patients experiencing these symptoms. Our patient of interest is a 24 year old male veteran with VN and a history of post-traumatic stress disorder, attention deficit disorder and multiple concussions resulting in reduced memory. The purpose of this literature review was to determine if vestibular rehabilitation with an emphasis on vestibular compensation is an effective treatment for relieving symptoms of vestibular hypofunction. Methods: A comprehensive search was performed using the databases: CINAHL, Cochrane, PubMed, and UptoDate. The search strings yielded an initial 333 articles. This manuscript included peer-reviewed articles that evaluated the effects of vestibular compensation exercises on the reduction of symptoms of dizziness, nausea, and imbalance in adults ages 19-44 years. Studies were excluded if they included non-human subjects, were not full text, or used acute manual treatments such as the Epley Maneuver. The articles that met our criteria were critically appraised to assess the validity and quality of the research. Any disagreements were settled by a third researcher. Results: The appraisal process eliminated 3 articles due to threats to internal validity, bias, and lack of subgroup analysis. The 4 remaining articles included one clinical practice guideline and three intervention-based assessments, which were used in formulating the clinical decision. The evidence supported vestibular rehabilitation as a treatment for symptoms of vestibular hypofunction resulting from VN. Discussion/Conclusion: The evidence supported the use of vestibular rehabilitation with a focus on vestibular compensation as a treatment to relieve symptoms of VN, however, the research on the topic is limited. Current literature on the topic have significant validity issues, with varying outcome measures, and small sample sizes. More studies with standardized measures need to be done in order to effectively compare the effects of vestibular compensation exercises on the chronic symptoms of vestibular hypofunction.