American Speech-Language-Hearing Association

EBP Compendium: Summary of Systematic Review

The Cochrane Collaboration; Centre for Allied Health Evidence (Australia)
Vestibular Rehabilitation for Unilateral Peripheral Vestibular Dysfunction

Hillier, S. L., & Hollohan, V. (2011).
Cochrane Database of Systematic Reviews(2).

Indicators of Review Quality:

The review addresses a clearly focused question Yes
Criteria for inclusion of studies are provided Yes
Search strategy is described in sufficient detail for replication Yes
Included studies are assessed for study quality Yes
Quality assessments are reproducible Yes

Description: This is a review of randomized controlled trials investigating vestibular rehabilitation (VR) in individuals with unilateral peripheral vestibular dysfunction (UPVD). Populations included individuals with benign paroxysmal positional vertigo (BPPV), Ménière’s disease and acoustic neuromas.

Question(s) Addressed:

What is the, “effectiveness of vestibular rehabilitation in the adult, community dwelling population of people with symptomatic UPVD?” (p. 3).

Population: Adults

Intervention/Assessment: “Interventions described as 'vestibular rehabilitation' that are predominantly exercise and movement-based, excluding specific (passive) repositioning manoeuvres” (p. 3).

Number of Studies Included: 21

Years Included: Through 2007

Findings:

Conclusions:

  • Treatment
    • Vestibular Rehabilitation
      • The authors found “moderate to strong evidence that vestibular rehabilitation (movement, exercise based) is a safe and effective approach for unilateral peripheral vestibular disorders” (p.10). There is moderate evidence for maintenance of improvement.
      • There is some evidence that VR is effective for individuals with acoustic neuroma post-surgery and for individuals with vestibular neuritis.
      • “There is some evidence for the use of vestibular rehabilitation in patients with Ménière’s disease in reducing dizziness” (p. 10).
      • The authors found more evidence for repositioning maneuvers as the initial treatment of BPPV with a “suggestion that VR be incorporated in the long term as a preventative measure” (p. 10).
  • Service Delivery
    • Dosage
      • No conclusions could be drawn regarding frequency, intensity or timing of vestibular rehabilitation due to the heterogeneity of studies. However, the authors indicate that “a minimalist approach of education, demonstration and home exercises may be effective” (p. 10).

Keywords: Balance Disorders, BPPV, Ménière's Disease, Vestibular Rehabilitation

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Added to Compendium: March 2012

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