A Speed-based Approach to Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: A Retrospective Chart Review

BACKGROUND: Current vestibular rehabilitation for peripheral vestibular hypofunction is an exercise-based approach that improves symptoms and function in most, but not all patients, and includes gaze stabilization exercises focused on duration of head movement. One factor that may impact rehabilitation outcomes is the speed of head movement during gaze stability exercises. OBJECTIVE: Examine outcomes of modified VOR X1 exercises that emphasize a speed-based approach for gaze stabilization while omitting substitution and habituation exercises. Balance training focused on postural realignment and hip strategy performance during altered visual and somatosensory inputs. METHODS: A retrospective chart review of 159 patients with vestibular deficits was performed and five outcome measures were analyzed. RESULTS: All outcomes – self-report dizziness and balance function, dynamic gait index, modified clinical test of sensory interaction and balance, and clinical dynamic visual acuity improved significantly and approached or achieved normal scores. CONCLUSIONS: The combination of modified VOR X1 gaze stability exercises, wherein patients achieved high-velocity head movement (240°/s) during short exercise bouts, with “forced use” gait and balance exercises for postural realignment and hip strategy recruitment, achieved 93–99% of normal scores for all five outcomes. These results compare favorably to the outcomes for current VR techniques and warrant further investigation