Purpose: This study was aimed at evaluating the clinical impact of vestibular rehabilitation (VR) in patients with chronic unilateral peripheral vestibular hypofunction, focusing on patient-centered outcomes, including the responder rates, reductions in dizziness severity, and improvement in fall risk.
Methods: A total of 27 patients underwent a four-week VR program consisting of weekly 40-minute physical therapy sessions and home exercises. Outcomes were assessed before and after the intervention using the Dizziness Handicap Inventory (DHI), Activities-Specific Balance Confidence scale (ABC scale), Dynamic Gait Index (DGI), and Functional Gait Assessment (FGA). Responder analysis (rate of improvement in severity levels), severity shift analysis (DHI classification and fall risk), clinically meaningful improvement (DHI improvement by ≥18 points), and fall risk reduction (based on an ABC scale score of <67%, DGI score of <19, and FGA score of <23) were performed.
Results: Significant improvements were observed in the total DHI score, as well as in the scores on the emotional and functional subscales, and in the ABC scale, DGI, and FGA scores (all p < 0.01). The score on the physical subscale of DHI showed no significant improvement (p = 0.065). Among the six patients who were classified as having severe symptoms at the baseline, the symptom severity improved in three patients (50.0%) to the moderate level. Of the 14 patients with moderate symptoms, six (42.9%) showed improvement of the severity to the mild level. Severity shift analysis showed significant reductions in moderate and severe symptoms (p = 0.041). Seven patients (25.9%) showed clinically meaningful improvement of the DHI score. In relation to the effects on the fall risk, 83.3%, 60.0%, 22.2% of patients classified as high-risk based on assessment by the DGI, FGA, and ABC scales transitioned to low risk. The percentage of patients with a high fall risk as classified based on the FGA improved significantly after the intervention (p = 0.041).
Conclusion: VR led to significant improvements in the dizziness severity and fall risk among patients with chronic unilateral vestibular hypofunction. These quantified outcomes may enhance patient comprehension and encourage adherence prior to initiating VR.
