Physical therapy for central vestibular dysfunction.
OBJECTIVE
To determine if vestibular physical therapy (PT) leads to improved functional outcomes in people with central vestibular dysfunction.


METHODS
Retrospective case series.


METHODS
Outpatient PT clinic.


METHODS
Forty-eight patients with central vestibular dysfunction met the criteria for inclusion in this retrospective chart review. The 48 patients were divided into various subgroups including central vestibulopathy, cerebellar dysfunction, stroke, mixed central and peripheral vestibulopathy, and posttraumatic central disorders.


METHODS
Patients were treated with a custom-designed PT program for a mean of 5 visits over an average of 5 months.


METHODS
Patients completed the Activities-Specific Balance Confidence Scale, the Dizziness Handicap Inventory (DHI), the Dynamic Gait Index, the Timed Up & Go test, and the Five Times Sit-to-Stand (FTSTS) Test.


RESULTS
Significant differences were demonstrated between initial evaluation and discharge in each of the assessment measures for the entire group. Post hoc tests were performed to determine if there was a significant difference in any of the assessment measures by diagnosis. Central vestibular diagnostic subgroup was shown to affect pre- to postintervention differences in the functional and disability measures (P< or =.05). With the exception of the FTSTS, effect sizes of change due to PT intervention were greater in those persons with severe disability at baseline as determined by a DHI score of more than 60.


CONCLUSIONS
Patients with central vestibular dysfunctions improved in both subjective and objective measures of balance after PT intervention. Persons with cerebellar dysfunction improved the least.
Brown
Kathryn E
KE
Department of Physical Therapy, School of Health and Rehabilitation Science, University of Pittsburgh, PA 15260, USA.
Whitney
Susan L
SL
Marchetti
Gregory F
GF
Wrisley
Diane M
DM
Furman
Joseph M
JM
D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D002490:Central Nervous System / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities / Q000592:standards* / Q000639:trends; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D015837:Vestibular Diseases / Q000175:diagnosis* / Q000534:rehabilitation*; D014724:Vestibular Function Tests