title: Variables associated with outcome in patients with bilateral vestibular hypofunction: Preliminary study.
abstract: BACKGROUND
  Vestibular rehabilitation (VR) improves symptoms and function in some but not all patients with bilateral vestibular hypofunction (BVH).
  
  
  OBJECTIVE
  The purpose of this retrospective study was to examine change following vestibular rehabilitation and to identify factors associated with rehabilitation outcome in patients with BVH.
  
  
  METHODS
  Data from 69 patients with BVH were analyzed. Factors studied included patient characteristics, subjective complaints and physical function. Outcome measures included symptom intensity, balance confidence, quality of life, gait speed, fall risk, and dynamic visual acuity. Bivariate correlations were used to examine relationships of patient characteristics and baseline measures with outcome measures. One-way ANOVAs were used to compare outcomes in patients with BVH versus unilateral vestibular hypofunction (UVH).
  
  
  RESULTS
  As a group, patients with BVH improved in all outcome measures except disability following a course of vestibular rehabilitation (VR); however, only 38-86% demonstrated a meaningful improvement, depending on the specific outcome measure examined. Several factors measured at baseline - age, DGI score, gait speed and perceived dysequilibrium - were associated with outcomes. For example, greater age was related to higher DVA scores at discharge; lower initial DGI scores were related to higher Disability scores at discharge. Compared to patients with UVH, reported previously [9], a smaller percentage of patients with BVH improve and to a lesser extent.
  
  
  CONCLUSIONS
  Consideration of baseline factors may provide guidance for setting patient goals. Further research is needed determine what factors predict outcome and to develop more effective treatment strategies for those patients who do not improve.
authors.affiliation: Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Herdman
authors.affiliation: James H. Quillen VA Medical Center, Mountain Home, TN, USA.|Department of Physical Therapy, East Tennessee State University, Johnson City, TN, USA.
authors.forename: Courtney D
authors.initials: CD
authors.lastname: Hall
authors.affiliation: Shepherd Center, Atlanta, GA, USA.|Emory University, Atlanta, GA, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Maloney
authors.affiliation: Emory University, Atlanta, GA, USA.|Triage Staffing, Omaha, NE, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Knight
authors.affiliation: Emory University, Atlanta, GA, USA.|Athletico Physical Therapy, Chicago, IL, USA.
authors.forename: Marti
authors.initials: M
authors.lastname: Ebert
authors.affiliation: Emory University, Atlanta, GA, USA.|State Home Health, New Orleans, LA, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Lowe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D004185:Disability Evaluation; D005260:Female; D007839:Functional Laterality; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D004856:Postural Balance; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome; D014717:Vertigo / Q000209:etiology / Q000534:rehabilitation; D015837:Vestibular Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D014724:Vestibular Function Tests
keywords: Vestibular rehabilitation; bilateral vestibular hypofunction; outcomes