Evaluation of quality of life pre- and post-vestibular rehabilitation in patients with benign paroxysmal positional vertigo associated with Meniere's disease

Abstract

Summary Introduction: Vertigo is a symptom that impacts the patients' quality of life and may force them to cease performing activities of daily living. Here, we discuss benign paroxysmal positional vertigo (BPPV) and Meniere's disease (MD), which show exacerbated symptoms when they appear in association. Vestibular rehabilitation (VR) is an effective treatment in reducing vertigo, especially in conjunction with other therapies. Aim: To evaluate the quality of life of patients with BPPV and MD before and after VR. Method: We conducted a descriptive observational qualitative and quantitative case study with 12 patients aged 35 to 86 years. All patients diagnosed with BPPV and MD received treatment in the ENT clinic. The Brazilian DHI questionnaire, which assesses the quality of life with a focus on physical, emotional, and functional aspects, was used for data collection, and was completed by patients before the first session and after the fifth session of VR. Data were tested using the Shapiro-Wilk normality test, followed by Wilcoxon, Friedman, and Spearman correlation tests (p < 0.05). Results: There were significant improvements in scores for all aspects, with median changes ranging from 12 to 0 in the physical, 6 to 1 in the emotional, and 11 to 1 in the functional aspect. There were no correlations between the scores and sample characteristics. Conclusion: VR was an effective method for the treatment of patients with BPPV and MD; it improves quality of life and shows the maximal influence on physical aspect scores, regardless of age or gender.

The impact of dizziness on quality-of-life in the elderly

“…The questionnaire comprises 14 items, 7 for anxiety, and 7 for depression [30]. • The multi-dimensional geriatric assessment (comprehensive geriatric evaluation-CGE) allows to explore the components of subject's welfare, particularly the affective state using specific tools (i.e., Geriatric Depression Scale, Hamilton Rating Scale for Depression, and Zung Self Rating Depression Scale) also allowing an objective assessment of patient's functional abilities through specific tools (i.e., ADL, IADL, and Barthel Index) [18][19][20][21][22][23][24][25][26][27][28][29][30].…”

“…In these cases, QoL has been reported to be more deteriorated when symptoms are more severe or their duration is longer [31]; moreover, vestibular symptoms of Meniere disease have been described as the factors with the greatest impact among QoL perception [32]. In addition, those affected by vestibular schwannoma and benign paroxysmal positional vertigo have been reported to show a lower QoL status perception in respect to non-dizzy subjects of same age [23,25]. We could not retrieve studies that have investigated among QoL status and vestibular neuronitis so far [8,33].…”

“…However, QoL has been then reported to improve in long-term rehabilitative settings [16]. In particular, customized vestibular rehabilitation programs (i.e., vestibular rehabilitation in individuals with peripheral vestibular syndrome of Among dizziness not related to vestibular problems, most authors agree that multidisciplinary medical approach and physiotherapy, during diagnosis and treatment, are also necessary to achieve greater security and adherence to treatment modality and, therefore, to improve QoL perception in those subjects [16,22,23]. Some authors have demonstrated that improvement in QoL status of subjects with undefined dizziness can be obtained after physical rehabilitation that can improve muscle strength and balance.…”

Déficits vestibulares e vertigem posicional paroxí­stica benigna em adultos jovens assintomáticos: um estudo transversal

“…Isso ocorre com a interação entre os sistemas vestibular, visual e proprioceptivo [1]. A alteração de um ou mais desses sistemas, promove um conjunto de sintomas, tais como tonturas e desequilíbrios [2,3]. Em especial, as alterações denominadas de vestibulopatias, que são decorrentes de distúrbios no sistema vestibular periférico e/ou central [4].…”

“…Representa uma entidade clínica comum que é encontrada não só por especialistas em distúrbios neurológicos e de equilíbrio, mas também por otorrinolaringologistas não especializados, neurologistas, ou geriatras e clínicos gerais em cuidados primários ou serviços de emergência, entre muitas outras configurações, na prática clínica de rotina [21]. A VPPB leva a um conjunto de perturbações físicas e emocionais com prejuízos funcionais intensos, comprometendo as atividades profissionais, sociais e domésticas do indivíduo [2,16].…”