Effects of vestibular rehabilitation training combined with anti-vertigo drugs on vertigo and balance function in patients with vestibular neuronitis: a systematic review and meta-analysis

Abstract

ObjectiveTo investigate the effects of vestibular rehabilitation training (VRT) combined with anti-vertigo drugs on vertigo and balance function in patients with vestibular neuronitis (VN).Data sourcesPubMed, EMBASE, The Cochrane Library, Web of Science, CNKI, Wan Fang Data, VIP, and CBM were searched until July 13, 2023.ParticipantsPatients with vestibular neuronitis participated in the study.ResultsTwenty one studies including 1,415 patients were included in this review for meta-analysis. According to the Physiotherapy Evidence Database (PEDro) quality assessment, four studies received high quality (≥seven scores) and 17 studies received moderate quality (six scores). The meta-analysis showed that VRT combined with anti-vertigo drugs significantly reduced the Dizziness Handicap Inventory (DHI) score, the Vestibular Disorders Activities of Daily Living Scale (VADL) score and the Canal Paresis (CP) score, and improved the overall efficiency and the Berg Balance Scale (BBS) score, promoting vestibular evoked myogenic potentials (VEMPs) returned to normal in VN compared to simple anti-vertigo drugs or VRT alone.ConclusionThe results of this meta-analysis demonstrate the efficacy and safety of VRT combined with anti-vertigo drugs in patients with VN. Combined therapy can alleviate vestibular dysfunction such as vertigo and vomiting in patients, improve daily activity ability and balance ability, in addition to VRT has fewer adverse reactions, so it is extremely safe. However, there are shortcomings such as lack of long-term follow-up and different frequency and duration of treatment. Therefore, future randomized controlled trials (RCTs) with larger sample sizes and longer-term observations are needed to verify the effectiveness of VRT in combination with anti-vertigo drugs for VN.Systematic Review Registration: https://www.crd.york.ac.uk/prospero/

Comparison of Halmágyi–Curthoys Head Impulse (Thrust) Test with Romberg’s Test in Detection of Vestibular Hypofunctioning in Vertigo Patients

“…Halmágyi-Curthoys head impulse (thrust) test: Patients underwent systematic head thrust maneuvers to assess the vestibulo-ocular reflex. Any corrective saccades were recorded as indicative of vestibular hypofunctioning [22]. 2.…”

“…Its simplicity, ease of administration, and valuable insights into postural control make it a versatile tool for clinicians. Electronystagmography (ENG) and caloric testing can further evaluate vestibular function and pinpoint the affected side [22].…”

Early vestibular rehabilitation training of peripheral acute vestibular syndrome—a systematic review and meta-analysis

“…To our knowledge, no other systematic review on early VRT for pAVS exists. Other related reviews concern vestibular rehabilitation/vestibular rehabilitation therapy for vestibular neuritis/vestibular neuronitis (9)(10)(11). The lack of knowledge regarding early VRT for pAVS, other than iatrogenic dysfunction and BPPV, raises the following question:…”

“…Regarding cAVS, some evidence supports the effectiveness of early rehabilitation ( 7 ). In pAVS, early rehabilitation is only sporadically described in available research and guidelines ( 8 , 9 ). Hypothetically, vestibular rehabilitation, that is, physical exercise developed to stimulate the vestibular system, may have a significant effect on the outcome of pAVS.…”

Vestibular rehabilitation in complex therapy of vestibular vertigo (consensus of experts)

“…Л е к а р с т в е н н а я т е р а п и я в к о м б и н а ц и и с в е с т и б у л я р н о й р е а б и л и т а ц и е й В одном из недавних метаанализов отмечено, что при вестибулярной реабилитации пациентов с вестибулярным нейронитом эффективно использование лекарственных препаратов: бетагистина, преднизолона и др. [46]. Метаанализ основан на результатах 21 исследования, включившего 1415 пациентов.…”