The effects of vestibular rehabilitation on dizziness and balance problems in patients after traumatic brain injury: a randomized controlled trial

Kleffelgaard, Ingerid; Søberg, Helene Lundgaard; Tamber, Anne-Lise; Bruusgaard, Kari Anette; Pripp, Are Hugo; Sandhaug, Maria; Langhammer, Birgitta

doi:10.1177/0269215518791274

Cited by 74 publications

(142 citation statements)

References 31 publications

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“…30 In a pilot randomized trial, exercise may 31 Patients postmild head injury (concussion) experience both symptomatic and functional improvements after VR. [32][33][34] Others have reported that VR may speed up recovery after concussion. 34 Factors that may affect outcome negatively for patients postconcussion include immediate dizziness, 35 larger changes in gait speed and cadence with dual tasks while walking, 36 anxiety or depression, 37 greater number of symptoms and symptom severity, 38 and the complaint of fogginess.…”

Section: Central Vestibular Disordersmentioning

confidence: 99%

Vestibular Rehabilitation and Factors That Can Affect Outcome

2019

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This review will discuss the developmental, environmental, medical, psychological, visual, and other sensory-related factors that affect recovery after vestibular dysfunction. A general overview of the evidence for vestibular rehabilitation for patients with peripheral and central vestibular disorders is provided. Recent findings suggest that age, physical activity, certain congenital disorders, length of symptoms, musculoskeletal, visual and neuromuscular comorbidities, cognition, sleep, and medications are all factors that influence the effectiveness and outcome of vestibular rehabilitation. Psychological factors that also affect outcome include anxiety, depression, fear of movement, and fear of falling. Recovery in patients with vestibular disorders may be enhanced if the practitioner recognizes and attempts to remediate modifiable factors.

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Section: Central Vestibular Disordersmentioning

confidence: 99%

Vestibular Rehabilitation and Factors That Can Affect Outcome

2019

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“…In this scenario, it is better to randomly assign separate groups for training and placebo, as done by some studies of vestibular therapy in mTBI. 86,87 Eighth, the statistical analyses relied on multiple t tests comparing initial and post-training assessments, without correction for multiple comparisons. For example, there were 8 laboratory-based measures of vergence, and Bonferroni adjustment would set significance at p < 0.006.…”

Section: The Ciuffreda Group's Studies Of 2013 / 2014mentioning

confidence: 99%

Vision Therapy: Ocular Motor Training in Mild Traumatic Brain Injury

Barton

Ranalli

2020

Annals of Neurology

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Vision therapy in the form of ocular motor training is increasingly used to treat visual complaints, particularly in the setting of persistent symptoms after mild traumatic brain injury (mTBI). In this review, we discuss the rationale behind this intervention and the evidence for its utility. Although the efficacy of exercises for primary convergence insufficiency is plausible and supported by data, there is not yet strong evidence of benefit for the post‐traumatic variant. It is not established that abnormalities in fixation, pursuit, and saccades in mTBI are the cause of post‐concussive symptoms, or that these abnormalities arise from ocular motor damage rather than being secondary effects of cognitive problems with attention or executive control. The few studies to date have significant methodological weaknesses. More substantial evidence is required before vision therapy can be accepted as a useful tool in the rehabilitation of patients with brain trauma. ANN NEUROL 2020;88:453–461

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“…The PICOS approach (Patients, Intervention, Control, Outcomes, and Study design) was followed (Liberati et al, 2009). Eight studies met the inclusion criteria (Peters et al, 2014;Damiano et al, 2016;Kleffelgaard et al, 2018;Cuthbert et al, 2014;Straudi et al, 2017;Cuff et al, 2014;Sveistrup et al, 2003;Thornton et al, 2005). A total of 259 patients post-TBI were included in this review, 71 (27.41%) of which were females.…”

Section: Participantsmentioning

confidence: 99%

“…The selected studies used various scales to assess balance ability in patients with TBI. The scales that were used: Berg Balance Scale (BBS) (Peters et al, 2014;Cuthbert et al, 2014), Dynamic Gait Analysis (DGI) (Peters et al, 2014), Limits of Stability-Reaction Time Backwards LOS (RT-B) (Damiano et al, 2016), Motor Control Test (MCT) (Damiano et al, 2016), Balance Error Scoring System (BBES) (Kleffelgaard et al, 2018), Unified Balance Scale (UBS) (Straudi et al, 2017), force platform (Straudi et al, 2017), Self-reported balance scales (Cuff et al, 2014), Community Balance and Mobility Scale (CB&M) (Straudi et al, 2017;Sveistrup et al, 2003), and Activities-specific Balance Confidence Scale (ABC) (Thornton et al, 2005). Outcome measures details was described in Table 3.…”

Section: Outcome Measuresmentioning

confidence: 99%

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Effects of physical therapy interventions on balance ability in people with traumatic brain injury: A systematic review

Alashram

Annino

Raju

et al. 2020

NRE

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BACKGROUND: Balance deficits are common impairments in individuals with post-traumatic brain injury (TBI). Balance deficits can restrict the activities of daily living and productive participation in social life. To date, no systematic reviews have examined the impact of physical therapy intervention on balance post-TBI. OBJECTIVE: To examine the effects of physical therapy interventions on balance impairments in individuals with TBI. METHODS: We systematically searched in PubMed, EMBASE, Scopus, PEDro, MEDLINE, REHABDATA, and Web of Science for randomized controlled trials (RCTs), clinical control trials, and pilot studies that examined the effects of physical therapy interventions on balance deficits in individuals post-TBI. The methodological quality was estimated using the Physiotherapy Evidence Database (PEDro) scale. RESULTS: Eight studies published from 2003 to 2019 were included in this study. A total of 259 TBI participants post-TBI were included in this review, 71 (27.41%) of which were females. The methodological quality of the selected studies ranged from low to high. There were no significant differences between experimental interventions, virtual reality (VR), vestibular rehabilitation therapy (VRT), control group interventions, and other traditional physical therapy interventions. CONCLUSIONS:The evidence about the effects of the physical therapy interventions in improving the balance ability post-TBI was limited. Further randomized controlled trials are strongly warranted to understand the role of physical therapy in patients with TBI who complain about balance deficits.

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The effects of vestibular rehabilitation on dizziness and balance problems in patients after traumatic brain injury: a randomized controlled trial

Abstract: The intervention appeared to speed up recovery for patients with dizziness and balance problems after traumatic brain injury. However, the benefits had dissipated two months after the end of the intervention.

Cited by 74 publications

References 31 publications

Vestibular Rehabilitation and Factors That Can Affect Outcome

Vestibular Rehabilitation and Factors That Can Affect Outcome

Vision Therapy: Ocular Motor Training in Mild Traumatic Brain Injury

Effects of physical therapy interventions on balance ability in people with traumatic brain injury: A systematic review

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