Vestibular-Balance Rehabilitation in Patients with Whiplash-Associated Disorders

Abstract

Background and objective: Whiplash associated syndrome is one of the neck disorders that is accompanied by several chronic symptoms. Balancing problems arising from common disorders and dizziness are considered as manifestations that are time-consuming to evaluate and treat. The present study aims to investigate the effect of vestibular-balance rehabilitation using a test that can be used for differential diagnosis of these lesions by comparing dizziness handicap inventory (DHI) and Smooth Pursuit Neck Torsion (SPNT) scores. Method: This was an analytical cross-sectional study with a two-stage design. Forty patients with whiplash-associated disorders were randomly divided into control and intervention groups. SPNT test and DHI evaluation were performed for both groups. For twenty people selected randomly in the intervention group, vestibular-balance rehabilitation was performed during 12 sessions. Finally, the SPNT and DHI tests were performed again to examine and compare the results. Results: The results of this study showed that there was a statistically significant difference between the scores of smooth pursuit neck torsion gain in the SPNT test, the total score of DHI, the functional components of this questionnaire between the control and intervention groups after the implementation of the rehabilitation, and the differences in the physical, functional, and emotional components of the questionnaires of the control and intervention groups after rehabilitation exercises. Conclusion: Vestibular-balance rehabilitation exercises can be an effective treatment for dizziness and improving the quality of life of a person suffering from whiplash-associated disorder, followed by the reduction in dizziness caused by disability.

Post-Traumatic Craniocervical Disorders From a Postural Control Perspective: A Narrative Review

“…About half of post-TBI patients experience dizziness that may last up to 5 years following mTBI [ 25 ]. Same observations have been made in a substantial amount of post-WI patients [ 69 ]. Dizziness following concussion is an important symptom to assess as it stands as a predictor of prolonged recovery [ 77 ].…”

“…Subsequently vestibular disturbances commonly result in vertigo, dizziness, or feeling of imbalance. These conditions are commonly observed after CCT [ 2 25 69 70 ].…”

“…Studies that examined the efficacy of VRT in PCS patients with dizziness documented significant improvement in self-perceived dizziness [ 27 77 ] and balance [ 27 ]. Concerning dizziness following WI, a small cross-sectional study reported a significant improvement in dizziness among the 20 patients that received VRT [ 69 ]. A randomized control trial run on 29 patients presenting WAD also reported a decrease in self-perceived handicap and an increase in postural control among patients performing VRT [ 81 ].…”

Psychophysiological Indicators of Postural Control. Contribution of the Russian Scientific School. Part I

“…The effect of descending cognitive and psychoemotional processes on the perception of vestibular stimulation, i.e., postural control disorders, is also investigated [ 73 ]. The results of these studies demonstrate that the changes in vestibular afferentation are accompanied by the shift in the mental representation of parts of the body [ 74 ], mood [ 75 ], tactile and pain perception [ 70 ].…”