Durable improvement in participant-reported measures of disability and objective posturography after computerized vestibular retraining

Abstract

BACKGROUND: Unilateral vestibular deficits are associated with postural instability and loss of quality of life. Common treatments frequently fail to achieve satisfactory outcomes. OBJECTIVE: To assess the durability of changes in participant-reported disability and objective posturography after computerized vestibular retraining. METHODS: This was a single-group study. Individuals with persistent symptoms of an objectively determined unilateral vestibular deficit completed questionnaires and posturography assessments before and after twelve sessions of computerized retraining, and 4–6 months and 10–12 months after treatment. RESULTS: 13 participants completed the post-treatment assessments; 9 completed the follow up. Mean improvements in perceived disability at 4–6 months after retraining were: DHI 14.3 points (95% confidence interval 4.0 to 24.5), ABC scale 14.9 points (4.3 to 25.6), FES-I 11.6 points (–3.2 to 26.5). The SOT composite score increased by 11.4 points (95% CI 1.9 to 20.9; p = 0.0175) immediately after treatment, 8.9 points (–2.9 to 20.7; p = 0.1528) at 4–6 months, and 10.6 points (2.2 to 19.0; p = 0.0162) after 10–12 months. At the 10–12 month time point, the areas of the functional stability region increased significantly for both endpoint excursion (p = 0.0086) and maximum excursion (p = 0.0025). CONCLUSION: Computerized vestibular retraining was associated with improved participant reported disability and objective measures of postural stability.