Disability and rehabilitation in the dizzy patient

[Guest guest]

Curr Opin Neurol. 2006 Feb;19(1):49-54.

Disability and rehabilitation in the dizzy patient.

Cohen HS.

Bobby R. Alford Department of Otorhinolaryngology - Head and Neck

Surgery, Baylor College of Medicine, Houston, Texas, USA.

PURPOSE OF REVIEW: This review focuses on prospective studies of

vertigo and balance therapy in the past 3 years, including advances

in vertigo-habituation exercises for adults, pediatric intervention,

and virtual reality techniques, and, in more depth, the literature

pertinent to driving motor vehicles.

RECENT FINDINGS: Increased support has been generated for the

efficacy of a minimal, home-based vertigo-habituation program for

adults with peripheral vestibular disorders. Vestibular

rehabilitation has been shown to be associated with improvements in

independence and dynamic visual acuity. Community-based vestibular

rehabilitation has been shown to be efficacious for selected

patients, after careful screening, when trained personnel provide

intervention. Vestibular rehabilitation has been incorporated into

the rehabilitation program for head-injured military personnel who

will be returned to duty, and multifactorial balance rehabilitation

has been shown to be useful for children with hearing and balance

impairments. Virtual reality techniques have made significant

advances, so immersive environments have potential for rehabilitation

for patients with vestibular disorders and for developing training

regimens for astronauts to ameliorate some effects of exposure to

microgravity. Driving skill, in general, is affected by use of

benzodiazepines. For many patients with vestibular impairments

driving is a particularly problematic activity of daily living.

SUMMARY: Progress has been made in studies of acute care, community-

based, and pediatric vestibular rehabilitation. Work on simulator-

based paradigms has moved toward readiness for implementation.

Studies of driving have provided some insight into the problems of

these patients. More work remains to be done on all of these problems.