Zhonghua Yi Xue Za Zhi. 2025 Oct 21;105(38):3415-3422. doi: 10.3760/cma.j.cn112137-20250505-01110.
ABSTRACT
Objective: To investigate the short-term effects and influencing factors of short-term personalized vestibular rehabilitation (ST-PVR) on acute peripheral vestibular syndrome (APVS). Methods: A randomized controlled study was conducted. APVS patients who visited the Department of Otolaryngology of Henan Provincial People’s Hospital from April 2024 to February 2025 were enrolled and divided into vestibular rehabilitation group and control group using the random number table method. The two groups completed clinical evaluation at 2 and 6 weeks after treatment, including spontaneous nystagmus (NYS), Romberg test (ROM), head shake test (HTT), unilateral weakness (UW) and directional preponderance (DP) in temperature test, video head impulse test (vHIT), and dizziness handicap inventory scale (DHI), visual analogue scale for vertigo (VAS), and activities-specific balance confidence (ABC) scale. The clinical indicators and vestibular rehabilitation grading scores of the two groups at different treatment time points were compared, and a multiple linear regression model was established to analyze the relationship between the baseline variables of the vestibular rehabilitation group and the vestibular rehabilitation grading score at 6 weeks after rehabilitation. Results: A total of 33 patients aged 53 (45, 60) years were included in the vestibular rehabilitation group, including 18 males and 15 females. There were 32 cases aged 52 (47, 57) years in the control group, including 17 males and 15 females. No statistically significant differences of the baseline data between the two groups were detected (all P>0.05). At 2 weeks after treatment, the positive rate of NYS, ROM and HTT, and DP value, DHI and VAS were lower than those in the control group, and the mean gain values of abnormal semicircular canals for vHIT and ABC were higher than those in the control group (all P<0.001). The number of abnormal semicircular canals in the vestibular rehabilitation group was smaller than that in the control group at 6 weeks after treatment (P=0.002), and DHI, ABC and VAS were improved compared with the control group (all P<0.001). The rehabilitation grading score of the vestibular rehabilitation group was higher than that of the control group at 6 weeks after rehabilitation [22 (21, 24) vs 16 (15, 18), P<0.001], and the total proportion of complete recovery and basic rehabilitation was higher than that of the control group [100% (33/33) vs 59.4% (19/32), P<0.001]. Multiple linear regression analysis showed that the vHIT grading score (β=0.996, 95%CI: 0.138-1.853, P=0.024), the average gain value of the affected semicircular canals (β=6.221, 95%CI: 0.870-11.572, P=0.024) and the number of affected semicircular canals (β=-1.172, 95%CI:-1.967—0.377, P=0.005) were the influencing factors of vestibular rehabilitation grading score after 6 weeks of rehabilitation. Conclusions: ST-PVR can quickly improve vertigo symptoms and balance function in APVS patients, and basic recovery can be achieved within 6 weeks. The pre-rehabilitation vHIT result is a weighting factor affecting the vestibular rehabilitation effect, and its dynamic change can be used as a sensitive monitoring index for efficacy.
PMID:41139622 | DOI:10.3760/cma.j.cn112137-20250505-01110
