Longitudinal modeling using GEE for The effects of vestibular rehabilitation exercises in adults with unilateral vestibular hypo function

Background: Vestibular rehabilitation therapy (VRT) has been suggested as an effective intervention for dizziness due to vestibular dysfunction. This study aimed to determine the effect of VRT exercises on balance function of the adults with unilateral vestibular hupofunction (UVH).Methods: Thirty-one patients (16 Males and 15 Females, mean age: 39.48±10.96) with confirmed unilateral vestibular problems were participated. The VRT program consisted of a habituation and adaptation exercises in combination with gait and balance exercises. The handicapping influences of dizziness was measured using a dizziness handicap inventory (DHI) scale to measure the level of respondent’s performance on physical, emotional, and functional dimensions. Visual analogue scale (VAS) was also conducted to assess the severity of dizziness symptoms. The DHI and VAS scales were carried out pre-intervention and at one-week , two-week , and four-week after the last rehabilitation session. Generalized estimating equations (GEE) regression analyses with robust standard errors were performed to identify potential predictors for the longitudinal alternation in DHI and VAS score per therapy session. The significance level was set at 0.05. Results: An analysis of variance test showed a significant reduction and a consequent improvement in DHI scores after vestibular exercises in all domains: emotional, physical and functional (p < 0.001, GEE Analysis). The mean improvement in the total DHI score was about 15 points after one-week, 24 points after two-week and 15 points after four-week VRT. The mean VAS value was 7.71 ± 0.91 at the beginning of the study and it reduced significantly during the course of the treatment (p<0.001, GEE Analysis).Conclusion: Our study suggests that exercise-based vestibular rehabilitation shows benefits for adult patients with chronic dizziness with regard to improvement in the vertigo symptom scale, fall risk, balance and emotional status.

کلیدواژه ها:

Longitudinal Data ، Generalized Estimating Equation ، Vestibular rehabilitation ، Adult ، Unilateral vestibular hypo function