İdiopatik Vertigo Hastalarında Brandt Daroff ve Bakış Stabilizasyon Egzersizlerinin Etkinliğinin Değerlendirilmesi

Year 2023, Issue: 19, 164 - 177, 29.04.2023

Ali Erman KENT Figen KARABEKİROGLU

https://doi.org/10.38079/igusabder.1186050

Abstract

Amaç: Bu çalışmanın amacı, tanısı konmuş nörolojik ve otolojik hastalığı olmayan, 3 ay ve daha uzun süredir başdönmesi şikayeti olan bireyler için Brandt Daroff ve bakış stabilizasyon egzersizlerinden oluşturulan vestibüler rehabilitasyon ev programının etkinliğinin değerlendirilmesidir.
Yöntem: Çalışmaya baş dönmesi şikayeti olan, otolojik ve nörolojik hastalığı olmayan, 25–45 yaş arası, 13 birey dahil edildi. Baş dönmesinin katılımcıların günlük yaşam aktiviteleri üzerindeki olumsuz etkisi Aktiviteye Özgü Denge Güven Ölçeği (AÖDGÖ) ile değerlendirildi. Kişiye özel vestibüler rehabilitasyon programı, günlük yaşam aktiviteleri sırasında baş dönmesinin artış gösterdiği baş hareketlerinin yönüne göre belirlendi. Brandt-Daroff Egzersizleri ve bakış stabilizasyon egzersizleri ev programı şeklinde verildi. Hastalar 3 hafta sonra ve 3 ay sonra AÖDGÖ ile tekrar değerlendirildi. Sonuçlar karşılaştırıldı.
Bulgular: AÖDGÖ skorlarının sonuçlarına göre 3. hafta ile 3. ay değerlendirmeleri arasındaki fark (p<0,001) ve ilk değerlendirme ile 3. ay değerlendirmeleri arasındaki fark (p=0,014) istatistiksel olarak anlamlı bulundu. İlk değerlendirme ile 3 hafta sonraki değerlendirme skorları arasındaki fark istatistiksel olarak anlamlı değildi (p=0,118).
Sonuç: Uzun süredir baş dönmesi şikayeti olan bireyler için hazırlanacak vestibüler rehabilitasyon egzersizleri ile günlük yaşam aktiviteleri sırasında baş dönmesinin yaratacağı olumsuzluklar azaltılabilir. Bireylerin günlük yaşam aktivitelerinde iyileşme gözlenebilmesi için vestibüler rehabilitasyon egzersizlerini düzenli olarak yapmaları önerilmelidir.

Keywords

Vertigo, vestibüler rehabilitasyon, egzersiz, ev programı

Evaluation of the Efficacy of Vestibular Rehabilitation Home Program Based on Brandt Daroff and Gaze Stabilization Exercises in Patients with Idiopathic Vertigo

Abstract

Aim: The aim of this study is to evaluate the effectiveness of the vestibular rehabilitation home program consisting of Brandt Daroff and gaze stabilization exercises for individuals who do not have a diagnosed neurological and otological disease and have had vertigo for 3 months or more.
Method: Thirteen individuals, aged 25–45 years, who had vertigo, no hearing loss, and no neurological disease was included in the study. The negative effect of vertigo on the participants' activities of daily living was evaluated with the Activity-Specific Balance Confidence Scale (ABC). The individualized vestibular rehabilitation program was determined according to the direction of head movements in which dizziness increased during activities of daily living. Brandt-Daroff Exercises and gaze stabilization exercises were given as a home program as a vestibular rehabilitation program. Patients were re-evaluated 3 weeks later and 3 months later with ABC Scale. The results were compared.
Results: According to ABC Scale results, the difference between the 3rd week and 3rd month evaluations (p<0.001) and the difference between the first evaluation and 3rd month evaluations (p=0.014) were found to be statistically significant. The difference between the first evaluation and the evaluation after 3 weeks was not statistically significant (p=0.118).
Conclusion: Vestibular rehabilitation exercises to be prepared for individuals with long-term complaints of dizziness can reduce the negative effects of vertigo during daily living activities. It should be recommended that individuals do vestibular rehabilitation exercises regularly in order to observe improvement in their daily living activities.

Keywords

Vertigo, vestibular rehabilitation, exercise, home program

References

• Akbaş RN. Vestibüler rehabilitasyonda sanal gerçeklik teknolojisi. İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi. 2021;(15):639-645. doi:10.38079/igusabder.999714.
• Kingma H. Posture, balance and movement: Role of the vestibular system in balance control during stance and movements. Neurophysiol Clin. 2016;46(4-5):238. doi:10.1016/j.neucli.2016.09.005.
• Hall CD, Herdman SJ, Whitney SL, Cass SP, Clendaniel RA, Fife TD. Vestibular rehabilitation for peripheral vestibular hypofunction: An evidence-based clinical practice guideline: from the American Physical Therapy Association Neurology Section. J Neurol Phys Ther. 2016;40(2):124. doi:10.1097/NPT.0000000000000120.
• Kroenke K, Lucas CA, Rosenberg ML, et al. Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. Ann Intern Med. 1992;117(11):898–904.
• Yiğider AP, Ayaz Z. Tek taraflı periferik vestibüler disfonksiyonda vestibüler rehabilitasyon. Prax Otorhinolaryngol. 2018;(6):113-119. doi:10.5606/kbbu.2018.00719.
• Dunlap PM, Holmberg JM, Whitney SL. Vestibular rehabilitation: Advances in peripheral and central vestibular disorders. Curr Opin Neurol. 2019;32(1):137-144. doi: 10.1097/WCO.0000000000000632.
• Lilios A, Chimona T, Nikitas C, Papadakis C, Chatziioannou I, Skoulakis C. The effect of supervision in vestibular rehabilitation in patients with acute or chronic unilateral vestibular dysfunction: A systematic review. Otol Neurotol. 2021;42(10):1422-1431. doi:10.1097/MAO.0000000000003354.
• Jung JY, Kim JS, Chung PS, Woo SH, Rhee CK. Effect of vestibular rehabilitation on dizziness in the elderly. Am J Otolaryngol –Head and Neck Medicine and Surgery. 2009;(30):295-299.
• Powell LE, Myers AM. The activities-specific balance confidence (ABC) scale. J Gerontol A Biol Sci Med Sci. 1995;50(1):28-34. doi:10.1093/gerona/50A.1.M28.
• Ayhan Ç, Büyükturan Ö, Kirdi N, Yakut Y, Güler Ç. The Turkish version of the activities specific balance confidence (ABC) scale: Its cultural adaptation, validation and reliability in older adults. Turk Geriatri Derg. 2014;17(2):157-163.
• Brandt T, Daroff RB. Physical therapy for benign paroxysmal positional vertigo. Arch Otolaryngol. 1980;106(8):484-485. doi:10.1001/archotol.1980.00790320036009.
• Matsugi A, Ueta Y, Oku K, et al. Effect of gaze-stabilization exercises on vestibular function during postural control. Neuroreport. 2017;28(8):439-443. doi:10.1097/WNR.0000000000000776.
• Dal BT, Bumin G, Aksoy S, Günaydın RÖ. Comparison of activity-based home program and cawthorne-cooksey exercises in patients with chronic unilateral peripheral vestibular disorders. Arch Phys Med Rehabil. 2021;102(7):1300-1307. doi:10.1016/j.apmr.2020.12.022.
• Agrawal Y, Carey JP, Della Santina CC, Schubert MC, Minor LB. Disorders of balance and vestibular function in US adults: Data from the national health and nutrition examination survey, 2001-2004. Arch Intern Med. 2009;169(10):938-944. doi:10.1001/archinternmed.2009.66.
• Koo JW, Chang MY, Woo S, Kim S, Cho YS. Prevalence of vestibular dysfunction and associated factors in South Korea. BMJ open. 2015;5(10):8224. doi:10.1136/bmjopen-2015-008224.
• Lawson J, Fitzgerald J, Birchall J, Aldren CP, Kenny RA. Diagnosis of geriatric patients with severe dizziness. J Am Geriatr Soc. 1999;47(1):12–7.
• Navi BB, Kamel H, Shah MP, et al. Rate and predictors of serious neurologic causes of dizziness in the emergency department. Mayo Clin Proc. 2012;87(11):1080–8.
• Güler T. Baş dönmesi ile başvuran hastaların demografik ve etyolojik özelliklerinin retrospektif değerlendirilmesi [Yüksek Lisan Tezi]. Ankara, Türkiye: Başkent Üniversitesi Tıp Fakültesi Nöroloji Anabilim Dalı; 2014.
• Kulcu DG, Yanik B, Boynukalin S, Kurtais Y. Efficacy of a home-based exercise program on benign paroxysmal positional vertigo compared with betahistine. J Otolaryngol Head Neck Surg. 2008;37(3):373-379. doi:10.2310/7070.2008.0063.
• Micarelli A, Viziano A, Augimeri I, Domenico M, Marco A. Three-dimensional head-mounted gaming task procedure maximizes effects of vestibular rehabilitation in unilateral vestibular hypofunction: a randomized controlled pilot trial. Int J Rehabil Res. 2017;40(4):325-332. doi:10.1097/MRR.0000000000000244.
• Norré ME, Beckers A. Comparative study of two types of exercise treatment for paroxysmal positioning vertigo. Adv Otolaryngol. 1988;(42):287-9. doi:10.1159/000416125.
• Amor-Dorado JC, Barreira-Ferna´ndez MP, Gonzalez IA. Particle repositioning maneuver versus brandt-daroff exercise for treatment of unilateral idiopathic BPPV of the posterior semicircular canal. Otol Neurotol. 2012;33(8):1401-1407. doi:10.1097/MAO.0b013e318268d50a.
• Ueta Y, Matsugi A, Oku K, et al. Gaze stabilization exercises derive sensory reweighting of vestibular for postural control. Journal of Physical Therapy Science. 2017;29(9):1494-1496. doi:10.1589/jpts.29.1494.
• Karkos P, Leong SC, Papouliakos SM, Korres SG, Thong JF. Semont's manoeuvre in BPPV: A forgotten technique. Clin Otolaryngol. 2006;31(5):464-465.
• Helminski JO, Janssen I, Kotaspouikis D. Strategies to prevent recurrence of benign paroxysmal positional vertigo. Arch Otolaryngol Head Neck Surg. 2005;131(4):344-348. doi:10.1001/archotol.131.4.344.
• Whitney SL, Wrisley DM, Marchetti GF, Furman MJ. The effect of age on vestibular rehabilitation outcomes. Laryngoscope. 2002;112(10):1785-1790. doi:10.1097/00005537-200210000-00015.