The Efficacy of Vestibular Rehabilitation Therapy for Mild Traumatic Brain Injury: A Systematic Review and Meta-analysis

被引:5
作者
Aljabri, Ammar [1 ,2 ]
Halawani, Alhussain [1 ,2 ]
Ashqar, Alaa [1 ,2 ]
Alageely, Omar [1 ,2 ]
Alhazzani, Adel [3 ,4 ]
机构
[1] King Saud Bin Abdulaziz Univ Hlth Sci, Coll Med, Jeddah, Saudi Arabia
[2] King Abdullah Int Med Res Ctr, Jeddah, Saudi Arabia
[3] King Faisal Specialist Hosp & Res Ctr, Neurosci Ctr, Riyadh, Saudi Arabia
[4] King Faisal Specialist Hosp & Res Ctr, Neurosci Ctr, Cerebrovasc IPU, Riyadh 11211, Saudi Arabia
关键词
brain concussion; postconcussion syndrome; traumatic brain injury; vestibular rehabilitation; SPORTS-RELATED CONCUSSION; HIGH-SCHOOL; DIZZINESS; SYMPTOMS; IMPROVEMENT; PLAY;
D O I
10.1097/HTR.0000000000000882
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective:Mild traumatic brain injury (mTBI) or concussion is a common yet undermanaged and underreported condition. This systematic review and meta-analysis aim to determine the efficacy of vestibular rehabilitation therapy (VRT) as a treatment option for mTBI. Method:This review and meta-analysis was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. It included randomized controlled trials and pre-VRT/post-VRT retrospective chart reviews. Records meeting the inclusion criteria were extracted from the following databases: MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL). Results:Eight articles met the inclusion criteria, from which 6 randomized controlled trials were included in the meta-analysis. VRT demonstrated significant improvement in decreasing perceived dizziness at the end of the intervention program as shown by Dizziness Handicap Inventory (DHI) scores (standardized mean difference [SMD] = -0.33, 95% confidence interval [CI]: -0.62 to -0.03, P = .03, I2 = 0%). However, no significant reduction in DHI was evident after 2 months of follow-up (SMD = 0.15, 95% CI: -0.23 to 0.52, P = .44, I2 = 0%). Quantitative analysis also depicted significant reduction in both Vestibular/Ocular Motor Screening (SMD = -0.40, 95% CI: -0.60 to -0.20, P < .0001, I2 = 0%) and Post-Concussion Symptom Scale (SMD= -0.39, 95% CI: -0.71 to -0.07, P = .02, I2 = 0%) following the intervention. Finally, there was no significant difference between intervention groups on Balance Error Scoring System scores (SMD = -31, 95% CI: -0.71 to 0.10, P = .14, I2 = 0%) and return to sport/function (95% CI: 0.32-30.80, P = .32, I2 = 82%). Conclusions:Current evidence on the efficacy of VRT for mTBI is limited. This review and analysis provides evidence that supports the role of VRT in improving perceived symptoms following concussion. Although findings from this analysis suggest positive effects of VRT on included outcomes, the low certainty of evidence limits the conclusions drawn from this study. There is still a need for high-quality trials evaluating the benefit of VRT using a standardized approach.PROSPERO registration number: CRD42022342473. Conclusions:Current evidence on the efficacy of VRT for mTBI is limited. This review and analysis provides evidence that supports the role of VRT in improving perceived symptoms following concussion. Although findings from this analysis suggest positive effects of VRT on included outcomes, the low certainty of evidence limits the conclusions drawn from this study. There is still a need for high-quality trials evaluating the benefit of VRT using a standardized approach.PROSPERO registration number: CRD42022342473.
引用
收藏
页码:E59 / E69
页数:11
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