Effects of vestibular rehabilitation in the management of patients with and without vestibular migraine

Abstract Objective: Vestibular Migraine (VM) is the second most common cause in patients with vertigo. Patients with VM complain about vestibular symptoms during a headache attack or during the period between attacks. Vestibular Rehabilitation (VR), an exercised based therapy to treat dizziness and balance dysfunction has been shown to be effective in vestibular diseases. In this study, we aimed to assess the effect of VR for vestibular symptoms and quality of life in VM patients, and to compare the results with patients with vestibular disorders without migraine. Methods: Sixty (60) patients who received VR treatment were divided into two groups: vestibular migraine group (30 patients) and non-migraine vestibular dysfunction group (30 patients). All patients received VR for 18 sessions and the program was completed in 1.5 months. Preand post-treatment Dizziness Handicap Inventory (DHI) scores, Vestibular Disorders Activities of Daily Living Scale (VADL) scores, the frequency of dizziness and headache, and Computerized Dynamic Posturography (CDP) scores were assessed and compared retrospectively. Results: With VR in both the vestibular migraine group and vestibular dysfunction group, DHI score, VADL score, the frequency of dizziness and headache scores significantly impaired. Post-treatment CDP results were higher than pre- treatment results for both patient groups. Conclusion: With VR, a significant improvement was observed in subjective and objective balance assessment measurement. Vestibular Rehabilitation must be considered in patients who do not benefit from medical therapy or have limited benefit. Level of evidence: Level III (evidence obtained from well-designed controlled trials without randomization).

**摘要**

### 研究目的
前庭性偏头痛（Vestibular Migraine, VM）是眩晕患者的第二大常见病因。VM患者可在头痛发作期或发作间期出现前庭症状。前庭康复（Vestibular Rehabilitation, VR）是一种以运动训练为基础的治疗手段，用于改善头晕与平衡功能障碍，现已被证实对前庭疾病具有临床疗效。本研究旨在评估VR对VM患者前庭症状与生活质量的影响，并将其治疗效果与无偏头痛的前庭功能障碍患者进行对比。

### 研究方法
本研究纳入60名接受VR治疗的患者，按诊断分为两组：前庭性偏头痛组（30例）与非偏头痛性前庭功能障碍组（30例）。所有患者均完成18次VR治疗，总疗程为1.5个月。本研究采用回顾性分析方法，对两组患者治疗前后的头晕障碍量表（Dizziness Handicap Inventory, DHI）评分、前庭疾病日常生活活动能力量表（Vestibular Disorders Activities of Daily Living Scale, VADL）评分、头晕与头痛发作频率，以及计算机动态姿势图（Computerized Dynamic Posturography, CDP）评分进行评估与对比。

### 研究结果
前庭性偏头痛组与前庭功能障碍组患者接受VR治疗后，DHI评分、VADL评分、头晕与头痛发作频率均显著改善。两组患者治疗后的CDP评分均高于治疗前。

### 研究结论
VR可显著改善受试者的主观与客观平衡评估指标。对于经药物治疗无效或疗效有限的患者，临床应考虑采用前庭康复治疗。

### 证据等级
III级（证据来源于设计良好的非随机对照试验）。