Alahmari Khalid A, Alshehri Sarah
Program of Physical Therapy, Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia.
Otology and Neurotology, Department of Surgery, College of Medicine, King Khalid University, Abha, Saudi Arabia.
Front Neurol. 2025 Feb 4;16:1524324. doi: 10.3389/fneur.2025.1524324. eCollection 2025.
Persistent Postural-Perceptual Dizziness (PPPD) is a chronic disorder that significantly affects the quality of life (QoL) and daily living. Vestibular rehabilitation therapy (VRT) has emerged as a promising treatment option, yet its effectiveness, particularly in relation to symptom duration, anxiety, and depression, remains underexplored.
This cross-sectional study assessed the effect of VRT on the QoL in 188 PPPD patients, as well as the correlation between the duration of symptoms and dizziness severity and the role of anxiety and depression in the treatment response. QoL was assessed using the EuroQol-5 Dimension (EQ-5D), and dizziness-related handicap using the Dizziness Handicap Inventory (DHI) and anxiety and depression using the Hospital Anxiety and Depression Scale (HADS).
Ninety three patients were included in the analysis. QoL was significantly improved post-VRT with a greater mean EQ-5D score (EQ-5D post-VRT 0.72; EQ-5D pre-VRT 0.61, = 0.032). Age was also found to correlate with increased dizziness severity ( < 0.001), although this was not as strong as the correlation of symptom duration (longer duration correlating with increased dizziness severity; < 0.01), anxiety ( = -0.45, = 0.002) and depression ( = -0.51, < 0.001) (both significantly associated with poorer outcomes especially with reference to VRT) emerging as independent correlates of reduced effectiveness of treatment.
This study revealed the benefit of VRT in patients with PPPD on QoL and indicates the importance of identifying and treating psychological factors to improve the success of treatment for PPPD.
持续性姿势-感知性头晕（PPPD）是一种慢性疾病，严重影响生活质量（QoL）和日常生活。前庭康复治疗（VRT）已成为一种有前景的治疗选择，但其有效性，特别是与症状持续时间、焦虑和抑郁相关的有效性，仍未得到充分研究。
这项横断面研究评估了VRT对188例PPPD患者生活质量的影响，以及症状持续时间与头晕严重程度之间的相关性，以及焦虑和抑郁在治疗反应中的作用。使用欧洲五维健康量表（EQ-5D）评估生活质量，使用头晕残障量表（DHI）评估与头晕相关的残障情况，使用医院焦虑抑郁量表（HADS）评估焦虑和抑郁情况。
93例患者纳入分析。VRT后生活质量显著改善，平均EQ-5D评分更高（VRT后EQ-5D为0.72；VRT前EQ-5D为0.61，P = 0.032）。还发现年龄与头晕严重程度增加相关（P < 0.001），尽管这种相关性不如症状持续时间（持续时间越长，头晕严重程度越高；P < 0.01）、焦虑（P = -0.45，P = 0.002）和抑郁（P = -0.51，P < 0.001）（两者均与较差的治疗结果显著相关，尤其是相对于VRT而言）作为治疗效果降低的独立相关因素。
本研究揭示了VRT对PPPD患者生活质量的益处，并表明识别和治疗心理因素对提高PPPD治疗成功率的重要性。
