Im Yeon Hee, Lee Hyun Jin, Jeon Eun-Ju
Department of Otorhinolaryngology-Head and Neck Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea.
Front Neurol. 2025 Feb 5;16:1538989. doi: 10.3389/fneur.2025.1538989. eCollection 2025.
Customized vestibular rehabilitation therapy (CVRT) is an effective treatment approach for various vestibular disorders. However, low adherence significantly limits its efficacy, and factors influencing adherence remain underexplored. This study aimed to identify factors affecting adherence to CVRT across major vestibulopathy categories, including acute unilateral vestibular hypofunction (AUVH), chronic unilateral vestibular hypofunction (CUVH), and bilateral vestibular hypofunction (BVH).
A retrospective analysis of 90 patients who were prescribed four sessions of CVRT and underwent the therapy was conducted. Patients were classified as adherent (≥3 sessions) or non-adherent (≤2 sessions). Demographic characteristics, baseline questionnaire scores, and vestibular function test (VFT) results were compared. Change in questionnaire scores and VFT results before and after CVRT, as well as mid-treatment follow-up questionnaire scores were analyzed.
Adherence rates were highest in CUVH (86.7%) and lowest in BVH (46.2%). Among patients with AUVH, poor functional reach test scores were significantly associated with lower adherence ( = 0.045). In the CUVH category, patients with mild dizziness in the initial questionnaire were non-adherent ( = 0.019). CVRT improved subjective dizziness symptoms and VFT parameters, with the greatest gains observed in AUVH. However, no significant differences in symptom improvement were found between adherent and non-adherent patients. Patients whose symptoms improved rapidly to a mild degree after starting the CVRT were more likely to be non-adherent, with this tendency being especially pronounced in those with AUVH.
Adherence to CVRT varies by vestibulopathy category and is influenced by baseline symptom severity. Tailoring CVRT strategies based on individual clinical profiles may enhance adherence and optimize therapeutic outcomes.
定制化前庭康复治疗（CVRT）是治疗各种前庭疾病的有效方法。然而，依从性低显著限制了其疗效，且影响依从性的因素仍未得到充分研究。本研究旨在确定影响各类主要前庭病变患者CVRT依从性的因素，包括急性单侧前庭功能减退（AUVH）、慢性单侧前庭功能减退（CUVH）和双侧前庭功能减退（BVH）。
对90例接受4次CVRT治疗的患者进行回顾性分析。将患者分为依从组（≥3次治疗）和非依从组（≤2次治疗）。比较人口统计学特征、基线问卷得分和前庭功能测试（VFT）结果。分析CVRT前后问卷得分和VFT结果的变化，以及治疗中期随访问卷得分。
CUVH患者的依从率最高（86.7%），BVH患者的依从率最低（46.2%）。在AUVH患者中，功能伸展测试得分低与依从性低显著相关（P = 0.045）。在CUVH组中，初始问卷中轻度头晕的患者不依从（P = 0.019）。CVRT改善了主观头晕症状和VFT参数，AUVH患者的改善最为明显。然而，依从组和非依从组患者在症状改善方面没有显著差异。开始CVRT后症状迅速改善至轻度的患者更有可能不依从，这种趋势在AUVH患者中尤为明显。
CVRT的依从性因前庭病变类型而异，并受基线症状严重程度影响。根据个体临床特征调整CVRT策略可能会提高依从性并优化治疗效果。
