González-García Miriam, Prieto-Sánchez-de-Puerta Lucía, Montilla-Ibáñez María Alharilla, Domínguez-Durán Emilio, Sánchez-Gómez Serafín, Sedeño-Vidal Ana
Department of Otorhinolaryngology, Hospital Universitario Virgen Macarena, Sevilla, Spain.
Department of Otolaryngology, Virgen Macarena University Hospital, Dr Fedriani Av. 3, Seville, E-41009, Spain.
Eur Arch Otorhinolaryngol. 2025 Mar 18. doi: 10.1007/s00405-025-09282-3.
Unilateral vestibular dysfunction leads to significant asymmetry in the horizontal vestibulo-ocular reflex (VOR) during swift head movements. This reflex can be enhanced through rehabilitation exercises and visual-vestibular adaptation techniques. This systematic review aims to evaluate the current evidence on the effectiveness of unidirectional rotation treatments for improving symptoms and function in patients with vestibular disorders.
A systematic review was conducted following the PRISMA 2020 guidelines, using databases such as PubMed, Cochrane Library, EMBASE, and Scopus. Included were experimental studies, randomized controlled trials (RCTs), or pilot RCTs. Meta-analysis was performed based on the findings of these studies.
Among 24 articles identified, three addressed the systematic review's question, two observational studies (one retrospective and one prospective) and a RCT. Studies included data from a total of 200 participants with vestibular disorders (n = 96; 48% males) for the meta-analysis. A meta-analysis, including a subgroup analysis, was conducted to assess the improvement in VOR asymmetry following vestibular rehabilitation. The analysis compared pre- and post-rehabilitation directional preponderance (DP) across three studies. Results showed a significant improvement in VOR asymmetry, with a mean difference of 18.72% in favour of rehabilitation.
Our findings substantiate the efficacy of unilateral vestibular stimulation in reducing asymmetry in the VOR among patients with vestibular dysfunction. This modality represents a promising rehabilitation strategy, significantly enhancing vestibular function and patient outcomes.
单侧前庭功能障碍会导致快速头部运动期间水平前庭眼反射（VOR）出现显著不对称。这种反射可通过康复训练和视前庭适应技术得到增强。本系统评价旨在评估单向旋转治疗对改善前庭疾病患者症状和功能有效性的现有证据。
按照PRISMA 2020指南进行系统评价，使用如PubMed、Cochrane图书馆、EMBASE和Scopus等数据库。纳入的有实验研究、随机对照试验（RCT）或RCT预试验。基于这些研究的结果进行荟萃分析。
在检索到的24篇文章中，3篇涉及本系统评价的问题，2篇观察性研究（1篇回顾性研究和1篇前瞻性研究）以及1项RCT。纳入荟萃分析的研究共包括200例前庭疾病患者的数据（n = 96；48%为男性）。进行了一项包括亚组分析的荟萃分析，以评估前庭康复后VOR不对称性的改善情况。该分析比较了三项研究中康复前后的方向优势（DP）。结果显示VOR不对称性有显著改善，平均差异为18.72%，有利于康复治疗。
我们的研究结果证实了单侧前庭刺激在减少前庭功能障碍患者VOR不对称性方面的疗效。这种治疗方式是一种有前景的康复策略，可显著增强前庭功能和改善患者预后。
