Piatti Diego, De Angelis Sara, Paolocci Gianluca, Minnetti Andrea, Manzari Leonardo, Verdecchia Daniel Hector, Indovina Iole, Tramontano Marco
Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, 00179 Rome, Italy.
Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy.
J Clin Med. 2025 Aug 5;14(15):5524. doi: 10.3390/jcm14155524.
: Persistent Postural-Perceptual Dizziness (PPPD) is a chronic vestibular disorder characterized by dizziness, instability, and visual hypersensitivity. Vestibular Physical Therapy (VPT) is commonly used, but its efficacy remains uncertain due to limited and heterogeneous evidence. : This systematic review and meta-analysis aimed to evaluate the effectiveness of VPT in reducing dizziness and improving balance in individuals with PPPD. : A systematic search of MEDLINE and PEDro was conducted in January 2025. Studies were selected following PRISMA guidelines and included if they assessed VPT interventions in patients diagnosed with PPPD. Risk of bias was assessed using the PEDro scale and the modified Newcastle-Ottawa Scale. The meta-analysis focused on pre- and post-intervention changes in Dizziness Handicap Inventory (DHI) scores using a random-effects model. : Six studies met the inclusion criteria. VPT significantly reduced DHI scores (pooled Hedges' g = 1.60; 95% CI: 0.75-2.45), indicating a moderate to large improvement. Additional outcomes included improvements in postural control (e.g., mini-BESTest and posturography) and psychological well-being (anxiety and depression questionnaires). However, high heterogeneity (I = 92%) was present across studies. : VPT may improve dizziness and balance in PPPD, though evidence is limited. Further high-quality trials with standardized protocols are needed.
持续性姿势-感知性头晕（PPPD）是一种慢性前庭疾病，其特征为头晕、不稳和视觉超敏反应。前庭物理治疗（VPT）是常用的治疗方法，但由于证据有限且存在异质性，其疗效仍不确定。：本系统评价和荟萃分析旨在评估VPT对减轻PPPD患者头晕和改善平衡的有效性。：于2025年1月对MEDLINE和PEDro进行了系统检索。按照PRISMA指南选择研究，纳入那些评估了诊断为PPPD的患者的VPT干预措施的研究。使用PEDro量表和改良的纽卡斯尔-渥太华量表评估偏倚风险。荟萃分析使用随机效应模型关注干预前后头晕残障量表（DHI）评分的变化。：六项研究符合纳入标准。VPT显著降低了DHI评分（合并Hedges' g = 1.60；95%CI：0.75 - 2.45），表明有中度到较大程度的改善。其他结果包括姿势控制（如简短BESTest和姿势描记法）和心理健康（焦虑和抑郁问卷）方面的改善。然而，各研究之间存在高度异质性（I² = 92%）。：VPT可能改善PPPD患者的头晕和平衡，尽管证据有限。需要进一步开展具有标准化方案的高质量试验。
