Vestibular Rehabilitation in Patients With Vestibular Migraine

Ege University

Status: Completed

Conditions: Migraine Variant; Vestibular Migraine; Vestibular Disorder

Treatments: Behavioral: Vestibular Rehabilitation; Other: Control

Study type: Interventional

Funder types: Other

Identifiers

NCT03417596

VM-Rehab

Details and patient eligibility

About

Abstract: Introduction:

Vestibular migraine(VM) is a disease that manifests with episodic vertigo attacks in patients with or without migraine type headaches, when present accompanying the headaches. Its prevalence was found out as %1 in a study in Germany. It usually involves middle aged women. VM can make a huge impact on quality of life, therefore advances in its diagnosis and management are valuable. While pharmacotherapy that is being used in migraine can be beneficial, vestibular rehabilitation(VR) programmes are predicted to be one of the most important types of treatment in management of VM. This study compares the results of pharmacological management options and vestibular rehabilitation programmes in the context of dizziness, balance problems and headache.

Material and methods:

77 patients with VM were included in study, and 60 of them completed it. While one group took only VR programme, and another took only pharmacological prophylaxis. The third group took a combined therapy, and the groups were consisted of 20 patients. Patients were assessed with caloric tests, audiometric studies, static posturography, Dizziness Handicap Inventory(DHI), and Activities Specific Balance Confidence(ABC) scales. All of the assessments were applied 3 times throughout the study, and the results were compared with relevant statistical tests.

Enrollment: 77 patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• 1-Vestibular Migraine diagnosis according to International Classification of Headache Disorders (3 rd edition-Beta version) 2- No history of vestibular rehabilitation or exercises

Exclusion criteria

• History of psychiatric disorder which might interfere with compliance to study
• Other diagnosis that might possibly cause vestibular disorder(cerebellar disorders, Meniere disease etc)
• Anatomical defects of the inner ear or vestibular system
• Patients who are unable to stand up straight or walk

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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77 participants in 3 patient groups

Vestibular Rehabilitation

Experimental group

Description:

Adaptation Exercises The exercises were performed in horizontal and vertical planes, for a period of one minute each, three times a day. Substitution Exercises Standing dynamic balance exercises: The patient stands and moves without walking. The patient might march in place, step forward or backward, step to the side, step up or down, or turn around. Habituation exercises: These exercises that cause mild to moderate difficulty in daily life was given as an exercise to the patient. These exercises involved movements and positions sufficient to cause mild-to-moderate symptoms during the patient's daily activities Ambulation exercises: Exercises that include walking with head moving towards different sides. The exercise program consisted of one session per week for a period of eight weeks. Each session lasted approximately 30-45 minutes and was conducted in the rehabilitation unit.

Treatment:

Behavioral: Vestibular Rehabilitation

Vestibular Rehabilitation+Pharmacological Therapy

Experimental group

Description:

Same exercises that were applied in first group were also applied to this group. For pharmacological therapy, patients were assessed by a neurologist and appropriate drug options were applied based on patients' needs and features. Propranolol was selected primarily and other prophylactic drugs were used in the case of its' being contraindicated.

Treatment:

Other: Control

Behavioral: Vestibular Rehabilitation

Pharmacological Therapy only

Other group

Description:

Patients were assessed by a neurologist and appropriate drug options were applied based on patients' needs and features. Propranolol was selected primarily and other prophylactic drugs were used in the case of its' being contraindicated.

Treatment:

Other: Control