Physical therapy for migraine-related vestibulopathy and vestibular dysfunction with history of migraine

Objectives/Hypothesis: To assess the efficacy of physical therapy for patients with a diagnosis of migraine-related vestibulopathy (MRV) or vestibular dysfunction with a history of migraine headache. Study Design: Retrospective case series Methods: Thirty-nine patients were identified through a retrospective chart review, 14 with a diagnosis of MRV and 25 with migraine headache. The patients were treated with a custom-designed physical therapy exercise program for a mean of 4.9 visits over a mean duration of 4 months. Patients completed the Dizziness Handicap Inventory (DHI), the Activities-Specific Balance Confidence Scale (ABC), and the Dynamic Gait Index (DGI), reported the number of falls they had experienced in the past 4 weeks, and rated the severity of their dizziness on an analogue scale of 0 to 100 at initial evaluation and at discharge. Results: Significant differences were seen before and after therapy in each of the outcome measures used. The average decrease in DHI score was 12 points (P < .01). ABC scores increased an average of 14 points (P < .01). Subjects increased their DGI scores an average of 4 points (P < .01). The number of patients reporting more than one fall decreased by 78% at discharge. (P < .05). Baseline symptoms of dizziness decreased an average of 11 points (P < .05). Conclusions: Patients with MRV and migraine headache demonstrated improvement in physical performance measures and self-perceived abilities after vestibular physical therapy.