The Association Between Physical Activity and Chronic Symptoms After a Unilateral Vestibular Deafferentation: Narrative Review

Objective: Most symptoms following acute unilateral vestibular deafferentation are expected to resolve spontaneously due to central vestibular compensation, yet 29%-66% of unilateral vestibular deafferentation patients develop chronic symptoms. This review investigates the influence of the level of therapeutic physical activity on the outcomes of chronic unilateral vestibular deafferentation patients. Methods: PubMed, Web of Science, and Scopus were systematically searched on May 5, 2022, for studies investigating the association between physical activity and chronic symptoms in unilateral vestibular deafferentation patients. Results: Eight studies met the eligibility criteria and were analyzed. Three cross-sectional studies objectified the level of physical activity and revealed a lower level of physical activity in unilateral vestibular deafferentation patients compared to healthy controls. Five interventional studies investigated the effect of a physical activity intervention on dizziness and balance performance. Interventions were categorized as: (1) movement sessions (Tai Chi, Lian Gong, and aquatic physiotherapy) and (2) technology-assisted physical activity using a balance platform. After the intervention, significant improvements were found in perceived health status, dizziness, or balance performance whereby 2 studies showed strong effect sizes. Furthermore, the effects of physical activity interventions were comparable to vestibular rehabilitation. Conclusion: Unilateral vestibular deafferentation patients show a reduced physical activity level despite, and in contrast to, the advice to remain physically active. Additionally, an association was found between the lack of physical activity and chronic symptoms. Measuring physical activity might be useful to determine patient compliance concerning physical activity prescriptions and thus enable timely intervention and guidance when needed.