Reabilitação vestibular em pacientes com migrânea vestibular: revisão escopo
Data
2023-11-14
Autores
Yabe, Leticia Lie 
Orientadores
Branco-Barreiro, Fátima Cristina Alves
Tipo
Trabalho de conclusão de curso
Título da Revista
ISSN da Revista
Título de Volume
Resumo
RESUMO: A Migrânea Vestibular é caracterizada pela associação de crises vertiginosas e de cefaléia, sendo uma variante da Migrânea e o diagnóstico mais frequente em adultos na Otoneurologia. A reabilitação vestibular (RV) é um programa de exercícios, que tem por objetivo diminuir sintomas vestibulares, por meio da compensação vestibular central. OBJETIVO: Compreender a extensão e o tipo das evidências científicas sobre a reabilitação vestibular em pacientes com diagnóstico de Migrânea Vestibular. MÉTODO:Trata-se de uma Revisão de Escopo, ou seja, um estudo que tem como objetivos principais mapear os principais conceitos, clarificar áreas de pesquisa e identificar lacunas do conhecimento, seguindo uma estrutura metodológica estabelecida. As buscas foram realizadas nas bases de dados: PubMed, LILACS, Web of Science e SCOPUS. A seleção dos artigos foi feita em duas etapas, a primeira relacionada à leitura dos títulos e resumos e a segunda relacionada à leitura na íntegra dos estudos selecionados anteriormente. Foram incluídos estudos com indivíduos maiores de 18 anos, com Migrânea, independente de gênero e nível socioeconômico cultural. Foram elegíveis ensaios clínicos controlados randomizados, não randomizados, série de casos, estudos de caso, estudos de coorte, estudos epidemiológicos e opinião de especialistas. Foram elegíveis estudos de todos os países desde que estejam escritos em português, inglês ou espanhol. RESULTADOS PARCIAIS: Na busca inicial foram encontrados 191 estudos nas bases de dados eletrônicas. Inicialmente foram excluídos 18 artigos duplicados. Em seguida, foi realizada a leitura de títulos e resumos, tendo sido excluídos 167 nessa etapa. Do total, 6 estudos atenderam os critérios de inclusão e foram selecionados para serem incluídos nesta revisão. Todos os estudos utilizaram mais de um método de avaliação dos resultados da reabilitação vestibular, sendo que os mais utilizados foram o Índice de Marcha Dinâmica (Dynamic Gait Index - DGI), o Questionário de Handicap da Tontura (Dizziness Handicap Inventory - DHI) e a Escala ABC (Activities-Specific Balance Confidence Scale). Quanto aos exercícios de Reabilitação Vestibular, três dos seis estudos mencionaram a adoção de protocolo personalizado e quatro dos seis utilizaram exercícios de habituação, de adaptação vestibular e de equilíbrio corporal. A duração da reabilitação vestibular variou de um mês e meio a três anos. Todos os estudos incluídos observaram melhora dos sintomas vestibulares e do equilíbrio corporal na comparação das medidas de resultados pré- e pós-RV. CONCLUSÃO: Não existe consenso sobre os instrumentos utilizados nas medidas dos resultados da reabilitação vestibular, sendo o DHI o mais adotado. Os exercícios de habituação, adaptação e treino de equilíbrio corporal são os mais utilizados. A reabilitação vestibular promove a melhora dos sintomas e do equilíbrio postural.
ABSTRACT: Vestibular Migraine is characterized by the association of vertiginous crises and headache, being a variant of Migraine and the most frequent diagnosis in adults in Otoneurology. Vestibular rehabilitation (VR) is an exercise program, which aims to reduce vestibular symptoms, through central vestibular compensation. OBJECTIVE: to understand the extent and type of scientific evidence on vestibular rehabilitation in patients diagnosed with Vestibular Migraine. METHOD: This is a Scope Review, that is, a study whose main objectives are to map the main concepts, clarify research areas and identify knowledge gaps, following an established methodological structure. The searches were carried out in the following databases: PubMed, LILACS, Web of Science and SCOPUS. The selection of articles was implemented in two stages, the first related to reading the titles and abstracts and the second related to reading the full studies previously selected. Studies with individuals over 18 years of age with Vestibular Migraine, regardless of gender and cultural socioeconomic level were included. Randomized and non-randomized controlled clinical trials, case series, case studies, cohort studies, epidemiological studies and expert opinion were eligible. Studies from all countries were eligible as long as they were written in Portuguese, English or Spanish. RESULTS: In the initial search, 191 studies were found in electronic databases. Initially, 18 duplicate articles were excluded. Titles and abstracts were then read, 167 of which were excluded at this stage. Of the total, 6 attended the inclusion criteria and were selected to be included in this study. All studies used more than one vestibular assessment method, the most used being the Dynamic Gait Index (DGI), the Dizziness Handicap Inventory (DHI) and the ABC Scale (Activities-specific balance confidence scale). Regarding Vestibular Rehabilitation exercises, three of the six studies mentioned the adoption of a personalized protocol and four of the six used habituation, vestibular adaptation and body balance exercises. The duration of vestibular rehabilitation varied from one and a half months to three years. CONCLUSION: There is no consensus on the instruments used to measure the results of vestibular rehabilitation, with the DHI being the most adopted. Habituation, adaptation and body balance training exercises are the most used. Vestibular rehabilitation promotes improvement in symptoms and postural balance.
ABSTRACT: Vestibular Migraine is characterized by the association of vertiginous crises and headache, being a variant of Migraine and the most frequent diagnosis in adults in Otoneurology. Vestibular rehabilitation (VR) is an exercise program, which aims to reduce vestibular symptoms, through central vestibular compensation. OBJECTIVE: to understand the extent and type of scientific evidence on vestibular rehabilitation in patients diagnosed with Vestibular Migraine. METHOD: This is a Scope Review, that is, a study whose main objectives are to map the main concepts, clarify research areas and identify knowledge gaps, following an established methodological structure. The searches were carried out in the following databases: PubMed, LILACS, Web of Science and SCOPUS. The selection of articles was implemented in two stages, the first related to reading the titles and abstracts and the second related to reading the full studies previously selected. Studies with individuals over 18 years of age with Vestibular Migraine, regardless of gender and cultural socioeconomic level were included. Randomized and non-randomized controlled clinical trials, case series, case studies, cohort studies, epidemiological studies and expert opinion were eligible. Studies from all countries were eligible as long as they were written in Portuguese, English or Spanish. RESULTS: In the initial search, 191 studies were found in electronic databases. Initially, 18 duplicate articles were excluded. Titles and abstracts were then read, 167 of which were excluded at this stage. Of the total, 6 attended the inclusion criteria and were selected to be included in this study. All studies used more than one vestibular assessment method, the most used being the Dynamic Gait Index (DGI), the Dizziness Handicap Inventory (DHI) and the ABC Scale (Activities-specific balance confidence scale). Regarding Vestibular Rehabilitation exercises, three of the six studies mentioned the adoption of a personalized protocol and four of the six used habituation, vestibular adaptation and body balance exercises. The duration of vestibular rehabilitation varied from one and a half months to three years. CONCLUSION: There is no consensus on the instruments used to measure the results of vestibular rehabilitation, with the DHI being the most adopted. Habituation, adaptation and body balance training exercises are the most used. Vestibular rehabilitation promotes improvement in symptoms and postural balance.