| Abstract [eng] |
Vestibular disorders can lead to significant balance control problems, negatively affecting patients’ quality of life and limiting their daily activities. Incomplete natural vestibular compensation encourages the search for additional interventions that can enhance neuroplastic mechanisms and optimise functional recovery. Vestibular rehabilitation therapy is considered one of the most appropriate approaches for managing balance disorders, and in recent years, increasing attention has been given to non-invasive neuromodulation. Therefore, it is important to evaluate the role of these methods in modern otoneurological practice. Objective. To review vestibular rehabilitation therapy and non-invasive neuromodulation methods, focusing on their clinical applications in the field of otoneurology, based on scientific literature. Methods. A literature review was performed using the PubMed and ScienceDirect databases, as well as the Google Scholar search engine, employing English-language keywords. Priority was given to scientific publications from the past ten years. Results. Vestibular rehabilitation therapy, based on the principles of adaptation, substitution and habituation, is an effective treatment strategy for managing various peripheral and certain central vestibular disorders. However, rehabilitation outcomes depend on individual factors that may complicate the course of functional recovery. Non-invasive neuromodulation techniques, including repetitive transcranial magnetic stimulation, transcranial direct current stimulation, noisy galvanic vestibular stimulation and transcutaneous vagus nerve stimulation, offer the ability to modulate the activity of central or peripheral vestibular structures and enhance central compensation processes in conditions such as chronic vestibular hypofunction, Mal de Débarquement syndrome, persistent postural-perceptual dizziness, bilateral vestibulopathy or vestibular migraine. Nonetheless, the application of these methods continues to be largely experimental, and their integration into clinical practice still lacks high-quality scientific evidence. Conclusions. Vestibular rehabilitation therapy remains the main evidence-based treatment strategy for managing balance disorders. Non-invasive neuromodulation represents a promising adjunctive approach that may promote neuroplasticity, enhance vestibular compensation and improve functional recovery. In the future, the integration of these innovative methods into clinical practice could significantly contribute to the individualised management of balance disorders in the field of otoneurology. |
