Effectiveness of vestibular rehabilitation in people with vestibular migraine. The primary care for VM is medicine and includes symptomatic relief and prophylactic treatment (Xxxxxxxxx Xxxxxxxxx et al., 2015) and alternative medicines (Xxxxxxxxx and Xxxxxxx, 2017). People are also, advised for lifestyle modifications (e.g., food, sleep, exercise, controlling/treatment for distressing symptoms) (Xxxxxxx et al., 2012; Xxx et al., 2019; Xxxx et al., 2020). Despite the above treatments, some people with VM may still present with complaints of vestibular symptoms such as dizziness, vertigo, and unsteadiness (Xxxxxx et al., 2013; Xxxxxxxx et al., 2013; Xxxxxxxxx and Xxxxxxx, 2017). There is a growing research evidence supporting the use of VRT in people with VM (Xxxxxxxxx and Xxxxxxx, 2017; Xxxxxxxx and Xxxxxx, 2018; Xxx et al., 2019) but the approach should be much gentler with gradual progression through exercise (Xxxxxx et al., 2013; Xxxxxxxx et al. 2013; Xxxxxxxxx and Xxxxxxx, 2017; Beh et al., 2019). The reason for the gentler VRT approach is because in these people, normal exercise intensity is likely to trigger migraine (Xxxxxxxxx and Xxxxxxx, 2017; Xxxxxxxx and Answer, 2018; Xxx et al., 2019; Xxx and Akkilic, 2022). The VRT can be helpful in people with VM if symptoms are triggered by head or body movements or there is presence of ViD (Xxxxxxxx and Answer, 2018). Also, it may be helpful if there is associated vestibular disorder causing interictal balance problems (Xxxxxxxxx and Xxxxxxx, 2017; Xxxxxxxx and Answer, 2018; Xxx and Akkilic, 2022). Evidence shows that people with or without migraine improved similarly following VRT in objective balance and subjective dizziness measures (Xxxxxxx et al., 2002; Xxxxxxxx et al., 2013). Xxxxxx and colleagues (2017) reported significant improvement with VRT involving repeated training of the VOR and vestibulo-spinal reflex, in headache, dizziness, anxiety, and depression scores in people with VM and tension-type headache, but the headache scores increased after a period of treatment. Xxxxxx and colleagues (2013) in their RCT, included people with CVD with and without VM aged 28-73 years old. The study provided customised VRT including OKS with weekly supervised and customised sessions over 8 weeks. People showed improvements on posturography, FGA, SCQ, VSS and Xxxx Depression and Anxiety Inventory for postural stability and gait, ViD, vestibular/autonomic symptoms, and anxiety and depression respectively, independently from their pathology or VM presence and VM history did not influence dropo...
