Di Fabio's article1 exhibits a number of serious, if not scientifically fatal, flaws. I herein present some of them.
Careful reading of this article strongly suggests, among other things, that the criteria for valid metaanalysis were not met. The diagnostic categories used for statistical analysis consisted of (1) peripheral vestibular deficits (no stratification for unilateral, bilateral, or deficit magnitude), (2) Meniere disease combined with benign paroxysmal positional vertigo, and (3) mixed central nervous system dysfunction combined with peripheral vestibular deficit. Because there was no justification stated for these categorizations, it is impossible for the reader to know why the author chose them. From a pathophysiological perspective they represent arbitrary, unjustifiable classifications. The pathophysiology of peripheral vestibular deficit is as variable as the number of possible causes. Unilateral and bilateral vestibular disorders are often associated with different pathophysiological processes that, in turn, result in different symptom patterns and functional deficits.
Black FO, Homer L. Platform Posturography. Arch Otolaryngol Head Neck Surg. 1996;122(11):1273–1274. doi:10.1001/archotol.1996.01890230115021
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