Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Updated Clinical Practice Guideline From the Academy of Neurologic Physical Therapy of the American Physical Therapy Association

Courtney D Hall, Susan J Herdman, Susan L Whitney, Eric R Anson, Wendy J Carender, Carrie W Hoppes, Stephen P Cass, Jennifer B Christy, Helen S Cohen, Terry D Fife, Joseph M Furman, Neil T Shepard, Richard A Clendaniel, J Donald Dishman, Joel A Goebel, Dara Meldrum, Cynthia Ryan, Richard L Wallace, Nakia J Woodward, Courtney D Hall, Susan J Herdman, Susan L Whitney, Eric R Anson, Wendy J Carender, Carrie W Hoppes, Stephen P Cass, Jennifer B Christy, Helen S Cohen, Terry D Fife, Joseph M Furman, Neil T Shepard, Richard A Clendaniel, J Donald Dishman, Joel A Goebel, Dara Meldrum, Cynthia Ryan, Richard L Wallace, Nakia J Woodward

Abstract

Background: Uncompensated vestibular hypofunction can result in symptoms of dizziness, imbalance, and/or oscillopsia, gaze and gait instability, and impaired navigation and spatial orientation; thus, may negatively impact an individual's quality of life, ability to perform activities of daily living, drive, and work. It is estimated that one-third of adults in the United States have vestibular dysfunction and the incidence increases with age. There is strong evidence supporting vestibular physical therapy for reducing symptoms, improving gaze and postural stability, and improving function in individuals with vestibular hypofunction. The purpose of this revised clinical practice guideline is to improve quality of care and outcomes for individuals with acute, subacute, and chronic unilateral and bilateral vestibular hypofunction by providing evidence-based recommendations regarding appropriate exercises.

Methods: These guidelines are a revision of the 2016 guidelines and involved a systematic review of the literature published since 2015 through June 2020 across 6 databases. Article types included meta-analyses, systematic reviews, randomized controlled trials, cohort studies, case-control series, and case series for human subjects, published in English. Sixty-seven articles were identified as relevant to this clinical practice guideline and critically appraised for level of evidence.

Results: Based on strong evidence, clinicians should offer vestibular rehabilitation to adults with unilateral and bilateral vestibular hypofunction who present with impairments, activity limitations, and participation restrictions related to the vestibular deficit. Based on strong evidence and a preponderance of harm over benefit, clinicians should not include voluntary saccadic or smooth-pursuit eye movements in isolation (ie, without head movement) to promote gaze stability. Based on moderate to strong evidence, clinicians may offer specific exercise techniques to target identified activity limitations and participation restrictions, including virtual reality or augmented sensory feedback. Based on strong evidence and in consideration of patient preference, clinicians should offer supervised vestibular rehabilitation. Based on moderate to weak evidence, clinicians may prescribe weekly clinic visits plus a home exercise program of gaze stabilization exercises consisting of a minimum of: (1) 3 times per day for a total of at least 12 minutes daily for individuals with acute/subacute unilateral vestibular hypofunction; (2) 3 to 5 times per day for a total of at least 20 minutes daily for 4 to 6 weeks for individuals with chronic unilateral vestibular hypofunction; (3) 3 to 5 times per day for a total of 20 to 40 minutes daily for approximately 5 to 7 weeks for individuals with bilateral vestibular hypofunction. Based on moderate evidence, clinicians may prescribe static and dynamic balance exercises for a minimum of 20 minutes daily for at least 4 to 6 weeks for individuals with chronic unilateral vestibular hypofunction and, based on expert opinion, for a minimum of 6 to 9 weeks for individuals with bilateral vestibular hypofunction. Based on moderate evidence, clinicians may use achievement of primary goals, resolution of symptoms, normalized balance and vestibular function, or plateau in progress as reasons for stopping therapy. Based on moderate to strong evidence, clinicians may evaluate factors, including time from onset of symptoms, comorbidities, cognitive function, and use of medication that could modify rehabilitation outcomes.

Discussion: Recent evidence supports the original recommendations from the 2016 guidelines. There is strong evidence that vestibular physical therapy provides a clear and substantial benefit to individuals with unilateral and bilateral vestibular hypofunction.

Limitations: The focus of the guideline was on peripheral vestibular hypofunction; thus, the recommendations of the guideline may not apply to individuals with central vestibular disorders. One criterion for study inclusion was that vestibular hypofunction was determined based on objective vestibular function tests. This guideline may not apply to individuals who report symptoms of dizziness, imbalance, and/or oscillopsia without a diagnosis of vestibular hypofunction.

Disclaimer: These recommendations are intended as a guide to optimize rehabilitation outcomes for individuals undergoing vestibular physical therapy. The contents of this guideline were developed with support from the American Physical Therapy Association and the Academy of Neurologic Physical Therapy using a rigorous review process. The authors declared no conflict of interest and maintained editorial independence.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A369).

Conflict of interest statement

All members of the Guideline Development Group and Advisory Board completed conflict of interest forms, which included information about grant funding, royalties, device/company shares, legal assistance, patents, device consultant/advocacy, publications, presentations, and clinical practice related to the Clinical Practice Guideline (CPG) topic. Forms were submitted to the Academy of Neurologic Physical Therapy (ANPT) Evidence-Based Documents Committee, who monitored and managed any identified perceived conflicts of interest. All recommendations were written as a group per standard CPG methodology. Therefore, no one individual made all the decisions. These recommendations are intended as a guide to optimize rehabilitation outcomes for individuals undergoing vestibular physical therapy. The contents of this guideline were developed with support from the American Physical Therapy Association and the Academy of Neurologic Physical Therapy using a rigorous review process. The authors declared no conflict of interest and maintained editorial independence.

Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of Academy of Neurologic Physical Therapy, APTA.

Figures

Figure.
Figure.
Flowcharts. (a) Initial identification of relevant articles from February 2015 through March 2019. (b) Identification of additional relevant articles through March 2020. (c) Identification of additional relevant articles from 2015 through June 2020 based on broader search terms.

References

    1. Hall CD, Herdman SJ, Whitney SL, et al. Vestibular rehabilitation for peripheral vestibular hypofunction: an evidence-based clinical practice guideline: from the American Physical Therapy Association Neurology Section. J Neurol Phys Ther. 2016;40(2):124–155. doi:10.1097/NPT.0000000000000120.
    1. Institute of Medicine (US) Committee on Standards for Developing Trustworthy Clinical Practice Guidelines, Graham R, Mancher M, Miller Wolman D, et al. eds. Clinical practice guidelines we can trust. Washington, DC: National Academies Press (US); 2011. doi:10.17226/13058.
    1. American Physical Therapy Association. APTA Clinical Practice Guideline Process Manual. Alexandria, VA: American Physical Therapy Association; 2018.
    1. Phillips B, Ball C, Sackett D, et al. Oxford Centre for Evidence-based Medicine—Levels of Evidence. . Published 2009.
    1. Herdman SJ, Tusa RJ, Blatt PJ, Suzuki A, Venuto PJ, Roberts D. Computerized dynamic visual acuity test in the assessment of vestibular deficits. Am J Otol. 1998;19(6):790–796.
    1. Li C, Beaumont JL, Rine RM, Slotkin J, Schubert MC. Normative scores for the NIH Toolbox Dynamic Visual Acuity Test from 3 to 85 years. Front Neurol. 2014;5:223. doi:10.3389/fneur.2014.00223.
    1. Longridge NS, Mallinson AI. A discussion of the dynamic illegible “E” test: a new method of screening for aminoglycoside vestibulotoxicity. Otolaryngol Head Neck Surg. 1984;92(6):671–677. doi:10.1177/019459988409200614.
    1. Herdman SJ. Computerized dynamic visual acuity test in the assessment of vestibular disorders. In: Eggers SDZ, Zee DS, eds. Vertigo and Imbalance: Clinical Neurophysiology of the Vestibular System, Handbook of Clinical Neurophysiology. Vol 9. Amsterdam, the Netherlands: Elsevier; 2010:181–190.
    1. Ward BK, Mohammad MT, Whitney SL, Marchetti GF, Furman JM. The reliability, stability, and concurrent validity of a test of gaze stabilization. J Vestib Res. 2010;20(5):363–372. doi:10.3233/VES-2010-0371.
    1. Weber KP, MacDougall HG, Halmagyi GM, Curthoys IS. Impulsive testing of semicircular-canal function using video-oculography. Ann N Y Acad Sci. 2009;1164:486–491. doi:10.1111/j.1749-6632.2008.03730.x.
    1. Kamei T. Two types of head-shaking tests in vestibular examination. Acta Otolaryngol Suppl. 1988;458:108–112. doi:10.3109/00016488809125112.
    1. Thyssen HH, Brynskov J, Jansen EC, Münster-Swendsen J. Normal ranges and reproducibility for the quantitative Romberg's test. Acta Neurol Scand. 1982;66(1):100–104. doi:10.1111/j.1600-0404.1982.tb03133.x.
    1. Ekdahl C, Jarnlo GB, Andersson SI. Standing balance in healthy subjects. Evaluation of a quantitative test battery on a force platform. Scand J Rehabil Med. 1989;21(4):187–195.
    1. Nashner LM, Black FO, Wall C, 3rd. Adaptation to altered support and visual conditions during stance: patients with vestibular deficits. J Neurosci. 1982;2(5):536–544. doi:10.1523/JNEUROSCI.02-05-00536.1982.
    1. Di Fabio RP. Sensitivity and specificity of platform posturography for identifying patients with vestibular dysfunction. Phys Ther. 1995;75(4):290–305. doi:10.1093/ptj/75.4.290.
    1. Honaker JA, Janky KL, Patterson JN, Shepard NT. Modified head shake sensory organization test: sensitivity and specificity. Gait Posture. 2016;49:67–72. doi:10.1016/j.gaitpost.2016.06.024.
    1. Zwergal A, Rettinger N, Frenzel C, Dieterich M, Brandt T, Strupp M. A bucket of static vestibular function. Neurol. 2009;72(19):1689–1692. doi:10.1212/WNL.0b013e3181a55ecf.
    1. Shumway-Cook A, Horak FB. Assessing the influence of sensory interaction of balance. Suggestion from the field. Phys Ther. 1986;66(10):1548–1550. doi:10.1093/ptj/66.10.1548.
    1. Anacker SL, Di Fabio RP. Influence of sensory inputs on standing balance in community-dwelling elders with a recent history of falling. Phys Ther. 1992;72(8):575–581 doi:10.1093/ptj/72.8.575.
    1. Cohen H, Blatchly AC, Gombash LL. A study of the clinical test of sensory interaction and balance. Phys Ther. 1993;73(6):346–354. doi:10.1093/ptj/73.6.346.
    1. Hall CD, Herdman SJ. Reliability of clinical measures used to assess patients with peripheral vestibular disorders. J Neurol Phys Ther. 2006;30(2):74–81. doi:10.1097/01.npt.0000282571.55673.ed.
    1. Toupet M, Ferrary E, Grayeli AB. Visual analog scale to assess vertigo and dizziness after repositioning maneuvers for benign paroxysmal positional vertigo. J Vestib Res. 2011;21(4):235–241. doi:10.3233/VES-2011-0420.
    1. Dannenbaum E, Chilingaryan G, Fung J. Visual vertigo analogue scale: an assessment questionnaire for visual vertigo. J Vestib Res. 2011;21(3):153–159. doi:10.3233/VES-2011-0412.
    1. Shepard NT, Telian SA, Smith-Wheelock M. Habituation and balance retraining therapy. A retrospective review. Neurol Clin. 1990;8(2):459–475.
    1. Yardley L, Masson E, Verschuur C, Haacke N, Luxon L. Symptoms, anxiety and handicap in dizzy patients: development of the vertigo symptom scale. J Psychosom Res. 1992;36(8):731–741. doi:10.1016/0022-3999(92)90131-k.
    1. Guralnik JM, Ferrucci L, Simonsick EM, Salive M, Wallace RB. Lower extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med. 1995;332(9):556–561. doi:10.1056/NEJM199503023320902.
    1. Whitney SL, Wrisley DM, Marchetti GF, Gee MA, Redfern MS, Furman JM. Clinical measurement of sit-to-stand performance in people with balance disorders: validity of data for the Five-times-sit-to-stand test. Phys Ther. 2005;85(10):1034–1045.
    1. Meretta BM, Whitney SL, Marchetti GF, Sparto PJ, Muirhead RJ. The five times sit to stand test: responsiveness to change and concurrent validity in adults undergoing vestibular rehabilitation. J Vestib Res. 2006;16(4/5):233–243.
    1. Rikli RE, Jones CJ. Senior Fitness Test Manual. Champaign, IL: Human Kinetics; 2001.
    1. Duncan PW, Studenski S, Chandler J, Prescott B. Functional reach: predictive validity in a sample of elderly male veterans. J Gerontol. 1992;47(3):M93–M98. doi:10.1093/geronj/47.3.m93.
    1. Mann GC, Whitney SL, Redfern MS, Borello-France DF, Furman JM. Functional reach and single leg stance in patients with peripheral vestibular disorders. J Vestib Res. 1996;6(5):343–353.
    1. Bohannon RW. Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants. Age Ageing. 1997;26(1):15–19. doi:10.1093/ageing/26.1.15.
    1. Perera S, Mody SH, Woodman RC, Studenski SA. Meaningful change and responsiveness in common physical performance measures in older adults. J Am Geriatr Soc. 2006;54(5):743–749. doi:10.1111/j.1532-5415.2006.00701.x.
    1. Studenski S, Perera S, Patel K, et al. Gait speed and survival in older adults. JAMA. 2011;305(1):50–58. doi:10.1001/jama.2010.1923.
    1. Horak FB, Wrisley DM, Frank J. The Balance Evaluation Systems Test (BESTest) to differentiate balance deficits. Phys Ther. 2009;89(5):484–498. doi:10.2522/ptj.20080071.
    1. Franchignoni F, Horak F, Godi M, Nardone A, Giordano A. Using psychometric techniques to improve the balance evaluation systems test: the mini-BESTest. J Rehabil Med. 2010;42(4):323–331. doi:10.2340/16501977-0537.
    1. Godi M, Franchignoni F, Caligari M, Giordano A, Turcato AM, Nardone A. Comparison of reliability, validity, and responsiveness of the mini-BESTest and Berg Balance Scale in patients with balance disorders. Phys Ther. 2013;93(2):158–167. doi:10.2522/ptj.20120171.
    1. Berg KO, Wood-Dauphinee SL, Williams JI, Maki B. Measuring balance in the elderly: validation of an instrument. Can J Public Health. 1992;83(suppl 2):S7–S11.
    1. Whitney SL, Wrisley DM, Furman JM. Concurrent validity of the Berg Balance Scale and the Dynamic Gait Index in people with vestibular dysfunction. Physiother Res Int. 2003;8(4):178–186. doi:10.1002/pri.288.
    1. Shumway-Cook A, Gruber W, Baldwin M, Liao S. The effect of multidimensional exercises on balance, mobility, and fall risk in community-dwelling older adults. Phys Ther. 1997;77(1):46–57. doi:10.1093/ptj/77.1.46.
    1. Whitney SL, Hudak MK, Marchetti GF. The Dynamic Gait Index related to self-reported fall history in individuals with vestibular dysfunction. J Vestib Res. 2000;10(2):99–105.
    1. Wrisley DM, Marchetti GF, Kuharsky DK, Whitney SW. Reliability, internal consistency, and validity of data obtained with the functional gait assessment. Phys Ther. 2004;84(10):906–918.
    1. Whitney SL, Marchetti GF, Morris LO, Sparto PJ. The reliability and validity of the Four Square Step Test for people with balance deficits secondary to a vestibular disorder. Arch Phys Med Rehabil. 2007;88(1):99–104. doi:10.1016/j.apmr.2006.10.027.
    1. Bohannon RW, Larkin PA, Cook AC, Gear J, Singer J. Decrease in timed balance test scores with aging. Phys Ther. 1984;64(7):1067–1070. doi:10.1093/ptj/64.7.1067.
    1. Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142–148. doi:10.1111/j.1532-5415.1991.tb01616.x.
    1. Whitney SL, Marchetti GF, Schade A, Wrisley DM. The sensitivity and specificity of the timed “Up & Go” and the Dynamic Gait Index for self-reported falls in persons with vestibular disorders. J Vestib Res. 2004;14(5):397–409.
    1. Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the timed up & go test. Phys Ther. 2000;80(9):896–903.
    1. Caixeta GC, Doná F, Gazzola JM. Cognitive processing and body balance in elderly subjects with vestibular dysfunction. Braz J Otorhinolaryngol. 2012;78(2):87–95.
    1. Powell LE, Myers AM. The Activities-specific Balance Confidence (ABC) scale. J Gerontol A Biol Sci Med Sci. 1995;50A(1):M28–M34. doi:10.1093/gerona/50a.1.m28.
    1. Myers AM, Powell LE, Maki BE, Holliday PJ, Brawley LR, Sherk W. Psychological indicators of balance confidence: relationship to actual and perceived abilities. J Gerontol A Biol Sci Med Sci. 1996;51(1):M37–M43. doi:10.1093/gerona/51a.1.m37.
    1. Alsubaie SF, Whitney SL, Furman JM, et al. Reliability and validity of ratings of perceived difficulty during performance of static standing balance exercises. Phys Ther. 2019;99(10):1381–1393. doi:10.1093/ptj/pzz091.
    1. Jacobson GP, Newman CW. The development of the dizziness handicap inventory. Arch Otolaryngol Head Neck Surg. 1990;116(4):424–427. doi:10.1001/archotol.1990.01870040046011.
    1. Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand. 1983;67(6):361–370. doi:10.1111/j.1600-0447.1983.tb09716.x.
    1. Herrmann C. International experiences with the Hospital Anxiety and Depression Scale—a review of validation data and clinical results. J Psychosom Res. 1997;42(1):17–41. doi:10.1016/s0022-3999(96)00216-4.
    1. Anson ER, Gimmon Y, Kiemel T, Jeka JJ, Carey JP. A tool to quantify the functional impact of oscillopsia. Front Neurol. 2018;9:142. doi:10.3389/fneur.2018.00142.
    1. Guinand N, Pijnenburg M, Janssen M, Kingma H. Visual acuity while walking and oscillopsia severity in healthy subjects and patients with unilateral and bilateral vestibular function loss. Arch Otolaryngol Head Neck Surg. 2012;138(3):301–306. doi:10.1001/archoto.2012.4.
    1. Hazlett RL, Tusa RJ, Waranch HR. Development of an inventory for dizziness and related factors. J Behav Med. 1996;19(1):73–85. doi:10.1007/BF01858175.
    1. Honrubia V, Bell TS, Harris MR, Baloh RW, Fisher LM. Quantitative evaluation of dizziness characteristics and impact on quality of life. Am J Otol. 1996;17(4):595–602.
    1. Duracinsky M, Mosnier I, Bouccar D, Sterkers O, Chassany O; Working Group of the Société Française d'Oto-Rhino-Laryngologie (ORL). Literature review of questionnaires assessing vertigo and dizziness, and their impact on patients' quality of life. Value Health. 2007;10(4):273–284. doi:10.1111/j.1524-4733.2007.00182.x.
    1. Alghwiri AA, Whitney SL, Baker CE, et al. The development and validation of the vestibular activities and participation measure. Arch Phys Med Rehabil. 2012;93(10):1822–1831. doi:10.1016/j.apmr.2012.03.017.
    1. Cohen HS, Kimball KT. Development of the vestibular disorders activities of daily living scale. Arch Otolaryngol Head Neck Surg. 2000;126(7):881–887. doi:10.1001/archotol.126.7.881.
    1. Morris AE, Lutman ME, Yardley L. Measuring outcome from vestibular rehabilitation, part I: qualitative development of a new self-report measure. Int J Audiol. 2008;47(4):169–177. doi:10.1080/14992020701843129.
    1. Morris AE, Lutman ME, Yardley L. Measuring outcome from vestibular rehabilitation, part II: refinement and validation of a new self-report measure. Int J Audiol. 2009;48(1):24–37. doi:10.1080/14992020802314905.
    1. Herdman SJ, Hall CD, Schubert MC, Das VE, Tusa RJ. Recovery of dynamic visual acuity in bilateral vestibular hypofunction. Arch Otolaryngol Head Neck Surg. 2007;133(4):383–389. doi: 10.1001/archotol.133.4.383.
    1. McDonnell MN, Hillier SL. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev. 2015;1:CD005397. doi:10.1002/14651858.CD005397.pub4.
    1. Grill E, Heuberger M, Strobl R, et al. Prevalence, determinants, and consequences of vestibular hypofunction. Results from the KORA-FF4 survey. Front Neurol. 2018;9:1076. doi:10.3389/fneur.2018.01076.
    1. Lee SU, Park SH, Kim HJ, Koo JW, Kim JS. Normal caloric responses during acute phase of vestibular neuritis. J Clin Neurol. 2016;12(3):301–307. doi:10.3988/jcn.2016.12.3.301.
    1. Zingler VC, Weintz E, Jahn K, et al. Causative factors, epidemiology, and follow-up of bilateral vestibulopathy. Ann N Y Acad Sci. 2009;1164:505–508. doi:10.1111/j.1749-6632.2009.03765.x.
    1. Smith PF, Curthoys IS. Mechanisms of recovery following unilateral labyrinthectomy: a review. Brain Res Brain Res Rev. 1989;14(2):155–80. doi:10.1016/0165-0173(89)90013-1.
    1. Fetter M. Vestibular system disorders. In: Herdman SJ, Clendaniel RA. Vestibular Rehabilitation. 4th ed. Philadelphia, PA: F. A. Davis Co; 2014:50–58.
    1. Schubert MC. Compensatory strategies for vestibulo-ocular hypofunction. In: Herdman SJ, Clendaniel RA, eds. Vestibular Rehabilitation. 4th ed. Philadelphia, PA: F. A. Davis Co; 2014:151–157.
    1. Brandt T, Zwergal A, Glasauer S. 3-D spatial memory and navigation: functions and disorders. Curr Opin Neurol. 2017;30(1):90–97. doi:10.1097/WCO.0000000000000415.
    1. Agrawal Y, Smith PF, Rosenberg PB. Vestibular impairment, cognitive decline and Alzheimer's disease: balancing the evidence. Aging Ment Heal. 2020;24:705–708.
    1. Giray M, Kirazli Y, Karapolat H, Celebisoy N, Bilgen C, Kirazli T. Short-term effects of vestibular rehabilitation in patients with chronic unilateral vestibular dysfunction: a randomized controlled study. Arch Phys Med Rehabil. 2009;90(8):1325–1331. doi:10.1016/j.apmr.2009.01.032.
    1. Cohen HS, Kimball KT. Increased independence and decreased vertigo after vestibular rehabilitation. Otolaryngol Head Neck Surg. 2003;128(1):60–70. doi:10.1067/mhn.2003.23.
    1. Yardley L, Owen N, Nazareth I, Luxon L. Prevalence and presentation of dizziness in a general practice community sample of working age people. Br J Gen Pract. 1998;48(429):1131–1135.
    1. Lahmann C, Henningsen P, Brandt T, et al. Psychiatric comorbidity and psychosocial impairment among patients with vertigo and dizziness. J Neurol Neurosurg Psychiatry. 2015;86(3):302–308. doi:10.1136/jnnp-2014-307601.
    1. Staab JP. Persistent postural-perceptual dizziness. Semin Neurol. 2020;40(1):130–137. doi:10.1055/s-0039-3402736.
    1. Lucieer F, Vonk P, Guinand N, Stokroos R, Kingma H, van de Berg R. Bilateral vestibular hypofunction: insights in etiologies, clinical subtypes, and diagnostics. Front Neurol. 2016;7:26. doi:10.3389/fneur.2016.00026.
    1. Rine RM, Braswell J, Fisher D, Joyce K, Kalar K, Shaffer M. Improvement of motor development and postural control following intervention in children with sensorineural hearing loss and vestibular impairment. Int J Pediatr Otorhinolaryngol. 2004;68(9):1141–1148. doi:10.1016/j.ijporl.2004.04.007.
    1. Hain TC, Cherchi M, Yacovino DA. Bilateral vestibular loss. Semin Neurol. 2013;33(3):195–203. doi:10.1055/s-0033-1354597.
    1. Herdman SJ, Blatt P, Schubert MC, Tusa RJ. Falls in patients with vestibular deficits. Am J Otol. 2000;21(6):847–851.
    1. Guinand N, Boselie F, Guyot JP, Kingma H. Quality of life of patients with bilateral vestibulopathy. Ann Otol Rhinol Laryngol. 2012;121(7):471–477. doi:10.1177/000348941212100708.
    1. Sun DQ, Ward BK, Semenov YR, Carey JP, Della Santina CC. Bilateral vestibular deficiency: quality of life and economic implications. JAMA Otolaryngol Head Neck Surg. 2014;140(6):527–534. doi:10.1001/jamaoto.2014.490.
    1. Dobbels B, Peetermans O, Boon B, Mertens G, Van de Heyning P, Van Rompaey V. Impact of bilateral vestibulopathy on spatial and nonspatial cognition: a systematic review. Ear Hear. 2019;40(4):757–765. doi:10.1097/AUD.0000000000000679.
    1. Agrawal Y, Carey JP, Della Santina CC, Schubert MC, Minor LB. Disorders of balance and vestibular function in US adults: data from the National Health and Nutrition Examination Survey, 2001-2004. Arch Intern Med. 2009;169(10):938–944. doi:10.1001/archinternmed.2009.66.
    1. Kovacs E, Wang X, Grill E. Economic burden of vertigo: a systematic review. Health Econ Rev. 2019;9(1):37. doi:10.1186/s13561-019-0258-2.
    1. Wang X, Strobl R, Holle R, Seidl H, Peters A, Grill E. Vertigo and dizziness cause considerable more health care resource use and costs: results from the KORA FF4 study. J Neurol. 2019;266(9):2120–2128. doi:10.1007/s00415-019-09386-x.
    1. Schlick C, Schniepp R, Loidl V, Wuehr M, Hesselbarth K, Jahn K. Falls and fear of falling in vertigo and balance disorders: a controlled cross-sectional study. J Vestib Res. 2016;25(5/6):241–251. doi:10.3233/VES-150564.
    1. Burns ER, Stevens JA, Lee R. The direct costs of fatal and non-fatal falls among older adults—United States. J Safety Res. 2016;58:99–103. doi:10.1016/j.jsr.2016.05.001.
    1. Florence CS, Bergen G, Atherly A, Burns E, Stevens J, Drake C. Medical costs of fatal and nonfatal falls in older adults. J Am Geriatr Soc. 2018;66(4):693–698. doi:10.1111/jgs.15304.
    1. Parry SW, Deary V, Finch T, et al. The STRIDE (Strategies to Increase confidence, InDependence and Energy) study: cognitive behavioural therapy-based intervention to reduce fear of falling in older fallers living in the community—study protocol for a randomised controlled trial. Trials. 2014;15:210. doi:10.1186/1745-6215-15-210.
    1. Kim H, Lee S, Kim J. Risk of injury after emergency department visit for acute peripheral vertigo: a matched-cohort study. Clin Exp Emerg Med. 2020;7(3):176–182. doi:10.15441/ceem.19.064.
    1. Neuhauser HK, Radtke A, von Brevern M, Lezius F, Feldmann M, Lempert T. Burden of dizziness and vertigo in the community. Arch Intern Med. 2008;168(19):2118–2124. doi:10.1001/archinte.168.19.2118.
    1. Adamec I, Skorić MK, Handžić J, Habek M. Incidence, seasonality and comorbidity in vestibular neuritis. Neurol Sci. 2015;36(1):91–95.
    1. Hülse R, Biesdorf A, Hörmann K, et al. Peripheral vestibular disorders: an epidemiologic survey in 70 million individuals. Otol Neurotol. 2019;40(1):88–95. doi:10.1097/MAO.0000000000002013.
    1. Kroenke K, Hoffman RM, Einstadter D. How common are various causes of dizziness? A critical review. South Med J. 2000;93(2):160–168.
    1. Brodsky JR, Lipson S, Bhattacharyya N. Prevalence of pediatric dizziness and imbalance in the United States. Otolaryngol Head Neck Surg. 2020;162(2):241–247. doi:10.1177/0194599819887375.
    1. Ward BK, Agrawal Y, Hoffman HJ, Carey JP, Della Santina CC. Prevalence and impact of bilateral vestibular hypofunction: results from the 2008 US National Health Interview Survey. JAMA Otolaryngol Head Neck Surg. 2013;139(8):803–810. doi:10.1001/jamaoto.2013.3913.
    1. Paige GD. Senescence of human visual-vestibular interactions: smooth pursuit, optokinetic, and vestibular control of eye movements with aging. Exp Brain Res. 1994;98(2):355–372. doi:10.1007/BF00228423.
    1. Peterka RJ, Black FO. Age-related changes in human posture control: sensory organization tests. J Vestib Res. 1990;1(1):73–85.
    1. Li C, Layman AJ, Carey JP, Agrawal Y. Epidemiology of vestibular evoked myogenic potentials: data from the Baltimore Longitudinal Study of Aging. Clin Neurophysiol. 2015;126(11):2207–2215. doi:10.1016/j.clinph.2015.01.008.
    1. Li C, Layman AJ, Geary R, et al. Epidemiology of vestibulo-ocular reflex function: data from the Baltimore Longitudinal Study of Aging. Otol Neurotol. 2015;36(2):267–272. doi:10.1097/MAO.0000000000000610.
    1. Dillon CF, Gu Q, Hoffman HJ, Ko C-W. Vision, hearing, balance, and sensory impairment in Americans aged 70 years and over: United States, 1999-2006. NCHS Data Brief. 2010(31):1–8.
    1. Agrawal Y, Van de Berg R, Wuyts F, et al. Presbyvestibulopathy: diagnostic criteria consensus document of the classification committee of the Bárány Society. J Vestib Res. 2019;29(4):161–170. doi:10.3233/VES-190672.
    1. Gadkaree SK, Sun DQ, Li C, et al. Does sensory function decline independently or concomitantly with Age? Data from the Baltimore Longitudinal Study of Aging. J Aging Res. 2016;2016:1865038. doi:10.1155/2016/1865038.
    1. O'Reilly RC, Morlet T, Nicholas BD, et al. Prevalence of vestibular and balance disorders in children. Otol Neurotol. 2010;31(9):1441–1444. doi:10.1097/MAO.0b013e3181f20673.
    1. Tribukait A, Brantberg K, Bergenius J. Function of semicircular canals, utricles and saccules in deaf children. Acta Oto-Laryngol. 2004;124(1):41–48. doi:10.1080/00016480310002113.
    1. Jacot E, Van Den Abbeele T, Debre HR, Wiener-Vacher SR. Vestibular impairments pre- and post-cochlear implant in children. Int J Pediatr Otorhinolaryngol. 2009;73(2):209–217. doi:10.1016/j.ijporl.2008.10.024.
    1. Wiener-Vacher SR, Quarez J, Priol AL. Epidemiology of vestibular impairments in a pediatric population. Semin Hear. 2018;39(3):229–242. doi:10.1055/s-0038-1666815.
    1. Martens S, Dhooge I, Dhondt C, et al. Vestibular infant screening—Flanders: the implementation of a standard vestibular screening protocol for hearing-impaired children in Flanders. Int J Pediatr Otorhinolaryngol. 2019;120:196–201. doi:10.1016/j.ijporl.2019.02.033.
    1. Herdman SJ, Hall CD, Maloney B, Knight S, Ebert M, Lowe J. Variables associated with outcome in patients with bilateral vestibular hypofunction: preliminary study. J Vestib Res. 2015;25(3/4):185–194. doi:10.3233/VES-150556.
    1. Meldrum D, Herdman S, Vance R, et al. Effectiveness of conventional versus virtual reality-based balance exercises in vestibular rehabilitation for unilateral peripheral vestibular loss: results of a randomized controlled trial. Arch Phys Med Rehabil. 2015;96(7):1319–1328.e1. doi:10.1016/j.apmr.2015.02.032.
    1. Allum JHJ, Cleworth T, Honegger F. Recovery of vestibulo-ocular reflex symmetry after an acute unilateral peripheral vestibular deficit: time course and correlation with canal paresis. Otol Neurotol. 2016;37(6):772–780. doi:10.1097/MAO.0000000000001054.
    1. Lehnen N, Kellerer S, Knorr AG, et al. Head-movement-emphasized rehabilitation in bilateral vestibulopathy. Front Neurol. 2018;9:562. doi:10.3389/fneur.00562.
    1. Navari E, Cerchiai N, Casani AP. Assessment of vestibulo-ocular reflex gain and catch-up saccades during vestibular rehabilitation. Otol Neurotol. 2018;39(10):e1111–e1117. doi:10.1097/MAO.0000000000002032.
    1. Smółka W, Smółka K, Markowski J, Pilch J, Piotrowska-Seweryn A, Zwierzchowska A. The efficacy of vestibular rehabilitation in patients with chronic unilateral vestibular dysfunction. Int J Occup Med Environ Health. 2020;33(3):273–282. doi:10.13075/ijomeh.1896.01330.
    1. Porciuncula F, Johnson CC, Glickman LB. The effect of vestibular rehabilitation on adults with bilateral vestibular hypofunction: a systematic review. J Vestib Res. 2012;22(5/6):283–298. doi:10.3233/VES-120464.
    1. Guidetti G, Guidetti R, Mandredi M, Mafredi M. Vestibular pathology and spatial working memory. Acta Otorhinolaryngol Ital. 2020;40(1):72–78. doi:10.14639/0392-100X-2189.
    1. Bhattacharyya N, Gubbels SP, Schwartz SR, et al. Clinical practice guideline: benign paroxysmal positional vertigo (update). Otolaryngol Head Neck Surg. 2017;156(3_suppl):S1–S47. doi:10.1177/0194599816689667.
    1. Basura GJ, Adams ME, Monfared A, et al. Clinical practice guideline: Ménière's disease. Otolaryngol Head Neck Surg. 2020;162(2_suppl):S1–S55. doi:10.1177/0194599820909438.
    1. Quatman-Yates CC, Hunter-Giordano A, Shimamura KK, et al. Physical therapy evaluation and treatment after concussion/mild traumatic brain injury. J Orthop Sports Phys Ther. 2020;50(4):CPG1–CPG73. doi:10.2519/jospt.2020.0301.
    1. Gandolfi MM, Reilly EK, Galatioto J, Judson RB, Kim AH. Cost-effective analysis of unilateral vestibular weakness investigation. Otol Neurotol. 2015;36(2):277–281. doi:10.1097/MAO.0000000000000649.
    1. Voelker CC, Lucisano A, Kallogjeri D, Sinks BC, Goebel JA. Comparison of the gaze stabilization test and the dynamic visual acuity test in unilateral vestibular loss patients and controls. Otol Neurotol. 2015;36(4):746–753. doi:10.1097/MAO.0000000000000689.
    1. Yeh SC, Huang MC, Wang PC, et al. Machine learning-based assessment tool for imbalance and vestibular dysfunction with virtual reality rehabilitation system. Comput Methods Programs Biomed. 2014;116(3):311–318.
    1. Jongkees LB. Thermic test and electronystagmography. Acta Otorhinolaryngol Belg. 1965;19(2):455–464.
    1. Krebs DE, Gill-Body KM, Riley PO, Parker SW. Double-blind, placebo-controlled trial of rehabilitation for bilateral vestibular hypofunction: preliminary report. Otolaryngol Head Neck Surg. 1993;109(4):735–741. doi:10.1177/019459989310900417.
    1. Shepard NT, Jacobson GP. The caloric irrigation test. Handb Clin Neurol. 2016;137:119–131. doi:10.1016/B978-0-444-63437-5.00009-1.
    1. Telian SA, Shepard NT, Smith-Wheelock M, Hoberg M. Bilateral vestibular paresis: diagnosis and treatment. Otolaryngol Head Neck Surg. 1991;104(1):67–71. doi:10.1177/019459989110400113.
    1. Yip CW, Glaser M, Frenzel C, Bayer O, Strupp M. Comparison of the bedside head-impulse test with the video head-impulse test in a clinical practice setting: a prospective study of 500 outpatients. Front Neurol. 2016;7:58. doi:10.3389/fneur.2016.00058.
    1. Lacour M, Laurent T, Alain T. Rehabilitation of dynamic visual acuity in patients with unilateral vestibular hypofunction: earlier is better. Eur Arch Otorhinolaryngol. 2020;277(1):103–113. doi:10.1007/s00405-019-05690-4.
    1. Horak FB, Jones-Rycewicz C, Black FO, Shumway-Cook A. Effects of vestibular rehabilitation on dizziness and imbalance. Otolaryngol Head Neck Surg. 1992;106(2):175–180.
    1. Basta D, Borsellino L, Ernst A. Antivertiginous drug therapy does not hinder the efficacy of individualized vibrotactile neurofeedback training for vestibular rehabilitation—a randomized trial. Int J Rehabil Res. 2017;40(4):333–338. doi:10.1097/MRR.0000000000000245.
    1. Berryhill W, Graham M. Chemical and physical labyrinthectomy for Meniere's disease. Otolaryngol Clin North Am. 2002;35(3):675–682. doi:10.1016/s0030-6665(02)00025-7.
    1. Cawthorne T. Vestibular injuries. Proc R Soc Lond B Biol Sci. 1946;39(5):270–273.
    1. Ricci NA, Aratani MC, Caovilla HH, Ganança FF. Effects of vestibular rehabilitation on balance control in older people with chronic dizziness: a randomized clinical trial. Am J Phys Med Rehabil. 2016;95(4):256–269.
    1. Jáuregui-Renaud K, Villanueva Padrón LA, Cruz Gómez NS. The effect of vestibular rehabilitation supplemented by training of the breathing rhythm or proprioception exercises, in patients with chronic peripheral vestibular disease. J Vestib Res. 2007;17(1):63–72.
    1. Gauthier GM, Robinson DA. Adaptation of the human vestibuloocular reflex to magnifying lenses. Brain Res. 1975;92(2):331–335. doi:10.1016/0006-8993(75)90279-6.
    1. Schubert MC, Migliaccio AA, Clendaniel RA, Allak A, Carey JP. Mechanism of dynamic visual acuity recovery with vestibular rehabilitation. Arch Phys Med Rehabil. 2008;89(3):500–507. doi:10.1016/j.apmr.2007.11.010.
    1. Schubert MC, Hall CD, Das V, Tusa RJ, Herdman SJ. Oculomotor strategies and their effect on reducing gaze position error. Otol Neurotol. 2010;31(2):228–231. doi:10.1097/MAO.0b013e3181c2dbae.
    1. Strupp M, Arbusow V, Maag KP, Gall C, Brandt T. Vestibular exercises improve central vestibulospinal compensation after vestibular neuritis. Neurology. 1998;51(3):838–844. doi:10.1212/wnl.51.3.838.
    1. Levac D, Glegg SM, Sveistrup H, et al. A knowledge translation intervention to enhance clinical application of a virtual reality system in stroke rehabilitation. BMC Health Serv Res. 2016;16(1):557. doi:10.1186/s12913-016-1807-6.
    1. Klatt BN, Carender WJ, Lin CC, et al. A conceptual framework for the progression of balance exercises in persons with balance and vestibular disorders. Phys Med Rehabil Int. 2015;2(4):1044.
    1. Espy D, Reinthal A, Kuchta N, Casey N, Wiland T. Development of a rating scale for perceived stability during balance training. Paper presented at: Combined Sections Meeting. February 4-7, 2015; Indianapolis, IN.
    1. Sienko KH, Whitney SL, Carender WJ, Wall C. The role of sensory augmentation for people with vestibular deficits: real-time balance aid and/or rehabilitation device? J Vestib Res. 2017;27(1):63–76. doi:10.3233/VES-170606.
    1. Yoo MH, Yang CJ, Kim SA, et al. Efficacy of steroid therapy based on symptomatic and functional improvement in patients with vestibular neuritis: a prospective randomized controlled trial. Eur Arch Otorhinolaryngol. 2017;274(6):2443–2451. doi:10.1007/s00405-017-4556-1.
    1. Ismail EI, Morgan AE, Abdel Rahman AM. Corticosteroids versus vestibular rehabilitation in long-term outcomes in vestibular neuritis. J Vestib Res. 2018;28(5/6):417–424. doi:10.3233/VES-180645.
    1. Tokle G, Mørkved S, Bråthen G, et al. Efficacy of vestibular rehabilitation following acute vestibular neuritis: a randomized controlled trial. Otol Neurotol. 2020;41(1):78–85. doi:10.1097/MAO.0000000000002443.
    1. Scheltinga A, Honegger F, Timmermans DP, Allum JH. The effect of age on improvements in vestibulo-ocular reflexes and balance control after acute unilateral peripheral vestibular loss. Front Neurol. 2016;7:18. doi:10.3389/fneur.2016.00018.
    1. Jeong J, Jung J, Lee JM, Suh MJ, Kwak SH, Kim SH. Effects of saccular function on recovery of subjective dizziness after vestibular rehabilitation. Otol Neurotol. 2017;38(7):1017–1023. doi:10.1097/MAO.0000000000001467.
    1. Büki B, Hanschek M, Jünger H. Vestibular neuritis: involvement and long-term recovery of individual semicircular canals. Auris Nasus Larynx. 2017;44(3):288–293. doi:10.1016/j.anl.2016.07.020.
    1. Herdman SJ, Clendaniel RA, Mattox DE, Holliday MJ, Niparko JK. Vestibular adaptation exercises and recovery: acute stage after acoustic neuroma resection. Otolaryngol Head Neck Surg. 1995;113(1):77–87. doi:10.1016/s0194-5998(95)70148-6.
    1. Mruzek M, Barin K, Nichols DS, Burnett CN, Welling DB. Effects of vestibular rehabilitation and social reinforcement on recovery following ablative vestibular surgery. Laryngoscope. 1995;105(7, pt 1):686–692. doi:10.1288/00005537-199507000-00004.
    1. Enticott JC, O'Leary SJ, Briggs RJ. Effects of vestibulo-ocular reflex exercises on vestibular compensation after vestibular schwannoma surgery. Otol Neurotol. 2005;26(2):265–269. doi:10.1097/00129492-200503000-00024.
    1. Vereeck L, Wuyts FL, Truijen S, De Valck C, Van de Heyning PH. The effect of early customized vestibular rehabilitation on balance after acoustic neuroma resection. Clin Rehabil. 2008;22(8):698–713.
    1. Sparrer I, Duong Dinh TA, Ilgner J, Westhofen M. Vestibular rehabilitation using the Nintendo® Wii Balance Board—a user-friendly alternative for central nervous compensation. Acta Otolaryngol. 2013;133(3):239–245. doi:10.3109/00016489.2012.732707.
    1. Venosa AR, Bittar RS. Vestibular rehabilitation exercises in acute vertigo. Laryngoscope. 2007;117(8):1482–1487. doi:10.1097/MLG.0b013e318068b54f.
    1. Teggi R, Caldirola D, Fabiano B, Recanati P, Bussi M. Rehabilitation after acute vestibular disorders. J Laryngol Otol. 2009;123(4):397–402. doi:10.1017/S0022215108002983.
    1. Marioni G, Fermo S, Zanon D, Broi N, Staffieri A. Early rehabilitation for unilateral peripheral vestibular disorders: a prospective, randomized investigation using computerized posturography. Eur Arch Otorhinolaryngol. 2013;270(2):425–435. doi:10.1007/s00405-012-1944-4.
    1. Magnusson M, Kahlon B, Karlberg M, Lindberg S, Siesjö P. Preoperative vestibular ablation with gentamicin and vestibular “prehab” enhance postoperative recovery after surgery for pontine angle tumours—first report. Acta Otolaryngol. 2007;127(12):1236–1240. doi:10.1080/00016480701663433.
    1. Tjernström F, Fransson PA, Kahlon B, et al. Vestibular PREHAB and gentamicin before schwannoma surgery may improve long-term postural function. J Neurol Neurosurg Psychiatry. 2009;80(11):1254–1260. doi:10.1136/jnnp.2008.170878.
    1. Magnusson M, Karlberg M, Tjernström F. “PREHAB”: vestibular prehabilitation to ameliorate the effect of a sudden vestibular loss. NeuroRehabilitation. 2011;29(2):153–156. doi:10.3233/NRE-2011-0689.
    1. Cohen HS, Kimball KT, Jenkins HA. Factors affecting recovery after acoustic neuroma resection. Acta Otolaryngol. 2002;122(8):841–850.
    1. Micarelli A, Viziano A, Augimen I, Micarelli D, Alessandrini M. Three-dimensional head-mounted gaming task procedure maximizes effects of vestibular rehabilitation in unilateral vestibular hypofunction: a randomized controlled pilot trial. Int J Rehabil Res. 2017;40(4):325–332. doi:10.1097/MRR.0000000000000244.
    1. Bao T, Klatt BN, Carender WJ, et al. Effects of long-term vestibular rehabilitation therapy with vibrotactile sensory augmentation for people with unilateral vestibular disorders—a randomized preliminary study. J Vestib Res. 2019;29(6):323–334. doi:10.3233/VES-190683.
    1. Bayat A, Saki N. Effects of vestibular rehabilitation interventions in the elderly with chronic unilateral vestibular hypofunction. Iran J Otorhinolaryngol. 2017;29(3):183–188.
    1. Crane BT, Schubert MC. An adaptive vestibular rehabilitation technique. Laryngoscope. 2018;128(3):713–718. doi:10.1002/lary.26661.
    1. Aratani MC, Ricci NA, Caovilla HH, Ganança FF. Benefits of vestibular rehabilitation on patient-reported outcomes in older adults with vestibular disorders: a randomized clinical trial. Braz J Phys Ther. 2020;24(6):550–559. doi:10.1016/j.bjpt.2019.12.003.
    1. Viziano A, Micarelli A, Augimeri I, Micarelli D, Alessandrini M. Long-term effects of vestibular rehabilitation and head-mounted gaming task procedure in unilateral vestibular hypofunction: a 12-month follow-up of a randomized controlled trial. Clin Rehabil. 2019;33(1):24–33. doi:10.1177/0269215518788598.
    1. Herdman SJ, Schubert MC, Das VE, Tusa RJ. Recovery of dynamic visual acuity in unilateral vestibular hypofunction. Arch Otolaryngol Head Neck Surg. 2003;129(8):819–824. doi:10.1001/archotol.129.8.819.
    1. Loader B, Gruther W, Mueller CA, et al. Improved postural control after computerized optokinetic therapy based on stochastic visual stimulation in patients with vestibular dysfunction. J Vestib Res. 2007;17(2/3):131–136.
    1. Shepard NT, Telian SA. Programmatic vestibular rehabilitation. Otolaryngol Head Neck Surg. 1995;112(1):173–182. doi:10.1016/S0194-59989570317-9.
    1. Ertugrul S, Emre Soylemez E. Investigation of the factors affecting the success of vestibular rehabilitation therapy in patients with idiopathic unilateral vestibular hypofunction and idiopathic bilateral vestibular hypofunction. ENT Updates. 2019;9(2):150–158. doi:10.32448/entupdates.570136.
    1. Strupp M, Kim JS, Murofushi T, et al. Bilateral vestibulopathy: diagnostic criteria consensus document of the classification committee of the Bárány Society. J Vestib Res. 2017;27(4):177–189. doi:10.3233/VES-170619.
    1. Gimmon Y, Migliaccio AA, Kim KJ, Schubert MC. VOR adaptation training and retention in a patient with profound bilateral vestibular hypofunction. Laryngoscope. 2019;129(11):2568–2573. doi:10.1002/lary.27838.
    1. Allum JHJ, Rust HM, Honegger F. Functional testing of vestibulo-spinal contributions to balance control: insights from tracking improvement following acute bilateral peripheral vestibular loss. Front Neurol. 2019;10:550. doi:10.3389/fneur.2019.00550.
    1. Brugnera C, Bittar RS, Greters ME, Basta D. Effects of vibrotactile vestibular substitution on vestibular rehabilitation—preliminary study. Braz J Otorhinolaryngol. 2015;81(6):616–621. doi:10.1016/j.bjorl.2015.08.013.
    1. Patarapak S, Jarusripan P, Isipradit P. Chulalongkorn vestibular balance exercise for rehabilitation in persons with various types of vestibular disorders. J Med Assoc Thai. 2015;98(suppl 1):S77–S84.
    1. Itani M, Koaik Y, Sabri A. The value of close monitoring in vestibular rehabilitation therapy. J Laryngol Otol. 2017;131(3):227–231. doi:10.1017/S0022215116009750.
    1. Szturm T, Reimer KM, Hochman J. Home-based computer gaming in vestibular rehabilitation of gaze and balance impairment. Games Health J. 2015;4(3):211–220. doi:10.1089/g4h.2014.0093.
    1. Krebs DE, Gill-Body KM, Parker SW, Ramirez JV, Wernick Robinson M. Vestibular rehabilitation: useful but not universally so. Otolaryngol Head Neck Surg. 2003;128(2):240–250. doi:10.1067/mhn.2003.72.
    1. Rosiak O, Krajewski K, Woszczak M, Jozefowicz-Korczynska M. Evaluation of the effectiveness of a virtual reality-based exercise program for unilateral peripheral vestibular deficit. J Vestib Res. 2018;28(5/6):409–415. doi:10.3233/VES-180647.
    1. Micarelli A, Viziano A, Micarelli B, Augimeri I, Alessandrini M. Vestibular rehabilitation in older adults with and without mild cognitive impairment: effects of virtual reality using a head-mounted display. Arch Gerontol Geriatr. 2019;83:246–256. doi:10.1016/j.archger.2019.05.008.
    1. Coelho AR, Fontes RC, Moraes R, Barros CGC, de Abreu DCC. Effects of the use of anchor systems in the rehabilitation of dynamic balance and gait in individuals with chronic dizziness of peripheral vestibular origin: a single-blinded, randomized, controlled clinical trial. Arch Phys Med Rehabil. 2020;101(2):249–257. doi:10.1016/j.apmr.2019.07.012.
    1. Koganemaru S, Goto F, Arai M, et al. Effects of vestibular rehabilitation combined with transcranial cerebellar direct current stimulation in patients with chronic dizziness: an exploratory study. Brain Stimul. 2017;10(3):576–578. doi:10.1016/j.brs.2017.02.005.
    1. Pavlou M, Lingeswaran A, Davies RA, Gresty MA, Bronstein AM. Simulator based rehabilitation in refractory dizziness. J Neurol. 2004;251(8):983–95. doi:10.1007/s00415-004-0476-2.
    1. Clendaniel RA. The effects of habituation and gaze stability exercises in the treatment of unilateral vestibular hypofunction: preliminary results. J Neurol Phys Ther. 2010;34(2):111–116. doi:10.1097/NPT.0b013e3181deca01.
    1. Szturm T, Ireland DJ, Lessing-Turner M. Comparison of different exercise programs in the rehabilitation of patients with chronic peripheral vestibular dysfunction. J Vestib Res. 1994;4(6):461–479.
    1. McGibbon CA, Krebs DE, Wolf SL, Wayne PM, Scarborough DM, Parker SW. Tai chi and vestibular rehabilitation effects on gaze and whole-body stability. J Vestib Res. 2004;14(6):467–478.
    1. Pavlou M, Kanegaonkar RG, Swapp D, Bamiou DE, Slater M, Luxon LM. The effect of virtual reality on visual vertigo symptoms in patients with peripheral vestibular dysfunction: a pilot study. J Vestib Res. 2012;22(5/6):273–281. doi:10.3233/VES-120462.
    1. Cakrt O, Chovanec M, Funda T, Kalitová P, Betka J, Zverina E, Kolár P, Jerábek J. Exercise with visual feedback improves postural stability after vestibular schwannoma surgery. Eur Arch Otorhinolaryngol. 2010;267(9):1355–1360. doi:10.1007/s00405-010-1227-x.
    1. Herdman SJ, Hall CD, Delaune W. Variables associated with outcome in patients with unilateral vestibular hypofunction. Neurorehabil Neural Repair. 2012;26(2):151–162. doi:10.1177/1545968311407514.
    1. Bergeron M, Lortie CL, Guitton MJ. Use of virtual reality tools for vestibular disorders rehabilitation: a comprehensive analysis. Adv Med. 2015;2015:916735. doi:10.1155/2015/916735.
    1. Rossi-Izquierdo M, Santos-Pérez S, Soto-Varela A. What is the most effective vestibular rehabilitation technique in patients with unilateral peripheral vestibular disorders? Eur Arch Otorhinolaryngol. 2011;268(11):1569–1574. doi:10.1007/s00405-011-1532-z.
    1. Winkler PA, Esses B. Platform tilt perturbation as an intervention for people with chronic vestibular dysfunction. J Neurol Phys Ther. 2011;35(3):105–115. doi:10.1097/NPT.0b013e31822a2af9.
    1. Nardone A, Godi M, Artuso A, Schieppati M. Balance rehabilitation by moving platform and exercises in patients with neuropathy or vestibular deficit. Arch Phys Med Rehabil. 2010;91(12):1869–1877. doi:10.1016/j.apmr.2010.09.011.
    1. Gillespie MB, Minor LB. Prognosis in bilateral vestibular hypofunction. Laryngoscope. 1999;109(1):35–41. doi:10.1097/00005537-199901000-00008.
    1. Brown KE, Whitney SL, Wrisley DM, Furman JM. Physical therapy outcomes for persons with bilateral vestibular loss. Laryngoscope. 2001;111(10):1812–1817. doi:10.1097/00005537-200110000-00027.
    1. Cohen HS, Kimball KT. Changes in a repetitive head movement task after vestibular rehabilitation. Clin Rehabil. 2004;18(2):125–131. doi:10.1191/0269215504cr707oa.
    1. Millar JL, Gimmon Y, Roberts D, Schubert MC. Improvement after vestibular rehabilitation not explained by improved passive VOR gain. Front Neurol. 2020;11:79. doi:10.3389/fneur.00079.
    1. Kao CL, Chen LK, Chern CM, Hsu LC, Chen CC, Hwang SJ. Rehabilitation outcome in home-based versus supervised exercise programs for chronically dizzy patients. Arch Gerontol Geriatr. 2010;51(3):264–267. doi:10.1016/j.archger.2009.11.014.
    1. Pavlou M, Bronstein AM, Davies RA. Randomized trial of supervised versus unsupervised optokinetic exercise in persons with peripheral vestibular disorders. Neurorehabil Neural Repair. 2013;27(3):208–218. doi:10.1177/1545968312461715.
    1. Hsu SY, Fang TY, Yeh SC, Su MC, Wang PC, Wang VY. Three-dimensional, virtual reality vestibular rehabilitation for chronic imbalance problem caused by Ménière's disease: a pilot study. Disabil Rehabil. 2017;39(16):1601–1606. doi:10.1080/09638288.2016.1203027.
    1. Muller I, Kirby S, Yardley L. Understanding patient experiences of self-managing chronic dizziness: a qualitative study of booklet-based vestibular rehabilitation, with or without remote support. BMJ Open. 2015;5(5):e007680. doi:10.1136/bmjopen-2015-007680.
    1. Yardley L, Barker F, Muller I, et al. Clinical and cost effectiveness of booklet based vestibular rehabilitation for chronic dizziness in primary care: Single blind, parallel group, pragmatic, randomised controlled trial. BMJ. 2012;344:e2237. doi:10.1136/bmj.e2237.
    1. Hondebrink MS, Mert A, van der Lint R, de Ru JA, van der Wurff P. Motion-based equilibrium reprocessing therapy a novel treatment method for chronic peripheral vestibulopathies: a pilot study. Medicine (Baltimore). 2017;96(24):e7128. doi:10.1097/MD.0000000000007128.
    1. Varriano B, Sulway S, Wetmore C, et al. Vestibular exercises as a fall prevention strategy in patients with cognitive impairment. Can J Neurol Sci. 2020;47(1):126–130. doi:10.1017/cjn.2019.309.
    1. van Vugt VA, van der Wouden JC, Essery R, et al. Internet based vestibular rehabilitation with and without physiotherapy support for adults aged 50 and older with a chronic vestibular syndrome in general practice: three armed randomised controlled trial. BMJ. 2019;367:l5922. doi:10.1136/bmj.l5922.
    1. Yardley L, Donovan-Hall M, Smith HE, Walsh BM, Mullee M, Bronstein AM. Effectiveness of primary care-based vestibular rehabilitation for chronic dizziness. Ann Intern Med. 2004;141(8):598–605. doi:10.7326/0003-4819-141-8-200410190-00007.
    1. Kammerlind ASC, Ledin TRE, Odkvist LM, Skargren EIB. Effects of home training and additional physical therapy on recovery after acute unilateral vestibular loss—a randomized study. Clin Rehabil. 2005;19(1):54–62. doi:10.1191/0269215505cr830oa.
    1. MacDowell SG, Wellons R, Bissell A, Knecht L, Naquin C, Karpinski A. The impact of symptoms of anxiety and depression on subjective and objective outcome measures in individuals with vestibular disorders. J Vestib Res. 2018;27(5-6):295–303. doi:10.3233/VES-170627.
    1. Roller RA, Hall CD. A speed-based approach to vestibular rehabilitation for peripheral vestibular hypofunction: a retrospective chart review. J Vestib Res. 2018;28(3/4):349–357. doi:10.3233/VES-180633.
    1. Lorin P, Donnard M, Foubert F. Vestibular neuritis: evaluation and effect of vestibular rehabilitation. Rev Laryngol Otol Rhinol (Bord). 2015;136(1):21–27.
    1. Bos JE, MacKinnon SN, Patterson A. Motion sickness symptoms in a ship motion simulator: effects of inside, outside, and no view. Aviat Space Environ Med. 2005;76(12):1111–1118.
    1. Staab JP, Eckhardt-Henn A, Horii A, et al. Diagnostic criteria for persistent postural-perceptual dizziness (PPPD): consensus document of the committee for the classification of vestibular disorders of the Bárány Society. J Vestib Res. 2017;27(4):191–208. doi:10.3233/VES-170622.
    1. Holmberg JM. Pathophysiology, differential diagnosis, and management of persistent postural- perceptual dizziness: a review. Perspectives. 2020;5(1):181–191. doi:10.1044/2019_PERSP-19-00105.
    1. Popkirov S, Stone J, Holle-Lee D. Treatment of persistent postural-perceptual dizziness (PPPD) and related disorders. Curr Treat Options Neurol. 2018;20(12):50. doi:10.1007/s11940-018-0535-0.
    1. Krueger WW. Controlling motion sickness and spatial disorientation and enhancing vestibular rehabilitation with a user-worn see-through display. Laryngoscope. 2011;121(suppl 2, 0 2):S17–S35. doi:10.1002/lary.21373.
    1. Keim RJ, Cook M, Martini D. Balance rehabilitation therapy. Laryngoscope. 1992;102(11):1302–1307. doi:10.1288/00005537-199211000-00019.
    1. Hall CD, Schubert MC, Herdman SJ. Prediction of fall risk reduction as measured by Dynamic Gait Index in individuals with unilateral vestibular hypofunction. Otol Neurotol. 2004;25(5):746–751. doi:10.1097/00129492-200409000-00017.
    1. Perez N, Santandreu E, Benitez J, Rey-Martinez J. Improvement of postural control in patients with peripheral vestibulopathy. Eur Arch Otorhinolaryngol. 2006;263(5):414–420. doi:10.1007/s00405-005-1027-x.
    1. Chen PY, Hsieh WL, Wei SH, Kao CL. Interactive wiimote gaze stabilization exercise training system for patients with vestibular hypofunction. J Neuroeng Rehabil. 2012;9:77. doi:10.1186/1743-0003-9-77.
    1. Telian S, Shepard N, Smith-Wheelock M, Kemink J. Habituation therapy for chronic vestibular dysfunction: preliminary results. Otolaryngol Head Neck Surg. 1990;103(1):89–95. doi:10.1177/019459989010300113.
    1. Shepard NT, Smith-Wheelock M, Telian SA, Raj A. Vestibular and balance rehabilitation therapy. Ann Otol Rhinol Laryngol. 1993;102(3, pt 1):198–205. doi:10.1177/000348949310200306.
    1. Topuz O, Topuz B, Ardiç FN, Sarhus M, Ögmen G, Ardiç F. Efficacy of vestibular rehabilitation on chronic unilateral vestibular dysfunction. Clin Rehabil. 2004;18(1):76–83. doi:10.1191/0269215504cr704oa.
    1. Pavlou M, Acheson J, Nicolaou D, Fraser CL, Bronstein AM, Davies RA. Effect of developmental binocular vision abnormalities on visual vertigo symptoms and treatment outcome. J Neurol Phys Ther. 2015;39(4):215–224. doi:10.1097/NPT.0000000000000105.
    1. Micarelli A, Viziano A, Della-Morte D, Augimeri I, Alessandrini M. Degree of functional impairment associated with vestibular hypofunction among older adults with cognitive decline. Otol Neurotol. 2018;39(5):e392–e400. doi:10.1097/MAO.0000000000001746.
    1. Sjögren J, Magnusson M, Tjernström F, Karlberg M. Steroids for acute vestibular neuronitis—the earlier the treatment, the better the outcome? Otol Neurotol. 2019;40(3):372–374. doi:10.1097/MAO.0000000000002106.
    1. Patatas OH, Ganança CF, Ganança FF. Quality of life of individuals submitted to vestibular rehabilitation. Braz J Otorhinolaryngol. 2009;75(3):387–394.
    1. Whitney SL, Wrisley DM, Marchetti GF, Furman JM. The effect of age on vestibular rehabilitation outcomes. Laryngoscope. 2002;112(10):1785–1790. doi:10.1097/00005537-200210000-00015.
    1. Bamiou DE, Davies RA, McKee M, Luxon LM. Symptoms, disability and handicap in unilateral peripheral vestibular disorders. Effects of early presentation and initiation of balance exercises. Scand Audiol. 2000;29(4):238–244. doi:10.1080/010503900750022862.
    1. Aranda C, Meza A, Rodríguez R, Mantilla MT, Jáuregui-Renaud K. Diabetic polyneuropathy may increase the handicap related to vestibular disease. Arch Med Res. 2009;40(3):180–185. doi:10.1016/j.arcmed.2009.02.011.
    1. Vitkovic J, Winoto A, Rance G, Dowell R, Paine M. Vestibular rehabilitation outcomes in patients with and without vestibular migraine. J Neurol. 2013;260(12):3039–3048. doi:10.1007/s00415-013-7116-7.
    1. Wrisley DM, Whitney SL, Furman JM. Vestibular rehabilitation outcomes in patients with a history of migraine. Otol Neurotol. 2002;23(4):483–487. doi:10.1097/00129492-200207000-00016.
    1. Fong E, Li C, Aslakson R, Agrawal Y. Systematic review of patient-reported outcome measures in clinical vestibular research. Arch Phys Med Rehabil. 2015;96(2):357–365. doi:10.1016/j.apmr.2014.09.017.
    1. Sheikh JI, Yesavage JA. Geriatric Depression Scale (GDS). Recent Evidence and Development of a Shorter Version in Clinical Gerontology. Brink TL, ed. Binghamton, NY: Haworth Press; 1986.
    1. Johansson M, Akerlund D, Larsen HC, Andersson G. Randomized controlled trial of vestibular rehabilitation combined with cognitive-behavioral therapy for dizziness in older people. Otolaryngol Head Neck Surg. 2001;125(3):151–156.
    1. Badaracco C, Labini FS, Meli A, De Angelis E, Tufarelli D. Vestibular rehabilitation outcomes in chronic vertiginous patients through computerized dynamic visual acuity and Gaze stabilization test. Otol Neurotol. 2007;28(6):809–813.
    1. Gottshall KR, Hoffer ME, Moore RJ, Balough BJ. The role of vestibular rehabilitation in the treatment of Meniere's disease. Otolaryngol Head Neck Surg. 2005;133(3):326–328.
    1. Meli A, Zimatore G, Badaracco C, De Angelis E, Tufarelli D. Vestibular rehabilitation and 6-month follow-up using objective and subjective measures. Acta Otolaryngol. 2006;126(3):259–266.
    1. Mantello EB, Moriguti JC, Rodrigues-Junior AL, Ferrioli E. Vestibular rehabilitation's effect over the quality of life of geriatric patients with labyrinth disease. Braz J Otorhinolaryngol. 2008;74(2):172–180.
    1. Morozetti PG, Ganança CF, Chiari BM. Comparison of different protocols for vestibular rehabilitation in patients with peripheral vestibular disorders. J Soc Bras Fonoaudiol. 2011;23(1):44–50.
    1. Murray K, Carroll S, Hill K. Relationship between change in balance and self-reported handicap after vestibular rehabilitation therapy. Physiother Res Int. 2001;6(4):251–263.
    1. Tee LH, Chee NWC, Zhu M, Jin J. Functional outcomes after customized vestibular rehabilitation in subjects with chronic vestibular dysfunction. Physiother Sing. 2010;13(2):4–7.
    1. Cowand JL, Wrisley DM, Walker M, Strasnick B, Jacobson JT. Efficacy of vestibular rehabilitation. Otolaryngol Head Neck Surg. 1998;118(1):49–54.
    1. Bittar RSM, Pedalini MEB, Lorenzi MC, Formigoni LG. Treating vertigo with vestibular rehabilitation: results in 155 patients. Rev Laryngol Otol Rhinol. 2002;123(1):61–65.
    1. Spielberger CD, Gorsuch RL, Lushene RD. STAI: Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press; 1970.
    1. Cass SP, Borello-France D, Furman JM. Functional outcome of vestibular rehabilitation in patients with abnormal sensory-organization testing. Am J Otol. 1996;17(4):581–594.
    1. Murray KJ, Hill K, Phillips B, Waterston J. Does otolith organ dysfunction influence outcomes after a customized program of vestibular rehabilitation? J Neurol Phys Ther. 2010;34(2):70–75. doi:10.1097/NPT.0b013e3181dde5dd.
    1. Ebrahimi AA, Jamshidi AA, Movallali G, Rahgozar M, Haghgoo HA. The effect of vestibular rehabilitation therapy program on sensory organization of deaf children with bilateral vestibular dysfunction. Acta Med Iran. 2017;55(11):683–689.
    1. Migliaccio AA, Schubert MC. Pilot study of a new rehabilitation tool: improved unilateral short-term adaptation of the human angular vestibulo-ocular reflex. Otol Neurotol. 2014;35(10):e310–e316. doi:10.1097/MAO.0000000000000539.
    1. Rinaudo CN, Schubert MC, Cremer PD, Figtree WVC, Todd CJ, Migliaccio AA. Improved oculomotor physiology and behavior after unilateral incremental adaptation training in a person with chronic vestibular hypofunction: a case report. Phys Ther. 2019;99(10):1326–1333. doi:10.1093/ptj/pzz083.
    1. Bechly KE, Carender WJ, Myles JD, Sienko KH. Determining the preferred modality for real-time biofeedback during balance training. Gait Posture. 2013;37(3):391–396. doi:10.1016/j.gaitpost.2012.08.007.
    1. Yamanaka T, Sawai Y, Murai T, Nishimura T, Kitahara T. Long-term effects of electrotactile sensory substitution therapy on balance disorders. Neuroreport. 2016;27(10):744–748. doi:10.1097/WNR.0000000000000606.
    1. Pereira CMM, Pinheiro do Vale JS, de Oliveira WP, et al. Aquatic physiotherapy: a vestibular rehabilitation option [published online ahead of print January 13, 2020]. Braz J Otorhinolaryngol. doi:10.1016/j.bjorl.2019.12.003.
    1. Gabilan YP, Perracini MR, Munhoz MS, Gananç FF. Aquatic physiotherapy for vestibular rehabilitation in patients with unilateral vestibular hypofunction: exploratory prospective study. J Vestib Res. 2008;18(2/3):139–146.
    1. Kutzner I, Richter A, Gordt K, et al. Does aquatic exercise reduce hip and knee joint loading? In vivo load measurements with instrumented implants. PLoS One. 2017;12(3):e0171972. doi:10.1371/journal.pone.0171972.
    1. Rushton D, Cox N. A new optical treatment for oscillopsia. J Neurol Neurosurg Psychiatry. 1987;50(4):411–415. doi:10.1136/jnnp.50.4.411.
    1. Pothier DD, Hughes C, Dillon W, Ranalli PJ, Rutka JA. The use of real-time image stabilization and augmented reality eyewear in the treatment of oscillopsia. Otolaryngol Head Neck Surg. 2012;146(6):966–971. doi:10.1177/0194599811434708.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe