Vestibular rehabilitation therapy in Europe: chances and challenges

  • Klaus JahnEmail author
  • Christophe Lopez
  • Andreas Zwergal
  • Oz Zur
  • Ondrej Cakrt
  • Silvy Kellerer
  • Hassen Kerkeni
  • Fredrik Tjernström
  • Dara Meldrum
  • Vestibular Rehabilitation Research Group in the European DIZZYNET
Letter to the Editors

Dear Sirs,

Dizziness, vertigo, and balance problems are among the most common complaints in patients and at least 50% of patients out of balance need some form of physical therapy [1]. Besides the excellent evidence that the specific physical maneuvers are effective for treatment in benign paroxysmal positional vertigo (level 1), there is also sufficient evidence that vestibular rehabilitation therapy (VRT) improves outcome in unilateral (level 1) and bilateral (level 1) vestibular hypofunction [2, 3, 4, 5, 6, 7]. The principles of treatment go back to the 1940s when Cawthorne and Cooksey first described exercises to improve balance after vestibular injuries [8]. While there is a general agreement that balance training is useful in vestibular disorders, there is insufficient evidence for specific interventions in specific clinical situations, optimal exercise dose, advantages of supervised vs. home-based exercises, and optimal duration of treatment programs [9, 10, 11, 12]. Recently,...



This work was supported by the German Federal Ministry of Education and Research (BMBF Grant 01EO1401).

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no competing interests to report.

Ethical approval

This work does not present original experimental data. However, all work related to the paper have been done in accordance with ethical standards (Declaration of Helsinki and later amendments).


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Klaus Jahn
    • 1
    • 2
    Email author
  • Christophe Lopez
    • 3
  • Andreas Zwergal
    • 1
    • 4
  • Oz Zur
    • 5
    • 6
  • Ondrej Cakrt
    • 7
  • Silvy Kellerer
    • 1
  • Hassen Kerkeni
    • 8
  • Fredrik Tjernström
    • 9
  • Dara Meldrum
    • 10
  • Vestibular Rehabilitation Research Group in the European DIZZYNET
  1. 1.German Center for Vertigo and Balance Disorders (DSGZ)University Hospital Grosshadern, Ludwig-Maximilians University of MunichMunichGermany
  2. 2.Department of Neurology and NeurorehabilitationSchoen Clinic Bad AiblingMunichGermany
  3. 3.Laboratoire de Neurosciences Sensorielles Et CognitivesCNRS Aix-Marseille UniversitéMarseilleFrance
  4. 4.Department of NeurologyUniversity Hospital Grosshadern, Ludwig-Maximilians University of MunichMunichGermany
  5. 5.Department of Physical TherapyBen Gurion University of the NegevBeer ShevaIsrael
  6. 6.The Israeli Center for Treating Dizziness and Balance DisordersRa’ananaIsrael
  7. 7.Department of Rehabilitation and Sports MedicineCharles University and Motol University Hospital PraguePragueCzech Republic
  8. 8.Department of NeurologyUniversity Hospital-InselspitalBernSwitzerland
  9. 9.Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Clinical SciencesLund UniversityLundSweden
  10. 10.Academic Unit of Neurology, School of MedicineTrinity Biomedical Sciences Institute, Trinity College DublinDublinIreland

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