Opinion statement
Vestibular rehabilitation of persons with peripheral and central vestibular disorders requires a thorough evaluation and a customized plan of care. Collaboration of the various members of the treatment team optimizes outcomes. Early intervention appears to be better than referring patients who have developed chronic symptoms of balance loss, dizziness, anxiety, and depression. There is a body of emerging evidence that supports that the central nervous system has the capability to reweigh sensory inputs in order to improve function. There continues to be a dearth of knowledge related to how to treat persons with otolithic dysfunction as compared to those with semicircular canal damage. With the use of vestibular rehabilitation, patients are less likely to fall, are less dizzy, balance and gait improve, and quality of life is enhanced. Recent Cochrane reviews and a clinical practice guideline support the use of vestibular rehabilitation for persons with vestibular dysfunction. Typical symptoms and their management including dysregulated gait, falling, fear of falling, increased sway in standing, visual blurring, symptoms with complex visual scenes in the periphery, and weakness are all discussed with ideas for intervention. Any patient with a vestibular disorder may benefit from a trial of vestibular rehabilitation. A discussion of recent evidence and innovations related to vestibular rehabilitation is also included.
Similar content being viewed by others
References and Recommended Reading
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
Cawthorne T. The physiological basis for head exercises. J Chart Soc Physiother. 1944;3:106–7.
Cooksey FS. Rehabilitation in vestibular injuries. Proc R Soc Med. 1946;39.
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):809–13.
Badke MB, Miedaner JA, Shea TA, Grove CR, Pyle GM. Effects of vestibular and balance rehabilitation on sensory organization and dizziness handicap. Ann Oto Rhinol Laryn. 2005;114(1):48–54.
Bjerlemo B, Kollen L, Boderos I, Kreuter M, Moller C. Recovery after early vestibular rehabilitation in patients with acute unilateral vestibular loss. Audiol Med. 2006;4:117–23.
Cakrt O, Chovanec M, Funda T, Kalitova P, Betka J, Zverina E, et al. Exercise with visual feedback improves postural stability after vestibular schwannoma surgery. Eur Arch Oto-Rhino-L. 2010;267(9):1355–60.
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.
Clendaniel RA. The effects of habituation and gaze stability exercises in the treatment of unilateral vestibular hypofunction: a preliminary results. J Neurol Phys Ther. 2010;34(2):111–6.
Donmez B, Akdal G. Vestibular rehabilitation in unilateral peripheral vestibulopathy: a preliminary report. J Neurol Sci Turk. 2008;25(2):128–35.
Enticott JC, O'Leary SJ, Briggs RJS. Effects of vestibulo-ocular reflex exercises on vestibular compensation after vestibular schwannoma surgery. Otol Neurotol. 2005;26(2):265–9.
Enticott JC, Vitkovic JJ, Reid B, O'Neill P, Paine M. Vestibular rehabilitation in individuals with inner-ear dysfunction: a pilot study. Audiol Neuro Otol. 2008;13(1):19–28.
Gabilan YPL, Perracini MR, Munhoz MSL, Gananc FF. Aquatic physiotherapy for vestibular rehabilitation in patients with unilateral vestibular hypofunction: exploratory prospective study. J Vestibul Res Equil. 2008;18(2–3):139–46.
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):1325–31.
Goudakos JK, Markou KD, Psillas G, Vital V, Tsaligopoulos M. Corticosteroids and vestibular exercises in vestibular neuritis single-blind randomized clinical trial. Jama Otolaryngol. 2014;140(5):434–40.
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.
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):264–7.
Kao CL, Tsai KL, Cheng YY, Kuo CH, Lee SD, Chan RC. Vestibular rehabilitation ameliorates chronic dizziness through the axis. Front Aging Neurosci. 2014;6.
Kvale A, Wilhelmsen K, Fiske HA. Physical findings in patients with dizziness undergoing a group exercise programme. Physiother Res Int: J Res Clin Phys Ther. 2008;13(3):162–75.
Maciaszek J, Osinski W. Effect of Tai Chi on Body Balance: Randomized Controlled Trial in Elderly Men with Dizziness. Am J Chin Med. 2012;40(2):245–53.
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):172–80.
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 Oto-Rhino-L. 2013;270(2):425–35.
McGibbon CA, Krebs DE, Parker SW, Scarborough DM, Wayne PM, Wolf SL. Tai Chi and vestibular rehabilitation improve vestibulopathic gait via different neuromuscular mechanisms: Preliminary report. Bmc Neurol. 2005;5.
Meldrum D, Herdman S, Vance R, Murray D, Malone K, Duffy D, 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):1319–28.
Mohammad MT, Whitney SL, Sparto PJ, Jennings JR, Furman JM. Perceptual and motor inhibition in individuals with vestibular disorders. J Neurol Phys Ther. 2010;34(2):76–81.
Morozetti PG, Gananca 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.
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):70–5.
Patatas OH, Gananca CF, Gananca FF. Quality of life of individuals submitted to vestibular rehabilitation. Braz J Otorhinolaryngol. 2009;75(3):387–94.
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):208–18.
Rocha Junior PR, da Peres Silva A, Garbi FP, Frizzo AC, Valenti VE. Effects of physiotherapy on balance and unilateral vestibular hypofunction in vertiginous elderly. Int Arch Med. 2014;7(1):8.
Rossi-Izquierdo M, Santos-Perez S, Rubio-Rodriguez JP, Lirola-Delgado A, Zubizarreta-Gutierrez A, Roman-Rodriguez ES, et al. What is the optimal number of treatment sessions of vestibular rehabilitation? Eur Arch Oto-Rhino-L. 2014;271(2):275–80.
Rossi-Izquierdo M, Santos-Perez S, Soto-Varela A. What is the most effective vestibular rehabilitation technique in patients with unilateral peripheral vestibular disorders? Eur Arch Oto-Rhino-L. 2011;268(11):1569–74.
Smaerup M, Gronvall E, Larsen SB, Laessoe U, Henriksen JJ, Damsgaard EM. Computer-assisted training as a complement in rehabilitation of patients with chronic vestibular dizziness—a randomized controlled trial. Arch Phys Med Rehabil. 2015;96(3):395–401.
Sparrer I, Thien ADD, Ilgner J, Westhofen M. Vestibular rehabilitation using the Nintendo (R) Wii Balance Board—a user-friendly alternative for central nervous compensation. Acta Oto-Laryngol. 2013;133(3):239–45.
Tee LH. Functional outcomes after customized vestibular rehabilitation in subjects with chronic vestibular dysfunction. Physiother Singapore. 2010;13(2):4–7.
Teggi R, Caldirola D, Fabiano B, Recanati P, Bussi M. Rehabilitation after acute vestibular disorders. J Laryngol Otol. 2009;123(4):397–402.
Venosa AR, Bittar RS. Vestibular rehabilitation exercises in acute vertigo. Laryngoscope. 2007;117(8):1482–7.
Verdecchia DH, Mendoza M, Sanguineti F, Binetti AC. Outcomes after vestibular rehabilitation and Wii(R) therapy in patients with chronic unilateral vestibular hypofunction. Acta Otorrinolaringol Esp. 2014;65(6):339–45.
Vereeck L, Wuyts FL, Truijen S, De Valck C, de Heyning PHV. The effect of early customized vestibular rehabilitation on balance after acoustic neuroma resection. Clin Rehabil. 2008;22(8):698–713.
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):3039–48. People with and without migraine dizziness appear to improve after completion of a vestibular rehabiliation program.
Yeh SC, Chen S, Wang PC, Su MC, Chang CH, Tsai PY. Interactive 3-dimensional virtual reality rehabilitation for patients with chronic imbalance and vestibular dysfunction. Technol Health Care. 2014;22(6):915–21.
McDonnell MN, Hillier SL. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev. 2015;1, CD005397. The paper provides the most current review related to peripheral vestibular hypofunction inclusive of BPPV.
Porciuncula F, Johnson CC, Glickman LB. The effect of vestibular rehabilitation on adults with bilateral vestibular hypofunction: a systematic review. J Vestib Res: Equilib Orientation. 2012;22(5–6):283–98.
Nagaratnam N, Ip J, Bou-Haidar P. The vestibular dysfunction and anxiety disorder interface: a descriptive study with special reference to the elderly. Arch Gerontol Geriatr. 2005;40(3):253–64.
Shefer S, Gordon C, Avraham KB, Mintz M. Balance deficit enhances anxiety and balance training decreases anxiety in vestibular mutant mice. Behav Brain Res. 2015;276:76–83.
Simon NM, Pollack MH, Tuby KS, Stern TA. Dizziness and panic disorder: a review of the association between vestibular dysfunction and anxiety. Ann Clin Psychiatry: Off J Am Acad Clin Psychiatrists. 1998;10(2):75–80.
Klatt BN, Carender WJ, Lin CC, Alsubaie SF, Kinnaird CR, Sienko KH, 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.
Hall CD, Herdman SD, Whitney SL, Cass SP, Clendaniel RA, Fife TD, et al. Vestibular rehabilitation for peripheral vestibular hypofunction: an evidence-based clinical practice guideline J Neurol Phys Ther. 2016;In press. The paper is the first clinical practice guidelilne generated related to peripehral vestibular hypofunction.
Curthoys IS. Vestibular compensation and substitution. Curr Opin Neurol. 2000;13(1):27–30.
Gauchard GC, Parietti-Winkler C, Lion A, Simon C, Perrin PP. Impact of pre-operative regular physical activity on balance control compensation after vestibular schwannoma surgery. Gait Posture. 2013;37(1):82–7.
Lacour M, Bernard-Demanze L. Interaction between vestibular compensation mechanisms and vestibular rehabilitation therapy: 10 recommendations for optimal functional recovery. Front Neurol. 2014;5:285.
Studenski S, Perera S, Patel K, Rosano C, Faulkner K, Inzitari M, et al. Gait speed and survival in older adults. JAMA. 2011;305(1):50–8.
Arnold SA, Stewart AM, Moor HM, Karl RC, Reneker JC. The effectiveness of vestibular rehabilitation interventions in treating unilateral peripheral vestibular disorders: a systematic review. Physiotherapy research international : the journal for researchers and clinicians in physical therapy. 2015.
Ricci NA, Aratani MC, Caovilla HH, Gananca FF. Effects of Vestibular Rehabilitation on Balance Control in Older People with Chronic Dizziness: A Randomized Clinical Trial. American journal of physical medicine & rehabilitation / Association of Academic Physiatrists. 2015.
Alahmari KA, Sparto PJ, Marchetti GF, Redfern MS, Furman JM, Whitney SL. Comparison of virtual reality based therapy with customized vestibular physical therapy for the treatment of vestibular disorders. IEEE Trans Neural Syst Rehabil Eng: Publ IEEE Eng Med Biol Soc. 2014;22(2):389–99.
Saman Y, Bamiou DE, Murdin L, Tsioulos K, Davies R, Dutia MB, et al. Balance, falls risk, and related disability in untreated vestibular schwannoma patients. J Neurol Surg Part B, Skull Base. 2014;75(5):332–8.
Herdman SJ, Blatt P, Schubert MC, Tusa RJ. Falls in patients with vestibular deficits. AmJOtol. 2000;21(6):847–51.
Brach JS, Francois SJ, VanSwearingen JM, Gilmore S, Perera S, Studenski SA. Translation of a motor learning walking rehabilitation program into a group-based exercise program for community-dwelling older adults. PM R. 2015.
Brach JS, Lowry K, Perera S, Hornyak V, Wert D, Studenski SA, et al. Improving motor control in walking: a randomized clinical trial in older adults with subclinical walking difficulty. Arch Phys Med Rehabil. 2015;96(3):388–94.
Brach JS, Van Swearingen JM, Perera S, Wert DM, Studenski S. Motor learning versus standard walking exercise in older adults with subclinical gait dysfunction: a randomized clinical trial. J Am Geriatr Soc. 2013;61(11):1879–86.
Basta D, Singbartl F, Todt I, Clarke A, Ernst A. Vestibular rehabilitation by auditory feedback in otolith disorders. Gait Posture. 2008;28(3):397–404.
Allum JH, Carpenter MG, Horslen BC, Davis JR, Honegger F, Tang KS, et al. Improving impaired balance function: real-time versus carry-over effects of prosthetic feedback. Conf Proc: Annu Int Conf IEEE Eng Med Biol Soc IEEE Eng Med Biol Soc Annu Conf. 2011;2011:1314–8.
Horlings CG, Carpenter MG, Honegger F, Allum JH. Vestibular and proprioceptive contributions to human balance corrections: aiding these with prosthetic feedback. Ann N Y Acad Sci. 2009;1164:1–12.
Dozza M, Horak FB, Chiari L. Auditory biofeedback substitutes for loss of sensory information in maintaining stance. Exp Brain Res. 2007;178(1):37–48.
Sienko KH, Balkwill MD, Oddsson LI, Wall 3rd C. The effect of vibrotactile feedback on postural sway during locomotor activities. J Neuroeng Rehabil. 2013;10:93.
Wrisley DM, Marchetti GF, Kuharsky DK, Whitney SL. Reliability, internal consistency, and validity of data obtained with the functional gait assessment. Phys Ther. 2004;84(10):906–18.
Lee BC, Kim J, Chen S, Sienko KH. Cell phone based balance trainer. J Neuroeng Rehabil. 2012;9:10.
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):938–44.
Liao WL, Chang TP, Chen HJ, Kao CH. Benign paroxysmal positional vertigo is associated with an increased risk of fracture: a population-based cohort study. J Orthop Sports Phys Ther. 2015;45(5):406–12.
Avin KG, Hanke TA, Kirk-Sanchez N, McDonough CM, Shubert TE, Hardage J, et al. Management of falls in community-dwelling older adults: clinical guidance statement from the Academy of Geriatric Physical Therapy of the American Physical Therapy Association. Phys Ther. 2015;95(6):815–34.
Moreland J, Richardson J, Chan D, O'Neill J, Bellissimo A, Grum R, et al. Evidence-based guidelines for the secondary prevention of falls in older adults. Gerontology. 2003;49(2):93–116.
Lowry KA, Vanswearingen JM, Perera S, Studenski SA, Brach JS. Walking smoothness is associated with self-reported function after accounting for gait speed. J Gerontol Ser A Biol Med Sci. 2013;68(10):1286–90.
Rosso AL, Olson Hunt MJ, Yang M, Brach JS, Harris TB, Newman AB, et al. Higher step length variability indicates lower gray matter integrity of selected regions in older adults. Gait Posture. 2014;40(1):225–30.
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: Equilib Orientation. 2004;14(5):397–409.
Alsalaheen BA, Whitney SL, Marchetti GF, Furman JM, Kontos AP, Collins MW, et al. Performance of high school adolescents on functional gait and balance measures. Pediatric Phys Ther: Off Publ Section Pediatr Am Phys Ther Assoc. 2014;26(2):191–9.
Ekvall Hansson E, Dahlberg LE, Magnusson M. Vestibular rehabilitation affects vestibular asymmetry among patients with fall-related wrist fractures—a randomized controlled trial. Gerontology. 2015;61(4):310–8.
Ekvall Hansson E, Magnusson M. Vestibular asymmetry predicts falls among elderly patients with multi-sensory dizziness. BMC Geriatr. 2013;13:77.
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):746–51.
Gananca FF, Gazzola JM, Gananca CF, Caovilla HH, Gananca MM, Cruz OL. Elderly falls associated with benign paroxysmal positional vertigo. Braz J Otorhinolaryngol. 2010;76(1):113–20.
Powell LE, Myers AM. The Activities-specific Balance Confidence (ABC) Scale. J Gerontol A Biol Sci Med Sci. 1995;50A(1):M28–34.
Morgan MT, Friscia LA, Whitney SL, Furman JM, Sparto PJ. Reliability and validity of the Falls Efficacy Scale-International (FES-I) in individuals with dizziness and imbalance. Otol Neurotol. 2013;34(6):1104–8.
Bigelow RT, Semenov YR, du Lac S, Hoffman HJ, Agrawal Y. Vestibular vertigo and comorbid cognitive and psychiatric impairment: the 2008 National Health Interview Survey. Journal of neurology, neurosurgery, and psychiatry. 2015.
Yuan Q, Yu L, Shi D, Ke X, Zhang H. Anxiety and depression among patients with different types of vestibular peripheral vertigo. Medicine. 2015;94(5), e453.
Kanzaki J, Goto F. Psychiatric disorders in patients with dizziness and Meniere's disease. Acta Otolaryngol. 2015;135(5):447–50.
Hill AM, Etherton-Beer C, Haines TP. Tailored education for older patients to facilitate engagement in falls prevention strategies after hospital discharge—a pilot randomized controlled trial. PLoS ONE. 2013;8(5), e63450.
Dai M, Cohen B, Smouha E, Cho C. Readaptation of the vestibulo-ocular reflex relieves the mal de debarquement syndrome. Front Neurol. 2014;5:124.
Liu W, Lipsitz LA, Montero-Odasso M, Bean J, Kerrigan DC, Collins JJ. Noise-enhanced vibrotactile sensitivity in older adults, patients with stroke, and patients with diabetic neuropathy. Arch Phys Med Rehabil. 2002;83(2):171–6.
Priplata AA, Niemi JB, Harry JD, Lipsitz LA, Collins JJ. Vibrating insoles and balance control in elderly people. Lancet. 2003;362(9390):1123–4.
Priplata AA, Patritti BL, Niemi JB, Hughes R, Gravelle DC, Lipsitz LA, et al. Noise-enhanced balance control in patients with diabetes and patients with stroke. Ann Neurol. 2006;59(1):4–12.
Jacob RG, Whitney SL, Detweiler-Shostak G, Furman JM. Vestibular rehabilitation for patients with agoraphobia and vestibular dysfunction: a pilot study. J Anxiety Disord. 2001;15(1–2):131–46.
Whitney SL, Jacob RG, Sparto PJ, Olshansky EF, Detweiler-Shostak G, Brown EL, et al. Acrophobia and pathological height vertigo: indications for vestibular physical therapy? Phys Ther. 2005;85(5):443–58.
Mallinson AI, Longridge NS. A new set of criteria for evaluating malingering in work-related vestibular injury. Otol Neurotol. 2005;26(4):686–90.
Staab JP. Chronic dizziness: the interface between psychiatry and neuro-otology. Curr Opin Neurol. 2006;19(1):41–8.
Larrosa F, Dura MJ, Menacho J, Gonzalez-Sabate L, Cordon A, Hernandez A, et al. Aphysiologic performance on dynamic posturography in work-related patients. Eur Arch Oto-Rhino-Laryngol: Off J Eur Fed Oto-Rhino-Laryngol Soc. 2013;270(1):93–7.
Dieterich M, Bauermann T, Best C, Stoeter P, Schlindwein P. Evidence for cortical visual substitution of chronic bilateral vestibular failure (an fMRI study). Brain : J Neurol. 2007;130(Pt 8):2108–16.
Mantokoudis G, Schubert MC, Tehrani AS, Wong AL, Agrawal Y. Early adaptation and compensation of clinical vestibular responses after unilateral vestibular deafferentation surgery. Otol Neurotol. 2014;35(1):148–54.
Schubert MC, Zee DS. Saccade and vestibular ocular motor adaptation. Restor Neurol Neurosci. 2010;28(1):9–18.
Schubert MC, Migliaccio AA, Della Santina CC. Modification of compensatory saccades after aVOR gain recovery. J Vestib Res: Equilib Orientation. 2006;16(6):285–91.
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):e310–6.
Bittar RS, Lins EM. Clinical characteristics of patients with persistent postural-perceptual dizziness. Braz J Otorhinolaryngol. 2015;81(3):276–82.
Bronstein A. Visual symptoms and vertigo. Neurol Clin. 2005;23(3):705–13. v-vi.
Jacob R, Woody SR, Clark DB, Lilienfeld SO, Hirsch BE, Kucera GD, et al. Discomfort with space and motion: a possible marker of vestibular dysfunction assessed by the Situational Characteristics Questionnaire. J Psychopathol Behav Assess. 1993;15(4):299–324.
Brandt T, Bles W, Arnold F, Kapteyn TS. Height vertigo and human posture. Adv Otorhinolaryngol. 1979;25:88–92.
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):215–24. The results of the paper provide support for the concept that persons with binoculare visual abnormalities take longer to get better after a vestiublar injury.
Bronstein AM, Golding JF, Gresty MA. Vertigo and dizziness from environmental motion: visual vertigo, motion sickness, and drivers' disorientation. Semin Neurol. 2013;33(3):219–30.
Winkler PA, Ciuffreda KJ. Ocular fixation, vestibular dysfunction, and visual motion hypersensitivity. Optometry. 2009;80(9):502–12.
Gonzalez-Franco M, Gilroy S, Moore JO. Empowering patients to perform physical therapy at home. Conf Proc: Annu Int Conf IEEE Eng Med Biol Soc IEEE Eng Med Biol Soc Annu Conf. 2014;2014:6308–11.
Frontera WR, Hughes VA, Fielding RA, Fiatarone MA, Evans WJ, Roubenoff R. Aging of skeletal muscle: a 12-yr longitudinal study. J Appl Physiol (1985). 2000;88(4):1321–6.
Fielding RA, Vellas B, Evans WJ, Bhasin S, Morley JE, Newman AB, et al. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc. 2011;12(4):249–56.
Ng TP, Feng L, Nyunt MS, Feng L, Niti M, Tan BY, et al. Nutritional, physical, cognitive, and combination interventions and frailty reversal among older adults: a randomized controlled trial. Am J Med. 2015;128(11):1225–36. e1.
Mickle KJ, Munro BJ, Lord SR, Menz HB, Steele JR. ISB Clinical Biomechanics Award 2009: toe weakness and deformity increase the risk of falls in older people. Clin Biomech (Bristol, Avon). 2009;24(10):787–91.
Mickle KJ, Munro BJ, Lord SR, Menz HB, Steele JR. Cross-sectional analysis of foot function, functional ability, and health-related quality of life in older people with disabling foot pain. Arthritis Care Res (Hoboken). 2011;63(11):1592–8.
Murray KJ, Hill KD, Phillips B, Waterston J. The influence of otolith dysfunction on the clinical presentation of people with a peripheral vestibular disorder. Phys Ther. 2007;87(2):143–52.
Lewis RF. Vestibular prostheses investigated in animal models. ORL; J Oto-Rhino-Laryngol Relat Spec. 2015;77(4):219–26.
Phillips C, Ling L, Oxford T, Nowack A, Nie K, Rubinstein JT, et al. Longitudinal performance of an implantable vestibular prosthesis. Hear Res. 2015;322:200–11.
Phillips JO, Ling L, Nie K, Jameyson E, Phillips CM, Nowack AL, et al. Vestibular implantation and longitudinal electrical stimulation of the semicircular canal afferents in human subjects. J Neurophysiol. 2015;113(10):3866–92.
Bhatti PT, Herdman SJ, Roy SD, Hall CD, Tusa RJ. A prototype head-motion monitoring system for in-home vestibular rehabilitation therapy. Journal of bioengineering & biomedical science. 2011;Suppl 1.
Huang K, Sparto PJ, Kiesler S, Siewiorek DP, Smailagic A. iPod-based in-home system for monitoring gaze-stabilization exercise compliance of individuals with vestibular hypofunction. J Neuroeng Rehabil. 2014;11:69.
Acknowledgments
The project was financially supported by King Saud University, through the Vice Deanship of Research Chairs, Rehabilitation Research Chair.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
Susan L. Whitney, Ahmad H. Alghadir, and Shahnawaz Anwer declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Additional information
This article is part of the Topical Collection on Neurologic Ophthalmology and Otology
Rights and permissions
About this article
Cite this article
Whitney, S.L., Alghadir, A.H. & Anwer, S. Recent Evidence About the Effectiveness of Vestibular Rehabilitation. Curr Treat Options Neurol 18, 13 (2016). https://doi.org/10.1007/s11940-016-0395-4
Published:
DOI: https://doi.org/10.1007/s11940-016-0395-4