Double‐blind, placebo‐controlled trial of rehabilitation for bilateral vestibular hypofunction: Preliminary report

TLDR

Vestibular rehabilitation is increasingly popular, yet limited evidence supports its efficacy for improving functional abilities in patients with bilateral vestibular hypofunction. In a double‑blind, controlled trial of eight older adults with bilateral vestibular hypofunction, one group received 8 weeks of vestibular rehabilitation followed by home exercises, while the other received 8 weeks of isometric strengthening before switching to rehabilitation. The rehabilitation group walked 8% faster and showed 10% greater maximum moment arm and 17% shorter double‑support duration, whereas the strengthening group improved less than 1%; both groups improved overall, but self‑reported dizziness scores did not differ, indicating that vestibular rehabilitation enhances functional stability while strengthening also yields symptomatic relief.

Abstract

Vestibular rehabilitation (VR) is increasingly popular, but few data exist to support enthusiasts' claims of efficacy in improving functional abilities of patients with bilateral vestibular hypofunction (BVH). A double‐blind, controlled study of eight subjects (mean, 64 ± 12 years; seven females, one male) with bilateral vestibular hypofunction was conducted. Subjects in group A Received 8 weeks of VR followed by 8 weeks of home VR exercises, whereas those in group B Received 8 weeks of control treatment (isometric strengthening exercises) followed by 8 weeks of VR. At the end of 8 weeks, group A walked 8% faster and, during paced gait and stair‐climbing, with greater stability, evidenced by a 10% larger maximum moment arm and a 17% decreased double‐support duration during gait and stair stance. Group B improved less than 1% during the control treatment. Self‐reported Dizziness Handicap Inventory scores did not differ significantly between control and active VR. All subjects improved compared with baseline tests at the 16‐week post‐test on both functional testing and on the Self‐reported Dizziness Handicap Inventory scale. We conclude that in this small sample, VR effectively improved functional, dynamic stability during locomotion, but even strengthening exercises result in self‐reported symptomatic improvement.