PURPOSE: Adults with bilateral vestibular hypofunction (BVH) experience significant disability. A systematic review assessed evidence for vestibular rehabilitation (VR). Number of studies: 14 studies. MATERIALS/METHODS: Search identification of studies based on inclusion criteria: (a) population: adults with BVH of peripheral origin; (b) interventions: vestibular exercises, balance training, education, or sensory prosthetics; (c) comparison: single interventions or compared to another psychophysical intervention, placebo, or healthy population; (d) outcomes: based on International Classification of Functioning, Disability and Health (ICF) Body Functions and Structure, Activity, and Participation; (e) study designs: prospective and interventional, levels of evidence I to III per Centre of Evidence-Based Medicine grading. Coding and appraisal based on ICF framework and strength of evidence synthesis. RESULTS: Five level II studies and nine level III studies: All had outcomes on gaze and postural stability, five with outcomes on gait speed and perceptions of oscillopsia and disequilibrium. CONCLUSIONS: (a) Moderate evidence strength on improved gaze and postural stability (ICF Body Functions) following exercise-based VR; (b) inadequate number of studies supporting benefit of VR on ICF-Participation outcomes; (c) sensory prosthetics in early phase of development. CLINICAL RELEVANCE: Moderate evidence strength in support of VR from an impairment level; clinical practice and research needed to explore interventions extending to ICF Activity and Participation.
Reprinted from the Journal of Vestibular Research with copyright permission from IOS Press.

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