Does vestibular rehabilitation physiotherapy work?
Extensive research has been conducted in the field of vestibular rehabilitation, mostly relating to conditions that cause unilateral peripheral vestibular dysfunction.
An important meta-analysis through the Cochrane collaboration in 2015 concluded from reviewing all research that:
there is moderate to strong evidence that vestibular rehabilitation is a safe, effective management for unilateral peripheral vestibular dysfunction
there is moderate evidence that vestibular rehabilitation resolves symptoms and improves functioning in the medium term
for the specific diagnostic group of BPPV, physical (repositioning) manoeuvres are more effective in the short term than exercise-based vestibular rehabilitation; although a combination of the two is effective for longer-term functional recovery.
Additionally, a synthesis of the research in 2016 by the American physical therapy association stated that:
there is strong evidence for vestibular rehabilitation in unilateral and bilateral vestibular hypofunction
rehabilitation should not only include eye movements without head movement to improve visual stability
there is moderate evidence to prescribe exercises to target impairments (clinical findings) and functional limitations (the impact to the patient’s life)
Furthermore, there is extensive research evidence for positional tests and repositioning manoeuvres for all sub-types of benign paroxysmal positional vertigo (BPPV). There is also growing research evidence for vestibular rehabilitation in multiple sclerosis, stroke, traumatic brain injury, concussion, after acoustic neuroma, vestibular migraine, and falls prevention.