Vestibular Rehabilitation for Peripheral Vestibular Hypofunction

Publication Date: April 1, 2016
Last Updated: March 14, 2022

SUMMARY OF ACTION STATEMENTS

Therapeutic Intervention for Persons With Peripheral Vestibular Hypofunction

EFFECTIVENESS OF VESTIBULAR REHABILITATION IN PERSONS WITH ACUTE AND SUBACUTE UNILATERAL VESTIBULAR HYPOFUNCTION

Clinicians should offer vestibular rehabilitation to patients with acute or subacute unilateral vestibular hypofunction. (I, A)
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EFFECTIVENESS OF VESTIBULAR REHABILITATION IN PERSONS WITH CHRONIC UNILATERAL VESTIBULAR HYPOFUNCTION

Clinicians should offer vestibular rehabilitation to patients with chronic unilateral vestibular hypofunction. (I, A)
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EFFECTIVENESS OF VESTIBULAR REHABILITATION IN PERSONS WITH BILATERAL VESTIBULAR HYPOFUNCTION

Clinicians should offer vestibular rehabilitation to patients with bilateral vestibular hypofunction. (I, A)
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EFFECTIVENESS OF SACCADIC OR SMOOTH-PURSUIT EXERCISES IN PERSONS WITH PERIPHERAL VESTIBULAR HYPOFUNCTION (UNILATERAL OR BILATERAL)

Clinicians should not offer saccadic or smooth-pursuit exercises in isolation (ie, without head movement) as specific exercises for gaze stability to patients with unilateral or bilateral vestibular hypofunction. (I, A)
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EFFECTIVENESS OF DIFFERENT TYPES OF EXERCISES IN PERSONS WITH ACUTE OR CHRONIC UNILATERAL VESTIBULAR HYPOFUNCTION

Clinicians may provide targeted exercise techniques to accomplish specific goals appropriate to address identified impairments and functional limitations. (II, B)
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EFFECTIVENESS OF SUPERVISED VESTIBULAR REHABILITATION

Clinicians may offer supervised vestibular rehabilitation to patients with unilateral or bilateral peripheral vestibular hypofunction. (, B)
(Evidence quality: I-III)
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OPTIMAL EXERCISE DOSE OF TREATMENT IN PEOPLE WITH PERIPHERAL VESTIBULAR HYPOFUNCTION (UNILATERAL AND BILATERAL)

Clinicians may prescribe a home exercise program of gaze stability exercises consisting of a minimum of 3 times per day for a total of at least 12 minutes per day for patients with acute/subacute vestibular hypofunction and at least 20 minutes per day for patients with chronic vestibular hypofunction. (V, D)
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DECISION RULES FOR STOPPING VESTIBULAR REHABILITATION IN PERSONS WITH PERIPHERAL VESTIBULAR HYPOFUNCTION (UNILATERAL AND BILATERAL)

Clinicians may use achievement of primary goals, resolution of symptoms, or plateau in progress as reasons for stopping rehabilitation. (V, D)
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FACTORS THAT MODIFY REHABILITATION OUTCOMES

Clinicians may evaluate factors that could modify rehabilitation outcomes.
(Evidence quality: I-III)
(recommendation strength: weak to strong)
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THE HARM/BENEFIT RATIO FOR VESTIBULAR REHABILITATION IN TERMS OF QUALITY OF LIFE/PSYCHOLOGICAL STRESS

Clinicians should offer vestibular rehabilitation to persons with peripheral vestibular hypofunction. (, A)
(Evidence quality: I-III)
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Recommendation Grading

Overview

Title

Vestibular Rehabilitation for Peripheral Vestibular Hypofunction

Authoring Organization

Publication Month/Year

April 1, 2016

Last Updated Month/Year

June 1, 2023

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

Assist physical therapists with the treatment of persons with peripheral vestibular hypofunction to optimize rehabilitation outcomes.

Inclusion Criteria

Female, Male, Adolescent, Adult, Child, Older adult

Health Care Settings

Ambulatory, Hospital, Outpatient

Intended Users

Physical therapist, nurse, nurse practitioner, physician, physician assistant

Scope

Rehabilitation, Management, Treatment

Diseases/Conditions (MeSH)

D014724 - Vestibular Function Tests, D015837 - Vestibular Diseases

Keywords

dizziness, vestibular rehabilitation, peripheral vestibular hypofunction, blurred vision, vestibular exercise

Source Citation

Hall, Courtney D. PT, PhD; Herdman, Susan J. PT, PhD, FAPTA; Whitney, Susan L. PT, PhD, NCS, ATC, FAPTA; Cass, Stephen P. MD, MPH; Clendaniel, Richard A. PT, PhD; Fife, Terry D. MD, FAAN, FANS; Furman, Joseph M. MD, PhD; Getchius, Thomas S. D. BA; Goebel, Joel A. MD; Shepard, Neil T. PhD; Woodhouse, Sheelah N. PT, BScPT Vestibular Rehabilitation for Peripheral Vestibular Hypofunction, Journal of Neurologic Physical Therapy: April 2016 - Volume 40 - Issue 2 - p 124-155 doi: 10.1097/NPT.0000000000000120
 

Supplemental Methodology Resources

Data Supplement