Vestibular rehabilitation - For whom and how? A systematic review

Vestibular rehabilitation was first developed as treatment for vestibular disorders but has also been used as treatment for other causes of dizziness. Many outpatients with dizziness are seen in primary care but vestibular rehabilitation is probably not well known among physiotherapist outside tertiary care. The aim of this systematic literature review was to describe and elucidate vestibular rehabilitation as a feasible treatment for various causes of dizziness. Using the keyword vestibular rehabilitation, searches were performed in PubMed, AMED, CINAHL and PeDro. Seventy-one studies were included in the review. Strong scientific evidence for vestibular rehabilitation was found for vestibular hypofunction, for multisensory dizziness and for Menie're's disease. Moderately strong scientific evidence was found for vestibular rehabilitation after vestibular surgery. For neurological causes of dizziness, benign positional paroxysmal vertigo (BPPV), phobic postural vertigo (PPV), dizziness concomitant to whiplash-associated disorders (WAD) and migraine-associated dizziness there seems to be insufficient scientific evidence. Vestibular rehabilitation can be recommended as treatment for vestibular hypofunction, for multisensory dizziness, for Menie're's disease and after vestibular surgery. The results of research on vestibular rehabilitation for neurological causes of dizziness, BPPV, PPV, dizziness concomitant to WAD and migraine-associated dizziness are promising enough for recommending vestibular rehabilitation for these diagnoses also, even though more studies are needed.