Cohort study shows individualized vestibular rehabilitation achieves 76% symptom resolution in chronic dizziness, indicating tailored exercise therapies optimize functional recovery.
Key Points
To evaluate the diagnostic accuracy of bedside and technological tools and compare the clinical effectiveness of individualized versus generic vestibular rehabilitation therapy in chronic dizziness.
Conducted a 12-week three-arm cohort study of 298 patients presenting with chronic dizziness across diverse vestibular disorders.
Assigned participants to individualized vestibular rehabilitation therapy (VRT) (n=148), generic vestibular exercises (n=82), or no structured VRT (n=68).
Compared diagnostic accuracy across the video head impulse test (vHIT), HINTS examination, Dizziness Handicap Inventory, and clinical history alone.
Video head impulse test (vHIT) demonstrated superior diagnostic accuracy for peripheral vestibular dysfunction (AUC 0.92) compared to HINTS (AUC 0.88), Dizziness Handicap Inventory (AUC 0.78), and clinical history (AUC 0.66).
Individualized VRT resulted in 76% symptom resolution at 12 weeks compared with 52% for generic exercises and 24% for no structured VRT.
Key independent predictors of symptom resolution included BPPV with canalith repositioning, individualized VRT prescription, recent symptom onset, acute peripheral etiology, and home exercise compliance.