Survey on the clinical practice and perceptions of Korean balance specialists regarding customized vestibular rehabilitation (customized vestibular exercise): a cross-sectional survey

Objectives: This study assessed clinical use, practitioner satisfaction, and barriers to customized vestibular exercise (CVE), the Korean term for individualized vestibular rehabilitation.Methods: A cross-sectional survey was conducted among 70 specialists from the Korean Otological Society and the Korean Balance Society. Practice patterns, satisfaction levels, and barriers to CVE use were analyzed.Results: Of the 70 respondents, 62.9% (44/70) currently use CVE, and 88.5% (23/26) of non-users plan for future adoption. The most common indication for CVE was vestibular neuritis (97.7%), followed by presbyvestibulopathy (65.9%) and labyrinthitis (63.6%). Vestibular neuritis was most often perceived as the disorder for which CVE was most beneficial. Most users delivered sessions of 30 minutes (54.5%) or 30–40 minutes (36.4%), most commonly one or two sessions per patient (56.8%), with fees per session most often between 30,000 and 79,999 Korean won (63.6%). While practitioners reported high clinical satisfaction (median 4.0) due to patient benefits (95.5%, 42/44), operational satisfaction (65.1%, 28/43) was numerically lower than perceived clinical helpfulness (79.1%, 34/43), although the difference was not statistically significant (p=0.070). The main barriers were structural: a lack of specialized personnel, time, and space, together with the difficulty of charging adequate fees for this resource-intensive but non-reimbursed procedure.Conclusions: Although CVE is recognized as a valued and widely used modality, structural challenges and the labor-intensive nature of ‘customization’ may restrict its widespread use. Standardized protocols by disorder subtype, a training system for specialized personnel, and systemic support may help support its sustainable use in routine practice.