The effects of online movement therapy on physical activity and sleep in persistent postural-perceptual dizziness

Patients with persistent postural-perceptual dizziness (PPPD) have comorbid low activity levels and the highest prevalence of poor sleep quality and insomnia across dizziness syndromes. Vestibular rehabilitation encourages physical activity and improves sleep in dizzy patients, so we sought to evaluate the effects of an online movement therapy course on physical activity and sleep in patients with PPPD. This study aims to compare sleep and physical activity in PPPD patients before and after online movement physiotherapy (OMP) sessions and investigate the correlation between sleep variables, using subjective scores and objective actimeter wristwatch measures.

The study included 19 adult patients with PPPD, recruited between February 2024 and January 2025. Participants answered validated self-assessment questionnaires (IPAQ, DIH, PSQI and HADS) and used an actimeter 24 h a day, for 2 weeks before OMP treatment and 2 weeks after.

Statistically significant differences and effect sizes were seen only for the DHI, with a 9-point decrease in mean DHI post-OMP. OMP sessions did not significantly improve other activity or sleep parameters (either objectively or subjectively) after 1 month of treatment. A positive correlation (although not statistically significant) was observed between increased physical activity and improved sleep. HADS did not show significant differences pre- and post-OMP.

This study shows that a short course of online physiotherapy can reduce patient subjective dizziness perception but does not significantly improve sleep quality or physical activity levels.