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The Effectiveness of Group-based Vestibular Rehabilitation in Adults With Central or Peripheral Vestibular
Jia Ying Ang1, Sabrina Hernandez, Matthew King
1Human Services and Sport, School of Allied Health, La Trobe University, Bundoora, Victoria, Australia (J.Y.A., M.K., D.S.); Physiotherapy Department, Eastern Health, Box Hill, Victoria, Australia (S.H.); Peninsula Clinical School, Central Clinical School, Monash University, Frankston, Victoria, Australia (D.S.); Academic Unit, Peninsula Health, Frankston, Victoria, Australia (D.S.); and National Centre for Healthy Ageing, Melbourne, Victoria, Australia (D.S.).
Background And Purpose:
Vestibular dysfunction causes dizziness, vertigo, and balance issues, reducing quality of life. Its high prevalence highlights the need for efficient, equitable management, such as group-based rehabilitation. This systematic review examined the effectiveness of group-based vestibular rehabilitation for adults with central or peripheral vestibular dysfunction.
Methods:
Databases (MEDLINE, Embase, CINAHL, and Cochrane Central Register of Controlled Trials) were searched for randomized controlled trials involving adults with vestibular dysfunction. Outcomes included symptom severity, function, and quality of life. Risk of bias was assessed using the Physiotherapy Evidence Database (PEDro) scale. Standardized mean differences (SMD) and 95% confidence intervals (CIs) were calculated and combined in meta-analyses. The Grading of Recommendations, Assessment, Development, and Evaluation approach was used to evaluate the certainty of evidence.
Results:
Nine trials (399 participants; median PEDro score: 5/10) were included. Low-certainty evidence suggests group-based rehabilitation may reduce dizziness compared with no intervention (SMD -0.40, 95% CI -0.73 to -0.07) and improve tandem walking (SMD -0.54, 95% CI -1.04 to -0.03). Group-based rehabilitation may also reduce dizziness compared with medical intervention (SMD -0.54, 95% CI -1.02 to -0.06). No differences were found compared with 1:1 rehabilitation.
Discussion And Conclusions:
Group-based vestibular rehabilitation may improve dizziness and tandem walking, though evidence certainty is low. Neither group-based nor 1:1 vestibular rehabilitation is superior in regard to its effects on patient outcomes. Group-based rehabilitation provides peer support for patients and requires fewer resources than 1:1 rehabilitation. Therefore, group-based rehabilitation may be a safe alternative in the management of central and peripheral vestibular dysfunction.
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