Effectiveness of vestibular rehabilitation. There is extended evidence that VRT exercises help to improve subjective dizziness, postural stability, gait speed, and visual acuity during head movements in people with vestibular disorders (Xxxxx et al., 1992; Xxxxxxx et al., 2000a; Xxxxxxx et al., 2000b; Xxxxxxx et al., 2003; Xxxxx et al., 2009; Xxxxxx et al., 2013; Xxxxxxx et al., 2015; Xxxxx et al., 2016; Xxxxxx et al., 2020). Recent clinical practice guidelines concluded that there is moderate to strong evidence supporting VRT for the management of people with UVD and BVD (Xxxxxxx and XxXxxxxxx, 2016; Xxxxxxxxxxx et al., 2012; XxXxxxxxx and Xxxxxxx, 2016; Xxxx et al., 2016; Xxxx et al., 2022). People with BVD improve following VRT but not as much as people with UVD (Hall et al., 2022). Also, there is weak evidence for the effectiveness of VRT in people with VM (Xxxxxxxxx and Xxxxxxx, 2017; Xxxxxxxx and Xxxxx, 2018; Xxx and Xxxxxxx, 2022), yet it is recommended to be offered to people with VM who experience symptoms or fear of movement related to head and body movements and busy visual surroundings, but a gentler approach is needed (Xxxxxx et al., 2013; Xxxxxxxxx and Xxxxxxx, 2017). A considerable number of studies demonstrated the superiority of supervised VRT (Xxxxxxx et al.., 2004; Xxx et al., 2010; Xxxxxx et al., 2013; Xxxxx et al., 2017; Xxxxxx et al., 2020) compared to home-based unsupervised exercise programme. Supervision may promote greater adherence and improvements in postural stability (Xxxxxx et al., 2013). Supervised VRT may be also effective in enhancing PA in daily life and may subsequently improve subjective dizziness and gait instability in people with CVD (Shiozaki et al., 2021). Supervised VRT seems to help with improvement in psychological symptoms, because supervision aims to increase patient confidence and independence, provide reassurance, and emphasise the potential benefits of vestibular exercises, thus, the compliance to VRT may be higher and affect indirectly treatment outcome as a comparison of those who complete the VRT versus those who drop out because they did not receive supervision (Xxxxx et al., 2000; Xxxxxx et al., 2012; Xxxxxx et al., 2013). Apart from any possible placebo effect due to therapist attention, it is also believed to increase motivation and compliance, and allows the therapist to evaluate the patient’s progress regularly, modifying and progressing exercises as required and making sure exercises are being performed correctly (Xxxxx et al., 2000; Xxxxx ...
