Effectiveness of vestibular rehabilitation in people with bilateral vestibular disorder. In a systematic review conducted by Xxxxxxxxxxx et al., (2012), people with BVD appeared to improve in their gaze and postural stability and showed functional improvements following VRT. However, none of the studies included in that review reported that people with BVD recovered fully following VRT. Many people with BVD will not be able to mobilise in complete darkness or on uneven surfaces (Xxxxxx et al., 2017). More recent studies also have reported improvements in postural control, dynamic visual acuity, and handicap perceived from dizziness in people with chronic BVD following VRT (Xxxxxxx et al., 2015; Xxxxxx et al., 2018; Xxxxx et al., 2019). Xxxxxxx and colleagues (2015) reported that in 69 people with chronic BVD, significant clinically meaningful changes were achieved on dynamic balance, gait speed, and balance confidence (e.g., 38-86% improvement depending on the specific outcome measured examined) following VRT. The authors (Xxxxxxx et al., 2015) suggested that VRT may help to decrease risk of falling and improve overall health in people with chronic BVD, but the full recovery remained less common. The treatment outcome may not be as favorable for people with vestibular disorders with other co-existing health problems (Xxxxxxx et al., 2020). For example, peripheral neuropathy in combination with BVD may cause further impairments, as people may present with more arhythmic walking patterns, and were observed to be at higher risk of falling (Xxxxxxxx et al., 2014) which may prolong recovery time. A recent study (Xxxxx et al., 2019) reported that balance and gait can improve even 6-12 months after the acute onset of BVD if the person follows regular VRT for at least 6 months (Xxxxx et al., 2019). Overall, current guidelines recommend that clinicians continue to provide VRT to people with BVD who are likely to benefit from a combination of gaze stabilisation exercises and static and dynamic balance exercises performed several times a day and possibly over an extended period (Hall et al., 2016; Xxxx et al., 2022).
