Assessments of balance-gait/fall risk and effects of vestibular rehabilitation by physiotherapist intervention in patients with unilateral peripheral vestibular hypofunction

In the United States, physiotherapists play an important role in the treatment of dizziness, and evidence-based vestibular rehabilitation therapy (VRT) is often adopted in medical settings. VRT has also been used traditionally in Japan, but is mostly administered by physicians. Since 2015, we have been treating patients with intractable dizziness in collaboration with physiotherapists, laboratory technicians, nurses, and a clinical psychologist as a one-team medical care approach. Herein, we propose that collaborating with physiotherapists enables us to evaluate fall risk, dynamic balance, and gait of patients with chronic unilateral vestibular hypofunction (CUVH) and to offer supervised VRT. In CUVH patients who received individualized VRT supervised by physiotherapists as a supplement to home exercises, the scores of Dizziness Handicap Inventory, Dynamic Gait Index, and Functional Gait Assessment improved significantly at four weeks after the start of the intervention as compared to the scores at the baseline. On the other hand, no significant improvements were seen in the group of CUVH patients who performed only home exercises. Therefore, we conclude that collaboration with physiotherapists may improve the quality of the evaluation and treatment of patients with dizziness.