A pilot prospective cohort study in 30 adults with peripheral vestibular disorders examined a five-session vestibular rehabilitation protocol.

This prospective pilot cohort study enrolled 30 adults with peripheral vestibular disorders, including conditions such as unilateral vestibular dysfunction, Meniere disease, or superior semicircular canal dehiscence, at a tertiary rehabilitation center. The intervention consisted of a customized five-session vestibular rehabilitation protocol, with no comparator group reported. The primary outcomes assessed were subjective clinical success, defined as an 18-point reduction in the Dizziness Handicap Inventory (DHI) score, and functional success, defined as a 3-point increase in the Dynamic Gait Index (DGI) score.

Results indicated that the mean DHI score improved from 53.7 to 37.8, and the mean DGI score improved from 19.5 to 22.1, with both changes reaching statistical significance (P = .003). Regarding raw improvement, 83% of participants demonstrated some level of improvement. Specifically, 37% of participants achieved the minimal clinically important difference (MCID) for subjective success, defined as an 18-point DHI reduction. Safety and tolerability were not reported, nor were adverse events or discontinuations documented in this pilot phase.

Subgroup analysis revealed that 0% of participants in the bilateral cVEMP absence group achieved subjective success, compared to 52.6% in the bilateral cVEMP present group (P trend = .08). Baseline DHI severity was identified as an independent predictor of success, with an odds ratio of 1.05 (95% CI 1.00-1.10; P = .04). Additionally, functional gait success was significantly correlated with baseline vestibular and visual preference ratios. The study notes that baseline DHI severity serves as a predictor rather than a causal factor for outcomes.

Key limitations include the small sample size (n=30), the lack of a control group, and the absence of reported safety data. Some findings, such as the cVEMP association, have borderline statistical significance (P trend = .08). Consequently, while the association between otolithic integrity and rehabilitation success is suggested, causality cannot be established. These results should be interpreted as preliminary evidence requiring validation in larger, randomized trials before altering standard practice.