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J Neurol. 2016 Apr;263 Suppl 1:S65-70. doi: 10.1007/s00415-015-7914-1. Epub 2016 Apr 15.

Current concepts and future approaches to vestibular rehabilitation.

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Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Clinical Sciences, Lund University, Lund, Sweden.
Department of Physical Therapy, Ben Gurion University of the Negev, Beer Sheva, Israel.
The Israeli Center for Treating Dizziness and Balance Disorders, Raanana, Israel.
German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-University of Munich, Munich, Germany.
Department of Neurology, Schön Klinik Bad Aibling, Kolbermoorer Str. 72, 83043, Bad Aibling, Germany.


Over the last decades methods of vestibular rehabilitation to enhance adaptation to vestibular loss, habituation to changing sensory conditions, and sensory reweighting in the compensation process have been developed. However, the use of these techniques still depends to a large part on the educational background of the therapist. Individualized assessment of deficits and specific therapeutic programs for different disorders are sparse. Currently, vestibular rehabilitation is often used in an unspecific way in dizzy patients irrespective of the clinical findings. When predicting the future of vestibular rehabilitation, it is tempting to foretell advances in technology for assessment and treatment only, but the current intense exchange between clinicians and basic scientists also predicts advances in truly understanding the complex interactions between the peripheral senses and central adaptation mechanisms. More research is needed to develop reliable techniques to measure sensory dependence and to learn how this knowledge can be best used--by playing off the patient's sensory strength or working on the weakness. To be able using the emerging concepts, the neuro-otological community must strive to educate physicians, physiotherapists and nurses to perform the correct examinations for assessment of individual deficits and to look for factors that might impede rehabilitation.


Adaptation; Habituation; Sensory reweighting; Vestibular rehabilitation

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