Vestibular rehabilitation for residual dizziness after benign paroxysmal positional vertigo

For Healthcare Professionals:

Many patients with benign paroxysmal positional vertigo (BPPV) report persistent dizziness or unsteadiness even after successful repositioning maneuvers— a clinical phenomenon referred to as residual dizziness (RD) .

A new study by Shiozaki et al. (2025) examined the effectiveness of vestibular rehabilitation for these residual symptoms.

🔗 Original study

Study design:

• Participants: 30 individuals with RD after successful BPPV treatment
• Two groups:
  • Group 1:
    received for 6 months weekly vestibular rehabilitation therapy + daily home exercises
  • Group 2:
    participated in aerobic exercise sessions every two months , with instructions for daily unsupervised endurance training (e.g., walking, cycling)
• Outcome measures:
  • Modified Dizziness Handicap Inventory (mDHI)
  • Functional Gait Assessment (FGA)
  • Posturography (center of pressure with eyes closed, COP EC)
  • Self-rating Depression Scale (SDS)

Results:

• Both groups improved in mDHI and FGA.
• Only Group 1 showed significant improvement in postural control (COP EC).
• Between-group comparison: Group 1 achieved superior improvement in mDHI and COP EC after the intervention.

Clinical relevance:

This study confirms that a structured vestibular rehabilitation program with therapeutic supervision and home training is in contrast to nonspecific aerobic activities for residual dizziness after BPPV clearly superior — both subjectively and objectively measurable.

▶ For IVRT® therapists: Targeted vestibular intervention is worthwhile — even beyond repositioning maneuvers.

👉 Interested in further knowledge about BPPV?

We recommend our practical IVRT® training in dizziness and vestibular therapy (see course search) — including current research content, differential diagnostic testing, and therapy planning.

For Patients – Easy to Understand

You experienced positional vertigo (BPPV), completed treatment successfully — but still feel slightly dizzy or unsteady sometimes?

That’s called residual dizziness (RD) — and a new study shows: targeted training helps!

🔗 See the original study (English)

What was examined?

30 people with residual dizziness were divided into two groups:

• Group 1:
  did once a week vestibular rehabilitation therapy + daily home exercises
• Group 2:
  Received advice every two months on general exercise (e.g., walking, cycling) and were asked to continue daily trainingon their own without direct support

What are the findings?

• Both groups felt better after a few months
• But Group 1 was clearly safer in walking and balance
• Especially standing with eyes closed showed the biggest difference

What really helps?

• Regular balance exercises
• Professional guidance
• Home training
• Not just general walking—but targeted therapy

👉 Need help?

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