{"id":17883,"date":"2026-04-22T21:06:53","date_gmt":"2026-04-22T19:06:53","guid":{"rendered":"https:\/\/ivrt.de\/?p=17883"},"modified":"2026-04-22T21:06:56","modified_gmt":"2026-04-22T19:06:56","slug":"pppd-und-physiotherapie-was-bringt-die-vestibulaere-rehabilitation-wirklich","status":"publish","type":"post","link":"https:\/\/ivrt.de\/en\/studien-evidenz\/pppd-und-physiotherapie-was-bringt-die-vestibulaere-rehabilitation-wirklich\/","title":{"rendered":"PPPD and physiotherapy: how effective is vestibular rehabilitation really?"},"content":{"rendered":"<p><strong>For Healthcare Professionals:<\/strong><\/p>\n\n\n\n<p>The\u00a0<a href=\"https:\/\/ivrt.de\/en\/schwindelerkrankungen\/persistierender-postural-perzeptiver-schwindel-pppd\/\" data-type=\"post\" data-id=\"5343\">persistent postural-perceptual dizziness<\/a> (PPPD) is one of the most common causes of chronic dizziness. A new meta-analysis by Piatti et al. (2025) now provides robust data on the effectiveness of <a href=\"https:\/\/ivrt.de\/en\/schwindelerkrankungen\/vestibulaere-rehabilitationstherapie-und-gleichgewichtstraining\/\" data-type=\"post\" data-id=\"8932\">vestibular physiotherapy<\/a> (VPT). The results show that targeted training works \u2013 but there are important details to consider.<\/p>\n\n\n\n<p>\ud83d\udd17 Piatti D, De Angelis S, Paolocci G, et al. The Role of Vestibular Physical Therapy in Managing Persistent Postural-Perceptual Dizziness: A Systematic Review and Meta-Analysis.\u00a0<em>J Clin Med<\/em>. 2025;14(15):5524. Published 2025 Aug 5. doi:10.3390\/jcm14155524.<\/p>\n\n\n\n<p><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40807145\/\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>Original study<\/strong><\/a><\/p>\n\n\n\n<p><strong>Scientific evidence<\/strong><\/p>\n\n\n\n<p>The meta-analysis evaluated six studies that focused on reducing dizziness-related impairment (measured using the Dizziness Handicap Inventory, DHI).<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Significant improvement<strong>:<\/strong>\u00a0The statistical analysis showed a significant reduction in DHI scores (Hedges\u2019 g = 1.60). This corresponds to a moderate to large clinical improvement in quality of life.<\/li>\n\n\n\n<li>Objective progress: In addition to subjective perception, objective parameters also improved, such as postural control (e.g. in the mini-BESTest) and posturographic values.<\/li>\n\n\n\n<li>Psychosomatic effects: The therapy had a positive impact on accompanying anxiety and depressive symptoms, underscoring the close connection between vestibular and psychological processes in PPPD.<\/li>\n<\/ul>\n\n\n\n<p><strong>The challenge: heterogeneity<\/strong><\/p>\n\n\n\n<p>Despite the overall positive effects, scientific uncertainty remains high (heterogeneity I<sup>2<\/sup>= 92%). This is mainly due to the fact that the training protocols studied were very different \u2013 ranging from classic gaze stabilization training to computer-assisted VR systems.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Conclusion for Practice<\/h3>\n\n\n\n<p>PPPD is not a classic inner ear disorder, but a misprocessing of sensory input (maladaptation). The brain relies too heavily on visual stimuli and interprets normal body movements as threatening.<\/p>\n\n\n\n<p><strong>Modern strategies in VPT:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Habituation:<\/strong>\u00a0Gradual desensitization to visual stimuli (e.g. visiting a supermarket, moving backgrounds).<\/li>\n\n\n\n<li><strong>Specific balance training:<\/strong>\u00a0Reduction of maladaptive protective postures and control of body sway.<\/li>\n<\/ul>\n\n\n\n<p><strong>Combination:<\/strong>&nbsp;The best results were often achieved when VPT was supplemented with cognitive behavioral therapy (CBT) or specialist-prescribed medication (SSRIs).<\/p>\n\n\n\n<p><strong>\ud83d\udc49 Are you interested in a comprehensive further training in <a href=\"https:\/\/ivrt.de\/en\/patientenedukation\/vestibulaere-rehabilitationstherapie-und-gleichgewichtstraining\/\" data-type=\"post\" data-id=\"8932\" target=\"_blank\" rel=\"noreferrer noopener\">vestibular rehabilitation<\/a> and want <strong>learn <strong><strong>how to safely guide PPPD patients out of the dizziness cycle using habituation techniques<\/strong>?<\/strong><\/strong>\u00a0<\/strong><\/p>\n\n\n\n<p>Current further education opportunities can be found in the <strong><a href=\"https:\/\/ivrt.de\/en\/fuer-medizinisches-fachpersonal\/fortbildungssuche\/\" data-type=\"link\" data-id=\"https:\/\/ivrt.de\/fuer-medizinisches-fachpersonal\/fortbildungssuche\/\" target=\"_blank\" rel=\"noreferrer noopener\">IVRT Course search<\/a>.<\/strong><\/p>\n\n\n\n<p><\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><\/p>\n\n\n\n<p><strong>For Patients \u2013 Easy to Understand<\/strong><\/p>\n\n\n\n<p><strong><strong><strong>Chronic dizziness (<a href=\"https:\/\/ivrt.de\/en\/schwindelerkrankungen\/persistierender-postural-perzeptiver-schwindel-pppd\/\" data-type=\"post\" data-id=\"5343\">PPPD<\/a>): how physiotherapy helps reprogram the brain<\/strong><\/strong><\/strong><\/p>\n\n\n\n<p>When dizziness becomes chronic, it is often not caused by a damaged ear, but because the brain has \u201cunlearned\u201d how to process stimuli correctly. People constantly feel unsteady, as if on a ship, and react sensitively to moving images. A new meta-analysis has now scientifically confirmed that <a href=\"https:\/\/ivrt.de\/en\/schwindelerkrankungen\/vestibulaere-rehabilitationstherapie-und-gleichgewichtstraining\/\" data-type=\"post\" data-id=\"8932\">specialized physiotherapy <\/a>is a crucial key to improvement here.<\/p>\n\n\n\n<p>\ud83d\udcc4 Piatti D, De Angelis S, Paolocci G, et al. The Role of Vestibular Physical Therapy in Managing Persistent Postural-Perceptual Dizziness: A Systematic Review and Meta-Analysis.\u00a0<em>J Clin Med<\/em>. 2025;14(15):5524. Published 2025 Aug 5. doi:10.3390\/jcm14155524<\/p>\n\n\n\n<p><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40807145\/\" data-type=\"link\" data-id=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40421807\/\" target=\"_blank\" rel=\"noreferrer noopener\">Original study<\/a><\/p>\n\n\n\n<p><strong>The most important findings from the study:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Noticeable relief: Most participants experienced a clear reduction in their dizziness symptoms in everyday life after the training.<\/li>\n\n\n\n<li>Greater confidence: Not only did the feeling improve, but actual steadiness in balance tests also measurably improved.<\/li>\n\n\n\n<li>Holistic effect: Since dizziness is often associated with anxiety, the training also reduced psychological distress in many participants.<\/li>\n<\/ul>\n\n\n\n<p><strong>What you can do<\/strong><\/p>\n\n\n\n<p>If you suffer from PPPD, waiting is usually not a solution. Your brain needs active stimuli to correct the \u201cfaulty wiring.\u201d<\/p>\n\n\n\n<p><strong>What should you keep in mind during therapy?<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>No standard program: PPPD requires exercises that gradually and specifically help you get used to movement and visual stimuli (habituation).<\/li>\n\n\n\n<li>Patience and guidance: Since the exercises can temporarily provoke dizziness, professional supervision is important so that you do not fall into avoidance behaviors.<\/li>\n\n\n\n<li>Combination: A mix of exercises, education, and psychological support is often the most effective approach.<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<p>\ud83c\udfaf <strong>Our IVRT\u00ae-certified dizziness and vestibular therapists<\/strong> support you<strong>:<\/strong> We know how to gently and safely help your brain get used to normal movements again. Find specialized colleagues in our <strong><a href=\"https:\/\/ivrt.de\/en\/fuer-betroffene\/therapeutensuche\/\" data-type=\"page\" data-id=\"101\" target=\"_blank\" rel=\"noreferrer noopener\">IVRT therapist search<\/a><\/strong><\/p>\n\n\n\n<p><a id=\"_msocom_1\"><\/a><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>","protected":false},"excerpt":{"rendered":"<p>F\u00fcr Fachpersonal: Der\u00a0persistierende postural-perzeptive Schwindel (PPPD)\u00a0ist eine der h\u00e4ufigsten Ursachen f\u00fcr chronischen Schwindel. Eine neue Meta-Analyse von Piatti et al. (2025) liefert nun belastbare Daten zur Wirksamkeit der vestibul\u00e4ren Physiotherapie (VPT). Die Ergebnisse zeigen: Gezieltes Training wirkt \u2013 doch es gibt wichtige Details zu beachten. \ud83d\udd17 Piatti D, De Angelis S, Paolocci G, et al. [&hellip;]<\/p>\n","protected":false},"author":11,"featured_media":17887,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_surecart_dashboard_logo_width":"180px","_surecart_dashboard_show_logo":true,"_surecart_dashboard_navigation_orders":true,"_surecart_dashboard_navigation_invoices":true,"_surecart_dashboard_navigation_subscriptions":true,"_surecart_dashboard_navigation_downloads":true,"_surecart_dashboard_navigation_billing":true,"_surecart_dashboard_navigation_account":true,"_jf_save_progress":"","iawp_total_views":2,"footnotes":""},"categories":[215],"tags":[],"class_list":["post-17883","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-studien-evidenz"],"_links":{"self":[{"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/posts\/17883","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/comments?post=17883"}],"version-history":[{"count":3,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/posts\/17883\/revisions"}],"predecessor-version":[{"id":17886,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/posts\/17883\/revisions\/17886"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/media\/17887"}],"wp:attachment":[{"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/media?parent=17883"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/categories?post=17883"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/tags?post=17883"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}