{"id":19248,"date":"2026-09-09T14:10:24","date_gmt":"2026-09-09T12:10:24","guid":{"rendered":"https:\/\/ivrt.de\/?p=19248"},"modified":"2026-09-09T14:10:30","modified_gmt":"2026-09-09T12:10:30","slug":"vestibular-migraine-helps-vestibular-rehabilitation-new-meta-analysis-shows-clear-improvements","status":"publish","type":"post","link":"https:\/\/ivrt.de\/en\/studien-evidenz\/vestibulaere-migraene-hilft-vestibulaere-rehabilitation-neue-meta-analyse-zeigt-deutliche-verbesserungen\/","title":{"rendered":"Vestibular migraine: Does vestibular rehabilitation help? New meta-analysis shows significant improvements"},"content":{"rendered":"<p><strong>For Healthcare Professionals:<\/strong><\/p>\n\n\n\n<p>Helps <a href=\"https:\/\/ivrt.de\/en\/dizziness-disorders\/vestibular-rehabilitation-therapy-and-balance-training\/\" data-type=\"post\" data-id=\"8932\">vestibular rehabilitation<\/a> at <a href=\"https:\/\/ivrt.de\/en\/dizziness-disorders\/vestibular-migraine\/\" data-type=\"post\" data-id=\"5313\" target=\"_blank\" rel=\"noreferrer noopener\">vestibular migraine<\/a> at all? This question is frequently asked in clinical practice. A new systematic review with meta-analysis provides an encouraging result: the vertigo burden improved significantly on average and to a clinically relevant degree.<\/p>\n\n\n\n<p>\ud83d\udcc4 El Ahdab J, Vilardo M, Ong B, et al. <em>The effect of vestibular rehabilitation in the management of vestibular migraine in adults: A systematic review and meta-analysis.<\/em> Headache. 2026;66(1):77\u201387. doi:10.1111\/head.70002.<\/p>\n\n\n\n<p><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/41288240\/\">Original study<\/a><\/p>\n\n\n\n<p><strong>What was examined?<\/strong><\/p>\n\n\n\n<p>The authors summarized seven studies involving a total of 413 adult patients with vestibular migraine. The mean age was 45.4 years, and 76 % of the participants were women.<\/p>\n\n\n\n<p>The focus was on the change in the Dizziness Handicap Inventory (DHI). The DHI assesses the extent to which dizziness impairs daily life physically, functionally, and emotionally.<\/p>\n\n\n\n<p><strong>The most important result: an average of 29.3 fewer DHI points<\/strong><\/p>\n\n\n\n<p>During vestibular rehabilitation, the DHI decreased by an average of 29.3 points. The 95% % confidence interval ranged from \u221240.2 to \u221218.3 points.<\/p>\n\n\n\n<p>A change of about 18 points is frequently considered clinically relevant. The average improvement was thus clearly above this threshold.<\/p>\n\n\n\n<p>The result suggests that vestibular rehabilitation can achieve more than just a small statistical change in vestibular migraine. Many patients can achieve a noticeable reduction in their dizziness-related limitations.<\/p>\n\n\n\n<p><strong>What content was used for training?<\/strong><\/p>\n\n\n\n<p>The programs were not uniform. Frequently used were:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/ivrt.de\/en\/for-patients\/dizziness-vestibular-therapy-exercises\/\" data-type=\"page\" data-id=\"104\" target=\"_blank\" rel=\"noreferrer noopener\">Gaze stabilization<\/a>\u2013 and adaptation exercises<\/li>\n\n\n\n<li>Habituation exercises for movement- or visually induced symptoms<\/li>\n\n\n\n<li><a href=\"https:\/\/ivrt.de\/en\/for-patients\/dizziness-vestibular-therapy-exercises\/\" data-type=\"page\" data-id=\"104\">Balance and gait training<\/a><\/li>\n\n\n\n<li>supervised exercises in the clinic and complementary home programs<\/li>\n<\/ul>\n\n\n\n<p>The duration also differed significantly: the programs ranged from four to approximately 30 weeks.<\/p>\n\n\n\n<p>Thus, while the meta-analysis shows that vestibular rehabilitation can be helpful in principle, it does not yet answer which specific exercise program is best suited for which patients.<\/p>\n\n\n\n<p><strong>Why the result must still be interpreted with caution<\/strong><\/p>\n\n\n\n<p>Statistical heterogeneity was very high, with I\u00b2 = 94.7 %. The results of the individual studies therefore differed significantly.<\/p>\n\n\n\n<p>Possible reasons include differing study designs, rehabilitation programs, treatment durations, concomitant medications, and patient groups.<\/p>\n\n\n\n<p>Furthermore, an average improvement of 29.3 points does not mean that every single person benefits to that extent. The available data indicate a clinically relevant benefit. However, they do not yet allow a definitive conclusion as to who responds particularly well and how large the effect would be under a standardized protocol.<\/p>\n\n\n\n<p><strong>What does this mean for practical application?<\/strong><\/p>\n\n\n\n<p>Vestibular migraine should not be treated with a rigid standard program. An individual selection and dosage of exercises based on the specific symptoms and findings is useful.<\/p>\n\n\n\n<p>Depending on the patient, movement tolerance, visual endurance, balance, or gait stability may be the primary focus.<\/p>\n\n\n\n<p>Vestibular rehabilitation is part of a comprehensive treatment concept. This also includes a confirmed diagnosis, patient education, medical treatment of the migraine, and\u2014if necessary\u2014medication prophylaxis.<\/p>\n\n\n\n<p>Especially with pronounced sensitivity to stimuli, the load should be increased gradually and adjusted regularly.<\/p>\n\n\n\n<p><strong>Conclusion<\/strong><\/p>\n\n\n\n<p>The new meta-analysis provides the clearest aggregated signal to date: vestibular rehabilitation can significantly and clinically relevantly reduce dizziness-related impairment in vestibular migraine.<\/p>\n\n\n\n<p>Due to the large differences between the studies, standardized randomized trials and subgroup analyses remain necessary.<\/p>\n\n\n\n<p>In practice, this means that vestibular rehabilitation is a sensible treatment option, but it should be planned and dosed individually.<\/p>\n\n\n\n<p><strong>\ud83d\udc49 Are you interested in a comprehensive further training in <a href=\"https:\/\/ivrt.de\/en\/patient-education\/vestibular-rehabilitation-therapy-and-balance-training\/\" data-type=\"post\" data-id=\"8932\" target=\"_blank\" rel=\"noreferrer noopener\">vestibular rehabilitation<\/a> and <strong>want to learn how to specifically assess and treat patients with vestibular migraine<\/strong>?\u00a0<\/strong><\/p>\n\n\n\n<p>Current further education opportunities and course dates can be found in the <strong><a href=\"https:\/\/ivrt.de\/en\/for-medical-professionals\/search-for-further-training\/\" 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>Vestibular migraine: Can targeted balance training help?<\/strong><\/p>\n\n\n\n<p>At a <a href=\"https:\/\/ivrt.de\/en\/dizziness-disorders\/vestibular-migraine\/\" data-type=\"post\" data-id=\"5313\" target=\"_blank\" rel=\"noreferrer noopener\">vestibular migraine<\/a> headaches are not always the primary symptom. Many sufferers primarily experience dizziness, unsteadiness when walking, nausea, or a high sensitivity to movement and visual stimuli.<\/p>\n\n\n\n<p>For example, crowded supermarkets, quick head movements, or moving images can trigger symptoms.<\/p>\n\n\n\n<p>A new review summarized seven studies with a total of 413 patients. The participants completed a <a href=\"https:\/\/ivrt.de\/en\/dizziness-disorders\/vestibular-rehabilitation-therapy-and-balance-training\/\" data-type=\"post\" data-id=\"8932\">vestibular rehabilitation<\/a> \u2013 so targeted training for gaze stability, motion tolerance, and balance.<\/p>\n\n\n\n<p><strong>Source<\/strong><\/p>\n\n\n\n<p>El Ahdab J, Vilardo M, Ong B, et al. <em>The effect of vestibular rehabilitation in the management of vestibular migraine in adults: A systematic review and meta-analysis.<\/em> Headache. 2026;66(1):77\u201387. doi:10.1111\/head.70002.<\/p>\n\n\n\n<p><strong>How strong was the improvement?<\/strong><\/p>\n\n\n\n<p>The burden of the dizziness was measured using a questionnaire, the Dizziness Handicap Inventory (DHI).<\/p>\n\n\n\n<p>On average, the value improved by 29.3 points. A change of around 18 points or more is considered clearly noticeable. The result was therefore well above that.<\/p>\n\n\n\n<p><strong>What is done during the therapy?<\/strong><\/p>\n\n\n\n<p>The training can look different depending on the symptoms. These include, for example:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/ivrt.de\/en\/for-patients\/dizziness-vestibular-therapy-exercises\/\" data-type=\"page\" data-id=\"104\" target=\"_blank\" rel=\"noreferrer noopener\">exercise<\/a>, where the gaze remains fixed on a target during head movements<\/li>\n\n\n\n<li>a slow buildup of tolerance to movement or visual stimuli<\/li>\n\n\n\n<li><a href=\"https:\/\/ivrt.de\/en\/for-patients\/dizziness-vestibular-therapy-exercises\/\" data-type=\"page\" data-id=\"104\">Balance and walking exercises<\/a><\/li>\n\n\n\n<li>an individually dosed home program<\/li>\n<\/ul>\n\n\n\n<p><strong>Does this help all those affected?<\/strong><\/p>\n\n\n\n<p>Not automatically. The results of the individual studies varied widely. The training programs also lasted between four and approximately 30 weeks.<\/p>\n\n\n\n<p>Therefore, it cannot yet be said which program is best for each person.<\/p>\n\n\n\n<p>It is important that the diagnosis is medically confirmed and that the exercises match one's specific symptoms. A program that is too difficult or progressed too quickly can cause temporary increased irritation. The exercises should therefore be individually selected and adapted.<\/p>\n\n\n\n<p><strong>In short<\/strong><\/p>\n\n\n\n<p>Current research shows: Vestibular rehabilitation can help significantly with vestibular migraine.<\/p>\n\n\n\n<p>It does not replace medical migraine treatment, but it can be a useful supplement and help you feel more secure and resilient in everyday life.<\/p>\n\n\n\n<p>\ud83c\udfaf <strong>Our IVRT\u00ae-certified dizziness and vestibular therapists<\/strong> Do you support:  <strong><a href=\"https:\/\/ivrt.de\/en\/for-patients\/therapist-search\/\" 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: Hilft vestibul\u00e4re Rehabilitation bei vestibul\u00e4rer Migr\u00e4ne \u00fcberhaupt? Diese Frage wird in der Praxis h\u00e4ufig gestellt. Eine neue systematische \u00dcbersichtsarbeit mit Meta-Analyse liefert dazu ein ermutigendes Ergebnis: Die Schwindelbelastung verbesserte sich im Mittel deutlich und auch klinisch relevant. \ud83d\udcc4 El Ahdab J, Vilardo M, Ong B, et al. The effect of vestibular rehabilitation in [&hellip;]<\/p>\n","protected":false},"author":11,"featured_media":19249,"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":5,"footnotes":""},"categories":[215],"tags":[],"class_list":["post-19248","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\/19248","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=19248"}],"version-history":[{"count":1,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/posts\/19248\/revisions"}],"predecessor-version":[{"id":19250,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/posts\/19248\/revisions\/19250"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/media\/19249"}],"wp:attachment":[{"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/media?parent=19248"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/categories?post=19248"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/tags?post=19248"}],"curies":[{"name":"WP","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}