Enhanced recovery in unilateral vestibular hypofunction: The synergistic effect of medication and vestibular rehabilitation training

Objective

This study aimed to compare the efficacy of medication combined with personalized vestibular rehabilitation training (VRT) versus medication alone in unilateral vestibular hypofunction (UVH) and identify predictors of long-term symptom progression.

Methods

Forty-eight UVH patients were randomized into a VRT group (n = 23, medication combined with personalized VRT) and a control group (n = 25, medication alone). Bithermal caloric tests, Dizziness Handicap Inventory (DHI), Vestibular Rehabilitation Benefit Questionnaire (VRBQ), Visual Analog Scale (VAS), Activities-specific Balance Confidence Scale (ABC), and Self-Rating Anxiety Scale (SAS) were assessed at baseline, 2 weeks, and 4 weeks. Symptom progression was tracked over 6 months post-intervention.

Results

Both groups improved significantly (P < 0.05), but the VRT group showed faster unilateral weakness (UW) reduction (30.43 % vs. 43.20 % at 4 weeks, P = 0.012) and greater symptom relief (DHI: 6.70 vs. 23.68, P < 0.001). Logistic regression identified abnormal UW (≥ 25 %) as an independent predictor of symptom recurrence (OR = 7.237, 95 % CI:1.43–36.58, P = 0.017), while DHI scores showed no significant association (P = 0.925).

Conclusion

Personalized VRT combined with medication accelerates symptom resolution and vestibular recovery compared to medication alone. Persistent abnormal caloric results, even with symptom relief, indicate a need for extended treatment and active lifestyle maintenance to mitigate recurrence.