Clinical Pathways in Vestibular Care: Referral Trends Between Vestibular Rehabilitation and Objective Vestibular Testing.

Purpose: Patients with vestibular-related dysfunction are commonly referred to a physical therapist for vestibular rehabilitation (VR) or possibly to an audiologist for objective vestibular test battery (VTB). As a conservative first step, patients are often referred to VR for evaluation and management and from there patients may be referred for VTB when patients are not meeting therapy goals or VR evaluation is unclear of the diagnosis. This research aimed to investigate the referral patterns from VR to VTB and VTB to VR.

Method: Retrospective chart review was completed at a large Midwestern tertiary hospital. This study included 149 patients aged 18 years and older with history of dizziness, vertigo, or imbalance concerns who received VR and VTB. Patients were divided into two groups: (a) VR-first group and (b) VTB-first group. Descriptive statistics were used to quantify the total number of VR sessions for total cohort and common vestibular diagnoses and determine differences in sessions between VR-first and VTB-first groups.

Results: Statistically significant differences in number of VR sessions were observed between the VR-first and VTB-first groups, with less sessions overall in the VTB- first group (p < .05), except for the BPPV group (p = .12).

Conclusion: Early and accurate objective vestibular testing can significantly impact the treatment trajectory for patients with unilateral, bilateral, and central vestibular findings.