LAUSR

Dizziness, vertigo, and balance problems are among the most common complaints in patients and at least 50% of patients out of balance need some form of physical therapy [1]. Besides the excellent evidence that the specific physical maneuvers are effective for treatment in benign paroxysmal positional vertigo (level 1), there is also sufficient evidence that vestibular rehabilitation therapy (VRT) improves outcome in unilateral (level 1) and bilateral (level 1) vestibular hypofunction [2–7]. The principles of treatment go back to the 1940s when Cawthorne and Cooksey first described exercises to improve balance after vestibular injuries [8]. While there is a general agreement that balance training is useful in vestibular disorders, there is insufficient evidence for specific interventions in specific clinical situations, optimal exercise dose, advantages of supervised vs. home-based exercises, and optimal duration of treatment programs [9–12]. Recently, the American Physical Therapy Association published evidence-based clinical practice guidelines for VRT in peripheral vestibular hypofunction [13]. Further, an ICF core set (ICF = International Classification of Functioning, Disability and Health) was set up by an international group to improve the meaningfulness of outcomes for clinical studies in the field [14, 15]. In Europe, the DIZZYNET, an international initiative for translational research in vertigo and balance disorders, recognized vestibular rehabilitation as one of the core fields of action for the network. In the 2018 meeting of the DIZZYNET, the vestibular rehabilitation research group identified the following areas that need urgent improvement: