Can Virtual Vestibular Rehabilitation Help?
If you live with dizziness or vertigo, travelling to appointments can be difficult. Virtual vestibular rehabilitation offers another way to access assessment, advice and guided exercises without always needing to attend a clinic in person.
But can online vestibular physiotherapy really help?
What does the research say?
Kriz et al. (2024) compared vestibular physiotherapy delivered in person with care delivered through telehealth. Their study adds to the evidence that remote delivery is a practical option worth considering for selected patients.
Telehealth is not the same as virtual reality. Telehealth means delivering assessment and rehabilitation remotely, often by video consultation. Virtual reality uses computer-generated visual environments or other immersive technology as part of treatment.
The best option depends on the person’s symptoms, diagnosis, examination requirements and ability to exercise safely at home.
What about PPPD and vestibular migraine?
Persistent postural-perceptual dizziness (PPPD) can cause ongoing dizziness or unsteadiness, often aggravated by standing, movement or visually busy environments. Vestibular rehabilitation may help some people gradually improve their tolerance of these triggers.
Vestibular migraine can cause episodes of vertigo, dizziness and motion sensitivity, sometimes with headache, light sensitivity or nausea. Rehabilitation may be useful for selected patients, particularly where imbalance or movement sensitivity persists between attacks.
However, neither condition has a single treatment that works for everyone. Rehabilitation needs to be tailored, and medical management may also be appropriate. Remote treatment cannot replace an in-person examination when physical testing, diagnostic clarification or safety assessment is necessary.
Research continues to develop in this area. For example, Eggers and Staab (2024) discuss the relationship between vestibular migraine and PPPD, including the importance of recognising when these conditions overlap.
Access specialist vestibular physiotherapy from further afield
Remote consultations may potentially allow patients in the Republic of Ireland, Great Britain, other European countries, the United States or Canada to access a UK-trained physiotherapist with a particular focus on vestibular rehabilitation.
For suitable patients, this could provide access to focused, ethical care, with clear goals, an individualised exercise programme and regular review of progress. The aim should be meaningful improvement as efficiently as is appropriate — not a promise of instant results.
Suitability depends on the clinical presentation, local professional and regulatory requirements, and whether remote assessment can be performed safely. Some patients will need an in-person assessment or referral to another healthcare professional.
At Longevity Physiotherapy, virtual vestibular rehabilitation may offer a practical option for selected people who want specialist guidance without always travelling to Belfast.
References:
Kriz M et al. (2024). Comparing in-clinic versus telehealth for vestibular physical therapy. Journal of Vestibular Research, 34(4), 215–222.
Eggers SDZ, Staab JP. (2024). Vestibular migraine and persistent postural perceptual dizziness. Handbook of Clinical Neurology, 199, 389–411. https://doi.org/10.1016/B978-0-12-823357-3.00028-8
