Vestibular Rehabilitation and Dizziness

Dizziness is among the most prevalent complaints for which people seek medical help and the
incidence increases with advancing age. Dizziness represents a diagnostic and treatment
challenge because it is a subjective sensation, refers to a variety of symptoms
(unsteadiness, spinning, sense of motion or lightheadedness), and has many potential
contributory factors. Dizziness is often related to vestibular disease which is treated
effectively with vestibular exercises. Successful management of dizziness is critical because
dizziness is a major risk factor for falls in older adults.

There are parallels between the effects of age-related versus disease-related loss of
vestibular function - in complaints of dizziness and increased risk for falls. The
investigators' question, then, is whether the same exercises that are beneficial for patients
with vestibular pathology are beneficial for older patients with dizziness but normal
vestibular function.

Older adults with dizziness who have been referred to Audiology for vestibular evaluation
will be randomized to receive either standard balance rehabilitation plus placebo eye
exercises (CON) or standard balance rehabilitation plus vestibular-specific exercises (GS).
Primary outcomes include symptoms, balance-related confidence, dynamic visual acuity,
postural stability as measured by sensory organization test, fall risk as measured by dynamic
gait index, and gait speed. Assessment will occur at baseline, discharge from physical
therapy (PT), 1 and 6 months post-PT.

Inclusion Criteria:

- at least 50 years of age

- documented balance or mobility problems

- normal vestibular function, including otolith function

Exclusion Criteria:

- cognitive impairment

- progressive medical issues that would impact mobility (e.g., Parkinson's disease,
cerebellar atrophy)

- dizziness due to orthostatic hypotension or Benign Paroxysmal Positional Vertigo
(BPPV)