Barriers and Facilitators of Vestibular Rehabilitation: Patients and Physiotherapists' Perspectives.
Liran Kalderon, Azriel Kaplan, Amit Wolfovitz and 2 others
PMID 38426842WHAT IT FOUND
Patients and therapists identified barriers like symptom provocation and lack of feedback.
Facilitators included clear education on expected dizziness, quantitative progress tracking, and tailoring exercise timing to daily life.
Key findings
01Most participants estimated adherence to vestibular home exercises was 70% or lower.
02Exercise-induced dizziness and a lack of trust in the treatment's effectiveness were primary barriers to adherence.
03Personal interaction with the therapist and quantitative feedback on progress were key facilitators of adherence.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Adherence rates were self-reported estimates based on memory and perception, not objective monitoring. The study focused on patients with chronic vestibular disorders, so findings may not apply to acute presentations. Focus groups were conducted online, which may have influenced group dynamics and the depth of shared personal stories. Findings are from a single cultural context (Israel), limiting generalizability to other populations. The facilitator was a physical therapist who knew some of the participating therapists, which could introduce bias.
Declared interests
The study was approved by the Ethics Review Board of Ben-Gurion University of the Negev and Sheba Medical Center. No specific funding sources or conflicts of interest were declared in the provided text.
The easy way to misread this
Do not interpret the identified facilitators as proven interventions that increase adherence. This study reports what patients and therapists said helps or hinders practice, but it did not test whether these strategies actually improve outcomes.