Vestibular Exercises Research Articles

Effectiveness of vestibular therapy as an adjunct to cognitive therapy to improve cognition in elderly with mild cognitive impairment (MCI)

The rapid global increase in aging populations is leading to a rise in age-related conditions like mild cognitive impairment (MCI), necessitating new treatment strategies. This study will conduct a double-blinded, three-arm, randomized controlled trial to evaluate the effectiveness of adding vestibular therapy to cognitive therapy (VT+CT) compared to cognitive therapy (CT) alone and a control group. Participants will be assigned to one of three groups: VT+CT, CT only, or a control group. The VT+CT group will receive vestibular rehabilitation exercises along with a computerized brain program, while the CT group will get only the computerized brain program. Primary outcomes will include electroencephalography (EEG), the Digit Symbol Substitution Test (DSST), and event-related potential (ERP-P300). Secondary outcomes will be the Stroop Color Word Test (SCWT), Trail-Making Test (TMT), and European Quality 5 Dimensions (EQ-5D-5L). This research aims to determine if VT+CT improves cognitive function in elderly individuals with MCI.

Current perspectives on vestibular insights into spatial cognition: A narrative review

Abstract: Conventionally, the focus on vestibular information has centered on basic functions such as adjusting eye movements, controlling posture, and gaze stabilization. However, there has been a noteworthy transformation in recent years as researchers seek to unravel the mysterious relationship between the vestibular system and spatial cognition. This narrative review endeavors, to provide a thorough analysis of current perspectives by delving into a vast body of research in this domain. The principal aim is to critically assess existing studies, offering nuanced insights into the complex interplay between the vestibular system and spatial abilities. For this the electronic database such as PubMed, EMBASE, CINAHL, and Google Scholar was searched for available literature from 2014 onward based on inclusion and exclusion criteria. After reviewing the literature by different authors, a brief review was conceptualized from the same. This article thoroughly explores brain regions related to vestibular function and their connections to spatial orientation and clinical implications. It identifies research gaps and proposes future avenues to deepen our understanding of the vestibular system’s role in spatial cognition, aiming for a holistic perspective. The intricate link between the vestibular system and spatial memory processing is a significant area in neuroscience, with vestibular exercises holding potential for personalized interventions, emphasizing the need to address research gaps for optimal cognitive well-being.

Effectiveness of neck-specific exercises with and without internet-based support on dizziness/unsteadiness in chronic whiplash-associated disorders: Secondary analyses of a randomised controlled trial.

To investigate the effectiveness in individuals with chronic whiplash-associated disorders (WADs) of neck-specific exercise (NSE) supervised by a physiotherapist twice a week for 12 weeks versus neck-specific exercise with internet support and four physiotherapy visits (NSEIT) regarding dizziness, unsteadiness and balance, and to investigate the differences between WAD grades. This is a secondary analysis of a prospective randomised multicentre study (RCT) with concealed allocation (ClinicalTrials.gov Protocol ID: NCT03022812). The outcomes were dizziness measured on the Dizziness Handicap Inventory (DHI); dizziness at rest and during activity and unsteadiness using visual analogue scales; and standing on one leg with eyes closed (SOLEC). Participants (n = 140) were randomised to NSE or NSEIT. Measurements were obtained at baseline, and at three- and 15-month follow-ups by assessor-blinded investigators. There were no significant differences between NSEIT and NSE in any of the outcomes (p>0.38). Both NSEIT and NSE improved over time (p<0.02; effect size (ES) = 0.74-1.01) in DHI score and dizziness during activity. There was a significant group-by-time interaction effect in dizziness (at rest: p = 0.035; ES: 0.66; and during activity: p = 0.016; ES: 1.24) between WAD grades. Individuals with WAD grade 3 had dizziness/unsteadiness to a greater extent and improved in all outcomes over time (p<0.04) compared to those with WAD grade 2, except for SOLEC. There were no significant group differences between NSEIT and NSE. Both groups decreased in terms of self-reported dizziness (DHI, dizziness during activity), with medium to large effect size. Those with WAD grade 3 have dizziness/unsteadiness to a greater extent than those with WAD grade 2. Despite improvements, many participants still reported dizziness at 15-month follow-up, and additional balance training and/or vestibular exercise may be investigated for potential additional effect.

The Effectiveness of Vestibular Exercises on Stress among Elderly

The Effectiveness of Vestibular Exercises on Stress among Elderly

The effect of proprioceptive vestibular rehabilitation on sensory-motor symptoms and quality of life.

Peripheral vestibular hypofunction (PVH) is characterized by balance and gait disorders and vestibulo-autonomic findings. The vestibular system and proprioceptive system work together to regulate sensorimotor functions. Vestibular exercises are effective in PVH, but their superiority over each other is still unclear. This study aims to examine the effect of proprioceptive vestibular exercises on patients with PVH. 30 individuals with unilateral PVH were assigned to 3 groups. Group 1 received proprioceptive vestibular rehabilitation, group 2 received standard vestibular rehabilitation. Both groups were given standard vestibular exercises as home exercises. No exercise was applied to the group 3. Patients were evaluated in terms of balance, functional mobility, posture, sensory profile, and quality of life. Although there was a significant intra-group difference in balance, functional mobility, and quality of life results in all groups (p < 0.05), the difference between groups was generally in favor of group 1 (p < 0.05). There was a significant difference between the groups in the posture analysis results (p < 0.05), while there was a significant difference in the 1st group (p < 0.05). There was a significant difference between the groups in the results of sensory sensitivity, sensory avoidance, and low recording (p < 0.05). There was no significant difference between the groups in sensory-seeking results (p > 0.05). There was a significant difference in quality of life between and within groups (p < 0.05). Proprioceptive vestibular rehabilitation is an effective method in PVH. We think that our study will guide clinicians and contribute to the literature. NCT04687371.

The Effect of Eight Weeks of Selected Vestibular Exercises on Functional Balance, Walking Speed and Quality of Life of Sedentary Elderly Men

Introduction: Aging and sedentary lifestyle are associated with a decrease in physical and mental abilities. The purpose of this study is to investigate the effect of eight weeks of selected vestibular exercises on functional balance, walking speed, and quality of life of sedentary elderly men. Methods: This semi-experimental research was conducted from the winter of 1402 to the summer of 1403 with the participation of 30 sedentary elderly men from Tawheed Golmkan Elderly Care Center in Mashhad. The samples were selected purposefully and based on previous studies (25) and were divided into two experimental and control groups of 15 people. The experimental group performed selected vestibular exercises three sessions a week for eight weeks, while the control group did not perform any exercises. Dynamic comparison test, 10-meter walking speed and short-term life questionnaire were used to evaluate the quality of life. Data analysis was performed using Shapiro-Wilk test, analysis of covariance, and t-test at a significance level of P&lt;0/05. Results: The results of paired t test showed that dynamic balance (P=0/001), walking speed (P=0/001), and quality of life (P=0/001) of the experimental group improved significantly after the exercise program. This was while there was no improvement in the control group. The covariance results did not show a significant difference between the groups in the pre-test phase, but there was a significant increase in the scores of the experimental group in the post-test phase. Conclusion: It is recommended to use exercises to prevent the disabilities of the elderly and improve their quality of independent life.

Improvement in Body's Dynamic Adaptation during Walking with Vestibular Rehabilitation Therapy in Patients with Cerebellopontine Angle Tumor Resection.

Our study aimed to investigate the effects of vestibular rehabilitation therapy on functional gait performance in patients with balance disorders. A total of 40 post-operative patients with balance disorders were included in the study. They were divided into two groups and participated in a vestibular rehabilitation program during their hospital stay. After discharge, the intervention group performed vestibular exercises at home, while the control group did not. Balance was assessed using the Functional Gait Assessment Scale at discharge and three months after surgery. The intervention group included 15 women and 5 men with an average age of 45 years, while the control group included 7 women and 13 men with an average age of 50 years. Three months after surgery, the change in Functional Gait Assessment (FGA) scores exceeded the clinically significant threshold of 5 points in 17 patients in the intervention group and 14 in the control group. There was a statistically significant difference in FGA progression between the groups (p = 0.034). After three months post-surgery, 7 patients in the intervention group experienced falls compared to 12 in the control group. Three months after surgery, we observed a significant improvement in the performance of balance tasks while walking and a lower risk of falls in the intervention group.

Telerehabilitation: Vestibular Physiotherapy vs. Multicomponent Exercise for Functional Improvement in Older Adults: Randomized Clinical Trial.

The loss of vestibular and motor function can occur naturally with aging. Vestibular physiotherapy exercises (VE) specifically address vestibular rehabilitation to reduce imbalances and improve physical condition, like therapeutic exercise (TE). During COVID-19, technology was used with the elderly for implementation. Objective: to determine if vestibular exercises are as effective as multicomponent exercises in improving functional capacity using technological tools. Methods: A randomized clinical trial compared two intervention groups of 21 subjects with functional limitations and frailty (average age 76.11 years). The intervention involved multicomponent exercise for the control group (Vivifrail protocol) and vestibular exercises for the experimental group (Cawthorne and Cooksey exercises) for 6 weeks with five sessions per week both groups. Two professionals implemented the exercises, and participants received tailored exercise videos. Primary outcomes were gait speed, dynamic balance, and physical capacity. Results: Both groups showed significant improvements. For physical function measured by SPPB (0-12 points), the multicomponent exercise group improved by 1.97 (0.91; 3.03), p < 0.001, and the vestibular exercise group improved by 1.63 (0.65; 2.60), p = 0.002. For dynamic balance measured by the Timed Up and Go (TUG) test, the multicomponent exercise group improved by -0.88 (-1.33; -0.42), p < 0.001, and the vestibular exercise group improved by -0.79 (-1.21; -0.37), p < 0.001. There were no significant differences between groups. Finally, regarding gait speed, there were no differences in either group between pretest and post-test (p > 0.05). Conclusions: Both multicomponent exercise and vestibular exercises improve functional capacities via telerehabilitation as measured by the SPPB, although vestibular physiotherapy does not show superior outcomes compared to the control group.

Nature-Based Therapeutic Intervention for Individuals with Post-Concussion Symptoms.

This study investigated the efficacy of a 10-session nature-based therapeutic intervention for people with post-concussion symptoms. The intervention involved physical and vestibular exercises, sensory training, relaxation, and psychoeducation, all of which were integrated with the natural environment in a forest therapy garden. This study was designed with a passive control period followed by the intervention (n = 30). The Mental Fatigue Scale (MFS) was the primary outcome measure. The secondary outcome measures were the Warwick-Edinburg Mental Wellbeing Scale and the short version of the Quality of Life after Brain Injury. A Likert scale was used to examine the mental strain of the sessions themselves. The MFS (primary outcome) exhibited a significant decrease with a medium-sized effect from before to after the intervention. The secondary outcomes exhibited significant increases from the beginning to the end of the intervention. All outcomes were sustained at follow-up ten weeks later. No significant difference was found from the control period. This study indicates that the described nature-based intervention is a feasible treatment for reducing prolonged post-concussion symptoms. However, it should be studied more in-depth to understand the impact of the natural environment and to validate the results on a larger representative population.

Postural motion perception during vestibular stimulation depends on the motion perception threshold in persistent postural-perceptual dizziness

Patients with persistent postural-perceptual dizziness (PPPD) perceive postural instability larger than the observed sway. It is unknown whether the concept of postural misperception prevails during vestibular stimulation and whether it may account for the unsteadiness patients complain during body movements. We tested the hypothesis of an abnormal sensory-perceptual scaling mechanism in PPPD by recording objective, perceived, and the reproduced postural sway under various standing conditions, modulating visual and proprioceptive input, by binaural galvanic vestibular stimulation (GVS). We related postural sway speed to individual vestibular motion perceptional thresholds and disease-related PPPD questionnaires in 32 patients and 28 age-matched healthy control subjects (HC). All participants showed normal vestibular function tests on quantitative testing at the time of enrollment. The perception threshold of GVS was lower in patients. Compared to HC, patients showed and perceived larger sway on the firm platform. With GVS, posturo-perceptual ratios did not show group differences. The ratio of reproduced to real postural sway showed no group differences indicating normal postural sway perception during vestibular stimulation. Noticeably, only in patients, reproduced postural instability became larger with lower individual thresholds of vestibular motion detection. We conclude that posturo-perceptual (metacognitive) scaling of postural control seems to be largely preserved in PPPD during GVS. Vestibular stimulation does not destabilize patients more than HC, even in challenging postural conditions. Low individual thresholds of vestibular motion perception seem to facilitate instability and postural misperception on solid grounds. This conclusion is important for an effective physical therapy with vestibular exercises in PPPD.

A game-based application increases enjoyment and motivation during vestibular rehabilitation exercises

A game-based application increases enjoyment and motivation during vestibular rehabilitation exercises

Evaluation of the effect of a nurse-led vestibular rehabilitation program enriched with yoga on knowledge levels and vertigo symptoms in patients with vertigo

Abstract Background: Around 9.9 million people in India experience vertigo or dizziness, making it difficult to perform daily activities. The aim of this study was to evaluate the effectiveness of nurse-led vestibular rehabilitation programs enriched with yoga on the level of knowledge and vertigo symptoms among patients with vertigo. Materials and Methods: Eighty patients were selected through purposive sampling, and 40 each were randomly assigned to the experimental and control groups. The experimental group received a nurse-led vestibular rehabilitation program comprising vestibular exercises and designated yoga routines. By contrast, the control group received standard care, including prescription of drugs by the physician and follow-up. Data collection involved structured instruments, including sociodemographic and clinical variables, a multiple-choice questionnaire to gauge knowledge levels, and a 5-point Likert scale to measure the intensity of vertigo symptoms. Statistical analysis was conducted using descriptive and inferential methods with IBM Statistical Package for the Social Sciences (SPSS), version 21 (Chicago, Illinois, USA). Results: The independent t value for comparing post-test knowledge (t = 16.87, P = 0.00) and vertigo symptoms (t = 9.25, P = 0.00) between the experimental and control groups indicated significant differences at a significance level of P &lt; 0.001. Conclusion: Incorporating yoga into a nurse-led vestibular rehabilitation program effectively improved the knowledge level and reduced vertigo symptoms among patients experiencing vertigo.

Efficacy of vestibular rehabilitation program in children with balance disorders and sensorineural hearing loss

ObjectiveAsses the efficacy of a Vestibular-balance rehabilitation program to minimize or reverse balance disability in children with sensorineural hearing loss. MethodForty-five hearing-impaired children with balance deficits (i.e., variable degrees of sensorineural hearing loss or auditory neuropathy). Thirty-five were rehabilitated with cochlear implants, and ten with hearing aids. Their age ranged from 4 to 10 years old. A Pre-rehab evaluation was done using questionnaires, neuromuscular evaluation, vestibular and balance office testing, and vestibular lab testing (using cVEMP and caloric test). Customized balances, as well as vestibular rehabilitation exercises, have been applied for three months. That was followed by post-rehab assessment, including the Arabic DHI questionnaire, PBS, BESS, HTT, and DVA test. ResultsThere was a statistically significant difference in all measured parameters (including the Arabic DHI questionnaire, PBS, BESS, HTT, and DVA test) after rehabilitation. ConclusionsVestibular-balance rehabilitation intervention positively impacts vestibular and balance functions in hearing-impaired children.

Effects of constructing vestibular rehabilitation exercise platform based on BS model on vertigo symptoms, balance ability and anxiety of vertigo patients

Objective:To explore the effect of vestibular rehabilitation exercise platform based on browser server（BS） mode on vertigo symptoms, balance ability and anxiety of vertigo patients. Methods:The clinical data of 110 patients with vertigo in our hospital were retrospectively analyzed. The patients who received routine vestibular rehabilitation exercise from March 2019 to may 2020 were set as the control group （55 cases）, and the patients who received vestibular rehabilitation exercise platform guidance based on BS mode from June 2020 to December 2021 were set as the study group （55 cases）. The scores of Fugl Meyer balance assessment scale（FMA）, hospital anxiety and Depression Scale（had）, vertigo disorder scale（DHI）, quality of life scale（SF-36）, vertigo visual analog scale（VAS）, Berg Balance Scale（BBS）, rehabilitation treatment effect and rehabilitation exercise compliance were compared between the two groups. Results:before rehabilitation exercise, there was no significant difference in the scores of DHI, VAS, FMA, BBS, had and SF-36 between the two groups（P>0.05）. After 3 months of exercise, the scores of DHI, had and vas in the study group were lower than those in the control group, and the scores of FMA, BBS and SF-36 in the study group were higher than those in the control group（P<0.05）. The excellent and good rate of rehabilitation efficacy and treatment compliance rate in the study group were higher than those in the control group（P<0.05）. Conclusion:The vestibular rehabilitation exercise platform based on CS mode can improve the limb movement and balance ability of patients with vertigo, reduce the vertigo symptoms and psychological anxiety, and improve the rehabilitation treatment effect and compliance of patients.

Barriers and Facilitators of Vestibular Rehabilitation: Patients and Physiotherapists' Perspectives.

Poor adherence to vestibular rehabilitation protocols is a known barrier to optimal care. Vestibular clinicians' comprehensive understanding of the barriers and facilitators to vestibular home exercise programs (VHEP) is a key element to achieving optimal care in the context of vestibular rehabilitation. The aims of this study are as follows: (1) to identify primary barriers and facilitators to VHEP from the perspective of patients with vestibular dysfunction and vestibular physical therapists (PTs); and (2) to provide strategies for clinicians to improve adherence and outcomes of VHEP. A qualitative research with single-session focus groups conducted separately for: (1) patients with vestibular disorders and (2) vestibular PTs. Six focus groups were conducted, 3 for each population, with a total of 39 participants. An online survey was conducted to evaluate the estimates of adherence rates, followed by a structured discussion over barriers and facilitators to VHEP as perceived by patients and PTs. Thematic data analyses were performed using a mixed deductive-inductive approach. Eighteen patients with vestibular disorders and 21 experienced vestibular PTs participated in this study. Six barrier categories and 5 facilitator categories were identified. Barriers included motivation aspects, provocation of symptoms, time management, associated impairments, missing guidance and feedback, and psychosocial factors. Facilitators included motivation aspects, time management, patient education and exercise instructions, exercise setting, and associated symptom management. Clinicians who prescribe home exercise to patients with vestibular disorders can use this information about common barriers and facilitators for patient education and to provide optimal care and improve rehabilitation outcomes. for more insights from the authors (see the video, Supplemental Digital Content, available at: http://links.lww.com/JNPT/A467 ).

The effect of vestibular and somatosensory rehabilitation in addition to early rehabilitation on balance after stroke: a randomized controlled trial

ABSTRACT Background The goal of post-stroke early rehabilitation is to regain ambulation, standing and balance. Objective The purpose of this study was to investigate the effects of vestibular and somatosensory rehabilitation in addition to early rehabilitation on balance in patients with early subacute stroke. Design and setting A randomized controlled trial was conducted at a university hospital. Methods The study was included 52 hemiplegic hospitalized early suacute stroke patients. The experimental group (n: 30), was applied with vestibular and somatosensorial rehabilitation together with early rehabilitation. Vestibular exercises, included Cawthorne-Cooksey exercises, stimulate the vestibulo-ocular and vestibulo-spinal reflex. Somatosensory exercises, which included Frenkel exercises, stimulate the sensory proprioception and somatosensory systems. The control group (n: 22) patients with early subacute stroke were treated with the early rehabilitation program only. The balance parameters of the patients were evaluated with the Korebalance System, Functional Reach Test, Postural Assessment Scale for Stroke, and Functional Ambulation Scale. Results The mean age of the patients was 67.32 ± 9.46 years, and the mean number of days that had passed since the stroke occurred was 17.90 ± 7.26. In calculating the balance scores, statistically significant differences were observed in the experimental and control groups, with a statistically greater improvement in the rehabilitation group. Statistically significant differences were determined between the groups in respect of the balance scores. Conclusions Based on these findings, the use of vestibular and somatosensory rehabilitation can be recommended for better functioning of the compensatory mechanism of early subacute-stroke hemiplegic patients in early ambulation, and this can lead to considerably improved standing and dynamic upper and lower body balance.

Improved Recovery after Vestibular Schwannoma Excision with Intratympanic Gentamicin Prehabilitation.

Translabyrinthine excision of a vestibular schwannoma is associated with acute vestibular failure. Preoperative intratympanic gentamicin (ITG) injections can improve objective balance function after surgery but its clinical benefits remain to be established. Adult patients undergoing translabyrinthine removal of a vestibular schwannoma between January 2014 and February 2018 underwent preoperative vestibular function testing. Patients were divided in to 3 groups, those with vestibular function (VF) who received ITG injections, those with VF but did not receive ITG and those with no VF. Groups were compared according to degree of vertigo, length of stay, time to unassisted mobilization, and postoperative anti-emetic consumption. Forty six patients had ITG injections (Group 1), 7 had residual VF but refused treatment (Group 2), 21 had no VF (Group 3). Group 1 had a significant improvement in vertigo over time whereas groups 2 and 3 did not. There was a statistically significant 70% decrease in time to independent mobilization between Group 1 and other groups and a 19% decrease in length of stay in Group 1 compared to other groups although this did not reach statistical significance. Two patients had injection-related complications. Group 1 used less anti-emetics than other groups but this was not statistically significant. Preoperative intratympanic gentamicin injection with vestibular rehabilitation exercises is associated with less postoperative vertigo and earlier postoperative mobilization. There was reduced duration of hospitalization and decreased consumption of anti-emetic but not significantly so possibly because of low numbers of patients in the no treatment group. 2 Laryngoscope, 134:3316-3322, 2024.

Concurrent vestibular activation and postural training recalibrate somatosensory, vestibular and gaze stabilization processes.

Postural instability is a common symptom of vestibular dysfunction that impacts a person's day-to-day activities. Vestibular rehabilitation is effective in decreasing dizziness, visual symptoms and improving postural control through several mechanisms including sensory reweighting of the vestibular, visual and somatosensory systems. As part of the sensory reweighting mechanisms, vestibular activation exercises with headshaking influence vestibular-ocular reflex (VOR). However, combining challenging vestibular and postural tasks to facilitate more effective rehabilitation outcomes is under-utilized. Understanding how and why this may work is unknown. The aim of the study was to assess sensory reweighting of postural control processing and VOR after concurrent vestibular activation and weight shift training (WST) in healthy young adults. Forty-two participants (18-35years) were randomly assigned into four groups: No training/control (CTL), a novel visual feedback WST coupled with a concurrent, rhythmic active horizontal or vertical headshake activity (HHS and VHS), or the same WST with no headshake (NHS). Training was performed for five days. All groups performed baseline- and post-assessments using the video head impulse test, sensory organization test, force platform rotations and electro-oculography. Significantly decreased horizontal eye movement variability in the HHS group compared to the other groups suggests improved gaze stabilization (p = .024). Significantly decreased horizontal VOR gain (p = .040) and somatosensory downweighting (p = .050) were found in the combined headshake groups (HHS and VHS) compared to the other two groups (NHS and CTL). The training also showed a significantly faster automatic postural response (p = .003) with improved flexibility (p = .010) in the headshake groups. The concurrent training influences oculomotor function and suggests improved gaze stabilization through vestibular recalibration due to adaptation and possibly habituation. The novel protocol could be modified into progressive functional activities that would incorporate gaze stabilization exercises. The findings may have implications for future development of vestibular rehabilitation protocols.

Assessing the Effects of Mild Traumatic Brain Injury on Vestibular Home Exercise Performance with Wearable Sensors.

After a mild traumatic brain injury (mTBI), dizziness and balance problems are frequently reported, affecting individuals' daily lives and functioning. Vestibular rehabilitation is a standard treatment approach for addressing these issues, but its efficacy in this population remains inconclusive. A potential reason for suboptimal outcomes is the lack of objective monitoring of exercise performance, which is crucial for therapeutic success. This study utilized wearable inertial measurement units (IMUs) to quantify exercise performance in individuals with mTBI during home-based vestibular rehabilitation exercises. Seventy-three people with mTBI and fifty healthy controls were enrolled. Vestibular exercises were performed, and IMUs measured forehead and sternum velocities and range of motions. The mTBI group demonstrated a slower forehead peak angular velocity in all exercises, which may be a compensatory strategy to manage balance issues or symptom exacerbation. Additionally, the mTBI group exhibited a larger forehead range of motion during specific exercises, potentially linked to proprioceptive deficits. These findings emphasize the usefulness of utilizing IMUs to monitor the quality of home-based vestibular exercises for individuals with mTBI and the potential for IMUs improving rehabilitation outcomes.

Chronic dizziness: modern treatment methods taking into account comorbidity

In most cases, chronic dizziness is persistent postural perceptual dizziness (PPPD), which is often combined with other diseases of the vestibular system and anxiety disorders. In real-life clinical practice, PPPD and comorbid disorders are rarely diagnosed and effective treatments are rarely prescribed, so the development of modern methods for managing patients with PPPD with comorbid diseases is important.Objective: to analyze the typical management practices and evaluate the effectiveness of complex therapy in patients with PPPD and comorbid disorders.Material and methods. We examined 60 patients (mean age – 42.5±13.8 years) with diagnosis of PPPD (according to the diagnostic criteria of the Barany Society) and comorbid diseases. All patients were examined twice: at the beginning and after completion of treatment, which lasted an average of 1 month. Treatment included antidepressants (serotonin reuptake inhibitors/serotonin-norepinephrine reuptake inhibitors), anti-anxiety medications, vestibular exercises, an educational program, and cognitive behavioral therapy. Arlevert (a combination of cinnarizine 20 mg + dimenhydrinate 40 mg) was used as a drug therapy for the treatment of vestibular dizziness in 28 patients. A clinical otoneurological evaluation and videonystagmography were performed to assess vestibular disorders; the severity of dizziness was assessed using an otoneurological questionnaire and the Dizziness Handicap Inventory (DHI); the Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Spielberger Anxiety Inventory (STAI) were used to assess anxiety and depressive disorders.Results. None of the 60 patients had previously been diagnosed with PPPD. They were observed with a misdiagnosis of cerebrovascular disease and/or cervical spine pathology and received ineffective treatment. Anxiety and depressive disorders were detected in 32 (53.33%) patients, migraine – in 20 (33.33%) and previous peripheral vestibular disorders – in 8 (13.33%) patients. After one month of treatment in patients with PPPD and comorbid conditions, the severity of dizziness according to DHI decreased from 45.59±15.47 to 29.9±12.56 points (p&lt;0.001), the severity of anxiety according to BAI from 27.50±6.38 to 15.66±4.07 points (p&lt;0.001), the severity of depression according to BDI from 11.91±6.24 to 7.06±4.12 points (p&lt;0.001), the severity of anxiety according to HADS from 13.47±4.16 to 8.60±2.86 points (p&lt;0.001), the severity of depression according to HADS from 6.34±3.72 to 4.31±2.82 points (p&lt;0.001), situational anxiety according to STAI from 50.69±7.13 to 41.26±6.24 points (p&lt;0.001), personal anxiety according to STAI from 54.66±8.21 to 43.78±6.75 points (p&lt;0.001).Conclusion. It was found that PPPD is rarely diagnosed, and anxiety disorders, migraine and peripheral vestibular disorders are very common in PPPD patients. The integrated approach in the treatment of patients with PPPG, taking into account concomitant disorders, has demonstrated high efficacy.