Clinical Effectiveness of Vestibular Rehabilitation Therapy on Dizziness, Balance, Mobility, and Quality of Life in Adults with Balance Disorders: A Systematic Review of Randomized Controlled Trials (2017–2025): Vestibular Rehabilitation for Balance Disorders

Aim: This review of randomized controlled trials examines the clinical effectiveness of vestibular rehabilitation therapy (VRT) on dizziness, balance, mobility, and quality of life in persons with balance disorders, synthesizing evidence from high-quality randomized controlled trials published between 2017 and 2025.

Method: A systematic search was conducted across PubMed, PEDro, Cochrane Library, and ScienceDirect using the PICO framework (Population: persons with balance disorders; Intervention: vestibular rehabilitation therapy; Comparison: usual care or alternative treatments; Outcomes: dizziness reduction, balance improvement, mobility enhancement, quality of life). Fourteen randomized controlled trials (RCTs) were included according to PRISMA guidelines. Study quality was assessed using the PEDro scale (scoring criteria 1–11). Heterogeneous outcomes prevented meta-analysis; findings are presented narratively organized by outcome domains.

Results: : Fourteen high-quality RCTs (n = 488 participants; mean PEDro score = 6.9/11, range 6–9) met inclusion criteria. Across all trials, conventional, virtual-reality (VR), and internet/blended vestibular rehabilitation demonstrated clinically meaningful reductions in dizziness disability (Dizziness Handicap Index: mean improvement 15–28 points), improvements in dynamic and static balance (Berg Balance Scale, Dynamic Gait Index, Timed Up and Go: moderate to large effect sizes), enhanced functional mobility, and modest to moderate improvements in health-related quality of life and psychosocial outcomes (reduced anxiety, fear of falling and depression). VR-augmented and internet-based delivery models showed comparable or superior outcomes for dynamic balance and functional mobility tasks compared with conventional therapy alone. Benefits were sustained over 3–6 month follow-up periods in trials reporting durability. Dose-response patterns indicate that interventions of ≥4–6 weeks' duration with supervised progressive training yield larger functional gains. Older adults, stroke survivors, and persons with traumatic brain injury demonstrated clinically relevant improvements; however, effect magnitudes varied by chronicity (greater gains in acute presentations) and baseline symptom severity.

Conclusion: Between 2017 and 2025, high-quality RCT evidence suggests that vestibular rehabilitation delivered conventionally, by VR, or via internet/blended models is associated with clinically meaningful reductions in dizziness and improvements in balance and mobility in several adult balance‑disorder populations. Standardized outcome reporting, longer follow-up (≥12 months), larger trials in neurological subgroups, and cost-effectiveness analyses remain important research priorities. Integration of VRT into disability-inclusive rehabilitation programs can enhance participation and independence in persons with balance disorders.