What is the most effective rehabilitation approach for patients with bilateral vestibular hypofunction?

Abstract Background: Bilateral vestibular hypofunction (BVH) is a disabling condition that may result in disequilibrium due to a diminished vestibulo-ocular reflex (VOR). For the majority of cases, the cause is unknown. Objective: The aim of this review paper is to evaluate all the current literature in order to consider whether or not vestibular rehabilitation (VR) is an efficient treatment for patients with BVH. The introduction of balance prostheses will also be considered as a suitable yet alternative treatment to VR for this patient group. Type of review: A narrative review was conducted of the publications relating to treatment of patients with BVH. Online databases: PubMed, Science Direct, and Web of Knowledge were used, supplemented by key words to identify literature published after 2000. Conclusion: This review concluded that VR is a useful treatment method for patients with BVH. However, further research is needed to investigate factors that influence success, such as the patient's clinical presentation, age, or compliance with the programme. The use of balance prosthesis is a developing field and, to date, positive outcomes in reducing postural sway in BVH patients have been documented. There are several disadvantages to this method of treatment; therefore, further developments are needed in the design of the sensory devices before they can be fully considered as an alternative treatment to VR.