Evaluating the effectiveness of an integrated treatment of vestibular rehabilitation and cognitive behavior therapy for chronic dizziness in a community-based population: a randomized controlled trial.

Chronic dizziness is a common problem seen in primary care, and clinicians have wondered whether pairing vestibular rehabilitation, which retrains the balance system, with cognitive behavioral strategies that address the thoughts and anxiety dizziness can provoke, might work better than vestibular exercises alone. This trial compared an 8-session group program combining both approaches against a single brief vestibular session followed by telephone check-ins, following 105 adults for a year. Both groups showed sustained improvement in dizziness-related handicap over the 12 months, but the trial did not detect a statistically significant difference between the two approaches on its main outcomes of dizziness handicap or walking speed. One secondary measure, dizziness after head movement, did differ between groups at both follow-ups, though this single result among many comparisons could be a chance finding.

The main limitation is that the added value of the more intensive combined program remains unclear, since people improved regardless of which approach they received.

If you live with ongoing dizziness, you may have heard that combining balance exercises with strategies that address the worry and stress dizziness can bring might help more than exercises alone. This study tested that idea with 105 adults, comparing an 8-session group program mixing both approaches against a single brief session of vestibular exercises followed by phone check-ins. The encouraging part is that people in both groups felt their dizziness-related handicap improve over the year.

But the study did not find a clear difference between the two approaches in how much people's dizziness handicap or walking speed changed. One specific symptom, dizziness triggered by head movement, did differ between the groups at both check points, though this single finding among several measured outcomes could be due to chance rather than a real effect of the longer program.

This means that, based on this trial, it is not clear whether the extra group sessions offered any additional benefit beyond the brief initial intervention, since both groups got better over time regardless.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This trial addresses a practical question for clinicians managing chronic dizziness in primary care: does adding a structured cognitive behavioral component to vestibular rehabilitation produce better outcomes than a brief vestibular intervention alone? In this single-blinded randomized controlled trial, 105 adults with chronic dizziness all received a brief vestibular intervention before being allocated to either an 8-session group-based program integrating vestibular rehabilitation and cognitive behavioral strategies (VR-CBT) or telephone follow-up as control. On the primary outcomes, dizziness-related handicap (measured with the Dizziness Handicap Inventory) improved in both groups across 12 months, but the between-group differences were not statistically significant (6.3 points at 6 months, 95% CI -12.7 to 0.2; 7.0 points at 12 months, 95% CI -13.3 to -0.6). Preferred gait speed likewise showed no statistically significant between-group difference at either follow-up.

A between-group difference did emerge for dizziness intensity after head movement at both time points, though this was one isolated secondary finding among several outcomes tested and may represent a chance result rather than a genuine treatment effect. This study informs, but does not resolve, questions about whether combining cognitive behavioral strategies with vestibular rehabilitation adds meaningful value beyond a brief vestibular-focused approach; both interventions were associated with improvement over time, but the trial does not establish that the more intensive program caused superior outcomes, and the control group's telephone contact leaves open whether attention effects contributed to improvements in patient-rated measures.