Enhanced recovery in unilateral vestibular hypofunction: The synergistic effect of medication and vestibular rehabilitation training.

Objective: This study aimed to compare the efficacy of medication combined with personalized vestibular rehabilitation training (VRT) versus medication alone in unilateral vestibular hypofunction (UVH) and identify predictors of long-term symptom progression.

Methods: Forty-eight UVH patients were randomized into a VRT group (n = 23, medication combined with personalized VRT) and a control group (n = 25, medication alone). Bithermal caloric tests, Dizziness Handicap Inventory (DHI), Vestibular Rehabilitation Benefit Questionnaire (VRBQ), Visual Analog Scale (VAS), Activities-specific Balance Confidence Scale (ABC), and Self-Rating Anxiety Scale (SAS) were assessed at baseline, 2 weeks, and 4 weeks. Symptom progression was tracked over 6 months post-intervention.

Results: Both groups improved significantly (P < 0.05), but the VRT group showed faster unilateral weakness (UW) reduction (30.43 % vs. 43.20 % at 4 weeks, P = 0.012) and greater symptom relief (DHI: 6.70 vs. 23.68, P < 0.001). Logistic regression identified abnormal UW (≥ 25 %) as an independent predictor of symptom recurrence (OR = 7.237, 95 % CI:1.43-36.58, P = 0.017), while DHI scores showed no significant association (P = 0.925).

Conclusions: Personalized VRT combined with medication accelerates symptom resolution and vestibular recovery compared to medication alone. Persistent abnormal caloric results, even with symptom relief, indicate a need for extended treatment and active lifestyle maintenance to mitigate recurrence.