Zak M. Y., Khramtsov D. M., Vorokhta Y. M., Pryputen A. M., Yablonska T. M.

VESTIBULAR REHABILITATION: INTERDISCIPLINARY ASPECTS

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About the author:

Zak M. Y., Khramtsov D. M., Vorokhta Y. M., Pryputen A. M., Yablonska T. M.

Heading:

THERAPY AND REHABILITATION

Type of article:

Scientific article

Annotation:

The study aimed to assess current practice in vestibular rehabilitation, identify key problems in its organisation and implementation, and outline potential directions for optimising the interdisciplinary management of patients with vestibular disorders. In 2024–2026, a Delphi expert study was conducted involving 30 specialists in neurology, otorhinolaryngology, physical and rehabilitation medicine, physical therapy, neurophysiology, neurosurgery, and family medicine. The study comprised successive rounds of anonymous assessment; consensus was defined as an agreement level of ≥75%. Agreement among expert ratings was assessed using Kendall’s coefficient of concordance (W); between-group differences were evaluated using Pearson’s χ² test/Fisher’s exact test, the Mann–Whitney U test, and the Kruskal– Wallis test, while associations between variables were assessed using Spearman’s rank correlation. In the first round, the greatest disagreement concerned the timing of initiation of physical therapy, prolonged use of vestibular suppressants, the relationship between clinical experience and clinical guidelines, and criteria for completion of rehabilitation. In the second round, consensus was achieved for all 28 closed statements (83.3– 100%); Kendall’s W increased from 0.62 to 0.79 (p<0.001). The main problems identified were the absence of a clear interdisciplinary patient pathway (80.0%), limited access to specialised vestibular physical therapy (73.3%), and insufficient proficiency in positional testing and repositioning manoeuvres (66.7%). Priority changes included standardisation of the patient pathway (83.3%), training specialists in evidence-based vestibular rehabilitation methods (76.7%), and expanding access to specialised physical therapy (70.0%). Repeated expert assessment resulted in marked convergence of interdisciplinary opinions. The principal remaining problems are inadequate patient routing, limited access to specialised physical therapy, insufficient proficiency in positional diagnosis and repositioning manoeuvres, and the unjustified predominance of symptomatic pharmacotherapy over active vestibular rehabilitation.

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Bibliography:

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Publication of the article:

«Bulletin of problems biology and medicine», 2026 Issue 3, 182, 503-507 pages, index UDC 616.28-008.5:615.8

DOI:

10.29254/2077-4214-2026-3-182-503-507