Exploring barriers and facilitators to adherence in vestibular rehabilitation therapy: A cross-sectional exploration

Abstract

Context

Vestibular dysfunction compromises balance and daily function, with benign paroxysmal positional vertigo (BPPV) being the most common. Vestibular rehabilitation therapy (VRT), an exercise-based intervention, enhances vestibular adaptation and symptom recovery. Tailored VRT combined with home exercises can improve adherence when aligned with recommended exercise dosing and clinician guidance.

Aims

To determine the facilitators and barriers to patient adherence to vestibular rehabilitation therapy.

Settings and Design

Cross-sectional Methods and Materials: A cross-sectional study was conducted among 60 patients aged 30–65 years receiving VRT at specialized centers. Ethical approval was obtained before study initiation. Participants completed a validated self-administered questionnaire on demographics, adherence, facilitators, and barriers to VRT participation. Data were analyzed descriptively to determine factors affecting adherence levels.

Statistical analysis used

Per-question analysis using Microsoft Excel.

Results

Of the 60 participants (61.7% females), BPPV accounted for 81.7% of diagnoses, followed by vestibular neuritis and Ménière’s disease and vestibular migraine. Over half of ongoing VRT patients had treatment duration >12 weeks, while most former patients received VRT <4 weeks. Adherence was moderate—60% maintained consistent home exercise practice. Key facilitators included therapist feedback and clear exercise instructions; main barriers were time constraints, symptom exacerbation, and motivation lapses. Overall, 73.3% rated VRT as “very effective.”

Conclusions

Adherence to VRT can be enhanced through personalized communication, structured education, and collaborative goal-setting. Addressing time limitations, symptom flares, and psychosocial challenges is essential for sustained compliance. Adaptive exercise programs supported by motivational frameworks such as self-determination theory warrant further investigation in longitudinal trials.