Does adding otolith specific exercises to a standard vestibular rehabilitation programme improve outcomes for adults with inner ear dizziness?

The overall duration of the treatment intervention is 9 weeks. Participants undergo a full subjective assessment of their condition at baseline and then complete self administered questionnaires that rate their perception of the problem and how this impacts on daily function and quality of life in the week prior to arriving for baseline assessment in Week 0 below. Week 0 (90 minutes) - Physiotherapist 1 will perform a baseline balance and gait assessment for each participant. Based on the assessment findings, participants will be given a tailored home exercise program consisting of habituation, gaze stability, and balance exercises. Participants will be asked to complete these exercises taking 10-15 minutes, three times daily for the duration of the 9 week rehabilitation. All participants will be asked to fill in a home exercise diary in order to record completion of the exercise programme. Weeks 1 and 5 (30 minute review session) - Physiotherapist 2 will review and modify exercises as necessary. Review sessions will take approximately half an hour. A compliance measure for adherence to exercise programmes will be taken at these times for both groups. At weeks 1 and 5, those participants in the intervention group of standard plus otolith specific vestibular rehabilitation program will be given added exercises to those above involving linear movement of head and/or movement of head position to change orientation with respect to gravity (eg side tilt or bouncing while sitting on a compliant surface). These exercises may add a further 5 minutes to their exercise program. Week 9 (60 minute review session) – Physiotherapist 1 will repeat the balance and gait assessment and questionnaires. 6 months following baseline assessment (60 minutes) - Physiotherapist 1 will review the exercises and repeat objective outcome measures and questionnaires.