Acceptance and commitment therapy combined with vestibular rehabilitation for persistent postural-perceptual dizziness: A pilot study

Am J Otolaryngol. 2020 Nov-Dec;41(6):102609. doi: 10.1016/j.amjoto.2020.102609. Epub 2020 Jun 11.


Purpose: This study investigated the feasibility of acceptance and commitment therapy for persistent postural-perceptual dizziness and preliminarily verified the long-term effectiveness of the therapy.

Materials and methods: This study implemented the within-group pre-post comparison design. We enrolled 27 adult patients who met the criteria of persistent postural-perceptual dizziness. They underwent a treatment program including acceptance and commitment therapy combined with vestibular rehabilitation once a week for a total of six sessions. The primary outcome was changes in the Dizziness Handicap Inventory score 6 months posttreatment.

Results: All 27 patients completed the acceptance and commitment therapy + vestibular rehabilitation program, and 25 patients (92.6%) could be followed for 6 months posttreatment. For 27 participants, the scores from pretreatment to 6 months posttreatment significantly declined (P < .001), and the Dizziness Handicap Inventory effect size was 1.11 (95% confidence interval = 0.80-1.42). At 6 months posttreatment, 11 patients (40.7%) achieved remission (the score ≤ 14), 16 (59.3%) achieved treatment response (reduction in the score ≥ 18), and 20 (74.1%) achieved remission and/or treatment response.

Conclusions: Acceptance and commitment therapy is feasible for persistent postural-perceptual dizziness and might have long-term effectiveness. However, a randomized controlled trial is warranted.

Keywords: Acceptance and commitment therapy; Chronic dizziness; Mindfulness; Persistent postural-perceptual dizziness; Vestibular rehabilitation.

MeSH terms

  • Acceptance and Commitment Therapy / methods*
  • Dizziness / etiology
  • Dizziness / rehabilitation*
  • Dizziness / therapy*
  • Feasibility Studies
  • Humans
  • Motion Perception / physiology
  • Neurological Rehabilitation / methods*
  • Pilot Projects*
  • Postural Balance / physiology
  • Time Factors
  • Treatment Outcome
  • Vestibular Diseases / complications
  • Vestibular Diseases / rehabilitation*
  • Vestibular Diseases / therapy*
  • Vestibule, Labyrinth / physiopathology*