1000 Section - Effectiveness of Vestibular Rehabilitation in Patients with Multiple Sclerosis: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Wednesday, May 20, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

HP

Hui-Hui Peng, MD

Resident
Department of Medical Education, Taipei Medical University Hospital, Taipei, Taiwan
Taipei, Taipei, Taiwan (Republic of China)

Corresponding Author/Autor a quien dirigir la corr(s)

WH

Wen-Hsuan Hou, MD, PhD, MPH

Attending Physician
Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan
Taipei, Taipei, Taiwan (Republic of China)

Objectives : Patients with multiple sclerosis (MS) often experience postural instability, dizziness, impaired coordination of eye, head, and body movements. Vestibular rehabilitation (VR), including gaze stabilization, balance, and habituation exercises, helps enhance vestibulo-ocular and vestibulo-spinal interactions. However, existing evidence remains inconsistent. This study aimed to evaluate the effects of VR on balance, gait function, transfer ability, dizziness, fatigue, depression, and QoL in MS.

Design:
A systematic search of PubMed, EMBASE, Cochrane Library, Web of Science, and ClinicalTrials.gov was conducted up to August 2025. Two investigators independently screened titles and abstracts, followed by full-text reviews to assess eligibility. All reported outcomes were continuous variables.

Results:
Nineteen RCTs involving 724 patients with MS were identified. VR showed significant improvements compared to control group in balance (standardized mean difference [SMD]: 1.24, 95% confidence interval [CI]: 0.46 to 2.01, p < 0.001), walking speed (MD: 0.19, 95% CI: 0.12 to 0.25, p < 0.001), walking endurance (SMD: 0.43, 95% CI: 0.08 to 0.78, p = 0.01), dizziness (MD: -10.56, 95% CI: -18.42 to -2.71, p = 0.008), fatigue (MD: -1.23, 95% CI: -2.25 to -0.21, p = 0.02), and depression (MD: -4.14, 95% CI: -7.16 to -1.12, p = 0.007). However, no significant differences were observed in transfer ability (SMD: -3.28, 95% CI: -7.09 to 0.53, p = 0.09), self-efficacy for balance (MD: 14.58, 95% CI: -2.92 to 32.09, p = 0.1), and QoL (SMD: 0.51, 95% CI: -0.45 to 1.48, p = 0.3).

Conclusion:
VR significantly improves balance, walking speed, walking endurance, dizziness, fatigue, and depression in patients with MS, targeting sensory integration and postural control to alleviate dizziness and instability while reducing secondary consequences like fatigue and mood disturbances. However, effects on transfer ability, self-efficacy, and QoL remain uncertain. Given its non-invasive and adaptable nature, VR may be a promising adjunct to conventional rehabilitation for MS.