Conservative Management of Persistent Postural-Perceptual Dizziness and Chronic Dizziness: A Systematic Review and a Randomized Trial of Vestibular Rehabilitation

Licensed physical therapists and physical therapist assistants who see adults reporting persistent dizziness, unsteadiness, or visually provoked symptoms in outpatient, neurologic, balance-clinic, and home-health settings.

Physical therapists and physical therapist assistants.

Intended audience

Physical Therapy

Level

Intermediate

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

This course is based on the following two sources, and on nothing else:

Zheng Y, Guo Z, Liu X, Chen H, Gang W, Chen H, Wang W. Effect of conservative therapy for persistent postural-perceptual dizziness: a systematic review and meta-analysis. Front Psychiatry. 2025;16:1676218. doi:10.3389/fpsyt.2025.1676218

Ebenezer A, Kumar K, Kalaiah MK, Dosemane D, Malik MR. Impact of vestibular rehabilitation therapy on quality of life and cognitive function in individuals with chronic dizziness or vertigo. Eur Arch Otorhinolaryngol. 2025;282(9):4563–4572. doi:10.1007/s00405-025-09382-0

After completing this course, you will be able to:

1. Describe what the systematic review and meta-analysis of conservative therapy for persistent postural-perceptual dizziness reported about vestibular rehabilitation used alone compared with vestibular rehabilitation combined with other conservative therapies.
2. State which quality-of-life and cognitive outcomes changed, and which did not, when vestibular rehabilitation therapy was added to medication in the randomized trial of adults with chronic dizziness or vertigo.
3. Distinguish the two study populations and their outcome measures, and explain the limits each group of authors placed on its own conclusions.

1. Start Here: The Clinical Question and How This Course Is Built
2. Part One: Conservative Therapy for Persistent Postural-Perceptual Dizziness
3. Who the Pooled Trials Enrolled and How PPPD Was Defined
4. How the Review Searched, Pooled, and Graded the Trials
5. What the Pooled Results Showed for Vestibular Rehabilitation and the Other Conservative Therapies
6. Risk of Bias, Certainty of Evidence, and What the Review Authors Concluded
7. Part Two: Vestibular Rehabilitation, Quality of Life, and Cognition in Chronic Dizziness
8. Who Took Part in the Chronic Dizziness Trial and Who Was Screened Out
9. How the Trial Was Run and What It Measured
10. Changes in Dizziness Handicap and on the Cognitive Tests
11. Limits the Trial Authors Named and the Conclusion They Drew
12. Bringing It Together
13. Where the Two Papers Point the Same Way
14. Where They Diverge and Which Paper Found What
15. What the Combined Evidence Supports for a Physical Therapy Plan of Care
16. What Remains Unanswered
17. Key Takeaways
18. Post-Test and Course Evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 1.0 contact hour (60 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. Zheng Y, Guo Z, Liu X, Chen H, Gang W, Chen H, Wang W. Effect of conservative therapy for persistent postural-perceptual dizziness: a systematic review and meta-analysis. Front Psychiatry. 2025;16:1676218. doi:10.3389/fpsyt.2025.1676218
2. Ebenezer A, Kumar K, Kalaiah MK, Dosemane D, Malik MR. Impact of vestibular rehabilitation therapy on quality of life and cognitive function in individuals with chronic dizziness or vertigo. Eur Arch Otorhinolaryngol. 2025;282(9):4563-4572. doi:10.1007/s00405-025-09382-0