Digital Vestibular Rehabilitation After Acute Vertigo: What a Negative Superiority Trial Means

Digital delivery did not beat structured written exercises

A new randomized trial in PLOS One tested whether an internet-based vestibular rehabilitation program could reduce symptoms more than standardized written instructions after acute onset vertigo. The short answer is no: the digital tool was not superior at the 6-week primary endpoint.

That negative result is clinically useful rather than uninformative. This was not a trial of online rehabilitation against no rehabilitation. It was a pragmatic superiority trial against an active comparator: written instructions for the same vestibular exercises, plus advice intended to prevent inactivity, secondary dizziness, and fear of movement. For clinicians, the key message is therefore not that digital vestibular rehabilitation failed as a concept, but that a structured paper-based exercise pathway performed similarly under trial conditions.