{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T09:00:06Z","timestamp":1791622806102,"version":"4.3.4"},"reference-count":33,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Dizziness symptoms account for nearly 2 million annual emergency department (ED) visits and present a diagnostic challenge for clinicians. Most dizziness research has focused on improving guideline-concordant care among clinicians, with little focus on developing patient-centered interventions to improve dizziness-related disability.<\/jats:p><\/jats:sec>Objective<\/jats:title>To examine the feasibility of ED vestibular rehabilitation therapy (ED-VeRT) using a protocolized diagnostic classification algorithm and collection of longitudinal patient-reported outcomes.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>A pilot nonrandomized clinical trial of ED-VeRT vs usual care for patients presenting to the ED with dizziness at a single urban US ED was conducted from November 16, 2021, to February 6, 2023, with collection of 3-month outcomes through May 1, 2023. Patients were allocated to ED-VeRT or usual care at the discretion of the treating physician.<\/jats:p><\/jats:sec>Interventions<\/jats:title>Use of ED-VeRT was delivered by an ED physical therapist via a protocolized diagnostic classification and treatment algorithm based on a diagnosis of benign paroxysmal positional vertigo, triggered undifferentiated dizziness, spontaneous undifferentiated dizziness, or unilateral peripheral hypofunction.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Feasibility outcomes included participant screening, enrollment, and retention rates to inform the design of a future randomized clinical trial; retention was defined as completing any of 4 follow-up surveys over 3 months. The primary efficacy outcome was change in the Dizziness Handicap Inventory score; the secondary efficacy outcome was change in the Vestibular Activities Avoidance Inventory-9 score.<\/jats:p><\/jats:sec>Results<\/jats:title>Of 366 patients screened, 125 participants were enrolled (median age, 52 [IQR, 40-66] years, 73 [58%] female, 61 [49%] White), and 105 retained (84.0%) in longitudinal data collection. Sixty-three participants (50.4%) received ED vestibular therapy and were assigned to primary diagnostic classifications of benign paroxysmal positional vertigo (23 [37.1%]), triggered undifferentiated dizziness (14 [22.6%]), spontaneous undifferentiated dizziness (14 [22.6%]), or unilateral peripheral hypofunction (9 [14.5%]). Despite having higher Dizziness Handicap Inventory and Vestibular Activities Avoidance Inventory scores at baseline, ED-VeRT participants reported lower dizziness handicap (difference: \u22121.68; 95% CI, \u221211.30 to 7.90) and vestibular activities avoidance (difference: \u22122.27; 95% CI, \u22128.40 to 3.86) at 3 months, although these differences were not statistically significant.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this nonrandomized clinical trial, ED vestibular therapy was feasibly delivered to patients presenting to the ED with undifferentiated dizziness symptoms. For participants receiving vestibular therapy the findings for dizziness-related disability over 3 months were not statistically significant, pointing to the need for a fully powered randomized clinical trial.<\/jats:p><\/jats:sec>Trial Registration<\/jats:title>ClinicalTrials.gov Identifier: NCT05122663<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.59567","type":"journal-article","created":{"date-parts":[[2025,2,14]],"date-time":"2025-02-14T16:31:44Z","timestamp":1739550704000},"page":"e2459567","source":"Crossref","is-referenced-by-count":7,"title":["Emergency Department Vestibular Rehabilitation Therapy for Dizziness and Vertigo"],"prefix":"10.1001","volume":"8","author":[{"given":"Howard S.","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois"},{"name":"Deputy Editor, JAMA Network 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