Background: Persistent Postural-Perceptual Dizziness (PPPD) is a chronic vestibular disorder characterized by dizziness, instability, and visual hypersensitivity. Vestibular Physical Therapy (VPT) is commonly used, but its efficacy remains uncertain due to limited and heterogeneous evidence. Objective: This systematic review and meta-analysis aimed to evaluate the effectiveness of VPT in reducing dizziness and improving balance in individuals with PPPD. Methods: A systematic search of MEDLINE and PEDro was conducted in January 2025. Studies were selected following PRISMA guidelines and included if they assessed VPT interventions in patients diagnosed with PPPD. Risk of bias was assessed using the PEDro scale and the modified Newcastle–Ottawa Scale. The meta-analysis focused on pre- and post-intervention changes in Dizziness Handicap Inventory (DHI) scores using a random-effects model. Results: Six studies met the inclusion criteria. VPT significantly reduced DHI scores (pooled Hedges’ g = 1.60; 95% CI: 0.75–2.45), indicating a moderate to large improvement. Additional outcomes included improvements in postural control (e.g., mini-BESTest and posturography) and psychological well-being (anxiety and depression questionnaires). However, high heterogeneity (I² = 92%) was present across studies. Conclusions: VPT may improve dizziness and balance in PPPD, though evidence is limited. Further high-quality trials with standardized protocols are needed.

Background: Patients with persistent postural-perceptual dizziness (PPPD) exhibit altered postural and gait dynamics, but development of these changes following precipitating illnesses is poorly understood. Objective: To compare posture and gait metrics in patients with PPPD or subacute unilateral vestibulopathies (sAUVP) to healthy controls (HC). Methods: Ten patients with sAUVP, nine with PPPD, and eleven HC completed the 10 Meters Walk Test (10MWT) (an eyes open task) and Fukuda Stepping Test (FST) (an eyes closed task). Gait stability, symmetry, and smoothness were compared among groups and correlated with Dizziness Handicap Inventory (DHI) scores. Results: 10MWT – Patients with PPPD had lower pelvis stability and gait symmetry than HCs. Patients with sAUVP had only lower pelvis stability. FST – Patients with PPPD and sAUVP had lower gait smoothness than HCs. Patients with sAUVP also had lower gait symmetry. Among patients with PPPD, DHI scores correlated positively with head stability. Conclusions: PPPD and sAUVP caused abnormal pelvis stability when walking and gait smoothness when stepping but differed in effects on gait symmetry with the presence/absence of visual inputs. For PPPD, visual stimuli had destabilizing effects, whereas for sAUVP vision aided stability. Symptom severity in patients with PPPD was related to head stability.

Background: Guillain–Barré syndrome (GBS) is an immune-mediated polyradiculoneuropathy that represents a leading cause of motor impairment. Robot-assisted therapy (RAT) has been widely applied in various neurological conditions. However, the use of RAT in GBS remains underexplored. This systematic review (SR) aims to evaluate the preliminary evidence regarding the efficacy of RAT in terms of motor recovery in people with GBS (pwGBSs). Secondly, the study protocol for a randomized RCT is reported. Methods: A comprehensive SR was conducted on PubMed, Scopus, EMBASE, Cochrane Library, and Epistemikos. Risk of bias was assessed using the National Institute of Health (NIH) study quality assessment. The SR’s protocol was recorded in the PROSPERO database. Results: Out of 116 articles found, four studies published in the past four years met the inclusion criteria. These studies investigated the effects of RAT on lower limbs (three studies) and upper limbs (one study) in four pwGBSs. The results showed improvements in motor function and patient engagement, but it is impossible to generalize the findings. Conclusions: Our SRs supports the rationale for an RCT to assess the efficacy of RAT in pwGBSs. We present the protocol for a double-blind RCT to evaluate the effects of RAT on upper limb motor function in pwGBSs.

Multiple Sclerosis (MS) is a chronic, inflammatory, and degenerative disease of the central nervous system. Balance impairments are very common symptoms among people with MS (PwMS). Vestibular physical therapy (VPT) is an evidence-based approach aimed at managing and improving gaze and balance stability, which could be used to mitigate balance disorders in MS. The objective of this systematic review with meta-analysis is to evaluate the effects of VPT in managing balance and dizziness in PwMS. Electronic databases were searched in February 2025 (PubMed, Scopus and Cochrane) and screened by two blind reviewers. Risk of Bias was assessed using PEDro Scale. A meta-analysis was conducted to evaluate, across multiple studies, the effect sizes for two clinical outcomes: the Dizziness Handicap Inventory (DHI) and the Activities-specific Balance Confidence Scale (ABC). After screening, 16 articles were included in the review, mostly comparing VPT with other conventional approaches. Analysis of the Risk of bias showed quality deficiencies in these studied with respect to the blinding of participants, assessor and physiotherapist. The meta-analysis showed significant efficacy of VPT against control using the DHI as outcome measure (Hedges’ g = 1.451, CI [0.190, 2.713]). In conclusion, VPT is a safe approach in reducing dizziness-related disability of PwMS. Further studies are needed to refine assessment methods and explore individualized approaches.

Background/Objectives: Stroke frequently leads to balance deficits. Vestibular physical therapy (VPT) may enhance postural control through neuroplastic mechanisms. Virtual reality (VR) can provide ecologically valid environments for rehabilitation, increasing patient engagement. Methods: In this randomized feasibility study, nine individuals with chronic stroke were randomized to either a Real visuo–vestibular rehabilitation group (n = 6) or a Sham VR group (n = 3) to explore the feasibility of the protocol and randomization procedures rather than to compare clinical efficacy. Both groups were trained in immersive VR environments for 12 sessions. The Real group experienced visuo–vestibular stimuli requiring sensorimotor integration; the Sham group trained in the same environments without such stimuli. Feasibility was assessed through attendance, participation (Pittsburgh Rehabilitation Participation Scale, PRPS), and user satisfaction (USEQ). Safety and acceptability were monitored through adverse event reporting. Secondary exploratory outcomes included measures of balance—the Mini Balance Evaluation Systems Test (MiniBESTest), the Berg Balance Scale (BBS), and the Performance-Oriented Mobility Assessment (POMA)—as well as functional independence (Barthel Index), health-related quality of life (Stroke-Specific Quality of Life Scale, SSQoL), and a set of spatiotemporal and gait quality parameters derived from inertial measurement unit (IMU) data collected during the 10-Meter Walk Test and the Figure of 8 Walk Test. Results: All participants completed the protocol without adverse events. Participation, as measured by the PRPS, remained consistently high across sessions (mean ≥5.7/6), while USEQ scores indicated excellent user satisfaction (mean ≥28/30). Exploratory analyses revealed improvements in MiniBESTest and BBS scores for the Real group. Instrumental measures derived from IMUs demonstrated improvements across groups. Conclusions: Exploratory outcomes suggested positive trends in balance improvements, and the integration of clinical scales with wearable sensors proved feasible and informative.

Background: Understanding the temporal relationship between neurological and functional recovery after cervical spinal cord injury (SCI) is crucial for optimizing rehabilitation timing and clinical interpretation. This prospective longitudinal study aimed to investigate the temporal dynamics of clinically meaningful neurological and functional recovery in individuals with subacute SCI during inpatient rehabilitation. Methods: We enrolled 21 individuals with incomplete cSCI (AIS C and D). Evaluations were performed every 15 days, from admission up to 120 days. Recovery was defined using the Time to First Improvement based on thresholds exceeding the Minimal Detectable Change or Minimal Important Difference) for neurological scales (Upper Extremities Motor Score—UEMS, Graded Redefined Assessment of Strength, Sensation and Prehension—GRASSP subtests for Strength and Sensation) and the Minimal Clinically Important Difference for functional scales (Spinal Cord Independence Measure, GRASSP Ability and Prehension Performance). Survival analysis (Kaplan–Meier) and pairwise comparisons were used to analyze the temporal sequence of recovery. Results: Neurological and functional recovery showed a parallel macro-evolution. However, granular analysis revealed that motor strength improved significantly earlier than sensory recovery and fine motor dexterity. No significant differences were found between dominant and non-dominant limbs. Conclusions: Upper limb recovery follows a phase-specific evolution where motor strength provides the substrate for functional gains supporting a phase-specific approach to rehabilitation.