Clinical Report: Examining the Discrepancy Between Referral and Attendance in VRT

Overview

This study reveals a significant 59% gap between referral and attendance for vestibular rehabilitation therapy (VRT) among a South Florida cohort. Despite the demonstrated benefits of VRT, sociodemographic and insurance factors did not significantly influence attendance rates.

Background

Vestibular dysfunction affects a substantial portion of the adult population, leading to increased fall risk and healthcare burdens. Vestibular rehabilitation therapy (VRT) is an effective intervention for managing symptoms associated with vestibular disorders. Understanding the factors influencing patient attendance to VRT is crucial for improving treatment uptake and outcomes.

Data Highlights

Key Findings

• 59% of referred patients did not attend VRT.
• No sociodemographic or insurance factors significantly influenced attendance rates.
• Among 25 patients with paired DHI data, the average DHI score decreased by 15.2 points.
• Neighborhood deprivation and insurance category were associated with DHI responder status.
• No medium-deprivation or publicly insured patients achieved the minimum clinically important difference (MCID) in DHI scores.

Clinical Implications

Healthcare providers should be aware of the substantial referral-to-attendance gap for VRT and consider potential structural or logistical barriers impacting patient access. Addressing these barriers may enhance treatment uptake and improve patient outcomes in vestibular rehabilitation.

Conclusion

The findings highlight the need for further investigation into the barriers affecting VRT attendance, as current sociodemographic and clinical variables do not account for the observed non-attendance. Future studies should aim to confirm these results in larger, more diverse populations.

Related Resources & Content

1. Frontiers in Neurology, 2026 -- Inconsistencies in care: a UK and Ireland survey exploring acute vestibular service provision in adult major trauma centres
2. Frontiers in Neurology, 2026 -- Reliability and minimal clinically important differences of gait characteristics in peripheral vestibular disorders
3. Journal of Neuro-Oncology, 2025 -- Comparison of Fully Endoscopic Retrosigmoid Keyhole Technique and Traditional Microscopic Surgery for Small to Medium Vestibular Schwannomas: A Retrospective Matched Cohort Analysis
4. Impact of Depression on Work Capacity Following Surgery for Vestibular Schwannoma: Insights from a Nationwide Registry-Based Matched Cohort Analysis of Antidepressant and Sedative Use, Alongside Sick Leave Patterns
5. American Physical Therapy Association Guidelines on Vestibular Rehabilitation
6. Effectiveness of three vestibular rehabilitation exercises for treating acute unilateral peripheral vestibular dysfunction
7. Otology & Neurotology