[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-208882-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-208882-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","internet-based-vestibular-rehabilitation-versus-written-instructions-after-acute-vertigo-a-randomised-controlled-trial","Internet-based vestibular rehabilitation versus written instructions after acute vertigo - A randomised controlled trial","","Acute vestibular syndrome causes sudden, continuous vertigo, dizziness, and postural instability, leading many patients to emergency care. Vestibular rehabilitation is evidence-based for chronic vestibular disorders, yet its benefit in acute vertigo is limited and underused. This multicentre randomised evaluator-blinded superiority trial compared a six-week internet-based VR tool with personalised home exercises versus written instructions, aiming to reduce vestibular symptoms within six weeks and assess functional and secondary outcomes.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/research-report/","Research & Report",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/internet-based-vestibular-rehabilitation-versus-written-instructions-after-acute-vertigo-a-randomised-controlled-trial/208882/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/internet-based-vestibular-rehabilitation-versus-written-instructions-after-acute-vertigo-a-randomised-controlled-trial/208882.png","ImageObject",300,407,{"name":42,"@type":43},"McGucket","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-23","2026-09-05",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",13,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What was the main goal of the study?","Question",{"text":63,"@type":64},"To evaluate whether an internet-based vestibular rehabilitation tool is more effective than standard written instructions in reducing vestibular symptoms after acute onset vertigo.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How were participants assigned to interventions?",{"text":68,"@type":64},"Adults with ongoing acute vestibular syndrome were recruited within 1–7 days after symptom onset and randomised in a 1:1 ratio to either internet-based VR with personalised home exercises or written instructions for home exercises.",{"name":70,"@type":61,"acceptedAnswer":71},"How was the primary outcome measured?",{"text":72,"@type":64},"Vestibular symptoms at six weeks were assessed using the Vertigo Symptom Scale Short Form (VSS-SF), with a between-group difference of ≥3 points defined as clinically significant.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},208882,1788606917,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,111,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":108,"show_sort_weight":109,"slug":110},7,"Healthcare",40,"healthcare",{"id":112,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":113,"slug":114},8,30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":112,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":140,"language":141,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":12,"update_tm":80,"read_time":145,"preview_page_count":4},1236954412713,"https://us-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","OPEN ACCESS  \nCitation: Surano S, Lindell E, Mathé J, Davidsson H, Tomanovic T, Bjurman M, et al.(2026) Internet-based vestibular rehabilitation versus written instructions after acute vertigo: A randomised controlled trial. PLoS One 21(6): e0351092. [https://doi.org/10.1371/journal](https://doi.org/10.1371/journal). pone.0351092  \nEditor: Jeyasakthy Saniasiaya, Universiti Malaya Fakulti Perubatan: University of Malaya Faculty of Medicine, MALAYSIA  \nReceived: March 19, 2026  \nAccepted: May 14, 2026  \nPublished: June 12, 2026  \nPeer Review History: PLOS recognizes the benefits of transparency in the peer review process; therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. The editorial history of this article is available here: [https://doi.org/10.1371/journal](https://doi.org/10.1371/journal). pone.0351092  \nCopyright: © 2026 Surano et al. This is an open access article distributed under the terms of the Creative Commons Attribution License,  \nRESEARCH ARTICLE  \nInternet-based vestibular rehabilitation versus written instructions after acute vertigo: A randomised controlled trial  \nSolmaz Surano1, Ellen Lindell2, Jan Mathé3, Hugo Davidsson2, Tatjana Tomanovic4, Maria Bjurman1, Erik Faergemann1, Torbjörn Ledin5, Anette Rostmark1, Helena Grip 6, Fredrik Öhberg6, Gabriel Granåsen7, Jonatan Salzer1*  \n1 Department of Clinical Sciences, Neurosciences, Umeå University, Umeå, Sweden, 2 Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, 3 Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, 4 Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden, 5 Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden, 6 Department of Diagnostics and Intervention, Biomedical Engineering and Radiation Physics, Umeå University, Umeå, Sweden, 7 Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden  \n* [jonatan.salzer@umu.se](jonatan.salzer@umu.se)  \nAbstract  \nBackground  \nAcute vestibular syndrome (AVS) causes sudden and continuous vertigo, dizziness, and postural instability and is a common reason for emergency department visits, most commonly due to vestibular neuritis and, in rare cases, stroke. Vestibular rehabilitation (VR) is an evidence-based exercise therapy that facilitates vestibular compensation and is effective in chronic vestibular disorders. However, evidence for VRin acute vertigo remains limited and, despite guideline support, it remains underused in practice. Internet-based VR has demonstrated benefit in chronic dizziness but has not been evaluated in acute vertigo. This study aimed to evaluate the efficacy of an internet-based VR tool compared with standard care (written instructions) in reducing vestibular symptoms after acute onset vertigo.  \nMethods and Findings  \nA multicentre, randomised, evaluator-blinded superiority trial was conducted across nine hospitals in Sweden. Adults with ongoing AVS were recruited within 1–7 days after symptom onset and randomised (1:1) to six weeks of internet-based VR with personalised, progressively adjusted home exercises or to written instructions for home-based VR exercises. The primary outcome was the between-group difference in vestibular symptoms at six weeks measured using the Vertigo Symptom Scale Short Form (VSS-SF; range 0–60), with a difference of ≥3 points prespecified as clinically significant. Secondary outcomes included dizziness-related disability, walking  \nPLOS One | [https://doi.org/10.1371/journal.pone.0351092](https://doi.org/10.1371/journal.pone.0351092) June 12, 2026 1 / 17  \nwhich permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.  \nData availability statement: Restrictions apply to the a","cbCaiuB86LmP5GyF","https://ap.wps.com/l/cbCaiuB86LmP5GyF","pdf",1935371,17,"English","# Abstract\n## Background\n## Methods and Findings\n## Outcomes","[{\"question\":\"What was the main goal of the study?\",\"answer\":\"To evaluate whether an internet-based vestibular rehabilitation tool is more effective than standard written instructions in reducing vestibular symptoms after acute onset vertigo.\"},{\"question\":\"How were participants assigned to interventions?\",\"answer\":\"Adults with ongoing acute vestibular syndrome were recruited within 1–7 days after symptom onset and randomised in a 1:1 ratio to either internet-based VR with personalised home exercises or written instructions for home exercises.\"},{\"question\":\"How was the primary outcome measured?\",\"answer\":\"Vestibular symptoms at six weeks were assessed using the Vertigo Symptom Scale Short Form (VSS-SF), with a between-group difference of ≥3 points defined as clinically significant.\"}]","Internet-based vestibular rehabilitation versus written instructions after acute vertigo - A randomised controlled trial | PDF",43]