[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-435961-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-435961-en":130},{"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","measures-of-clinical-effect-in-vestibular-rehabilitation-letter-1","Measures of clinical effect in vestibular rehabilitation - Letter 1","","Letter discussing the clinical usefulness of findings from vestibular rehabilitation for peripheral vestibular hypofunction, focusing on how statistical results translate into practical effects. It reviews proprioceptive training as a treatment approach and highlights limitations that may involve type-II error. Clinical effect measures include Cohen’s d, Cohen’s U3, number needed to treat (NNT), and probability of superiority (PS), comparing groups using Tinetti balance, Tinetti Gait, and TUG 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/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/measures-of-clinical-effect-in-vestibular-rehabilitation-letter-1/435961/",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/measures-of-clinical-effect-in-vestibular-rehabilitation-letter-1/435961.png","ImageObject",300,407,{"name":42,"@type":43},"Olivia Brown","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-03","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",10,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What condition is addressed in this letter?","Question",{"text":63,"@type":64},"The letter focuses on peripheral vestibular hypofunction, characterized by functional loss of one or both peripheral vestibular systems and symptoms such as dizziness, vertigo, and postural instability.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Which clinical effect metrics are calculated?",{"text":68,"@type":64},"Measures include Cohen’s d, Cohen’s U3, number needed to treat (NNT), and probability of superiority (PS) to interpret group differences beyond statistical significance.",{"name":70,"@type":61,"acceptedAnswer":71},"How were groups compared in balance and gait tests?",{"text":72,"@type":64},"Group differences were assessed using Tinetti balance, Tinetti Gait test, and Timed Up and Go (TUG), with effect estimates indicating larger clinical effects for group 1 in key dynamic balance outcomes.","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},435961,1791092760,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,126],{"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":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",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":55,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":55,"slug":125},"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":30,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":111,"preview_page_count":4},16904993612988,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Article published online: 2025-10-31  \nLetter 1  \nMeasures of clinical effect in vestibular rehabilitation  \nGabriela Ramos Ventura 1 Maristela Linhares dos Santos2 Joubert Vitor de Souto Barbosa2 Emannuel Alcides Bezerra Rocha2 Gerônimo Bouza Sanchis3 Rafael Limeira Cavalcanti4 Marcello Barbosa Ottoni Gonçalves Guedes 1 Johnnatas Mikael Lopes5  \n1 Universidade Federal do Rio Grande do Norte, Centro de Ciências da Saúde, Departamento de Fisioterapia, Natal RN, Brazil.  \n2 Universidade Federal do Rio Grande do Norte, Natal RN, Brazil.  \n3 Universidade Federal de Minas Gerais, Belo Horizonte MG, Brazil.  \n4 Marinha do Brasil, Natal RN, Brazil.  \n5 Universidade Federal do Vale do São Francisco, Paulo Afonso BA, Brazil.  \nAddress for correspondence Johnnatas Mikael Lopes (email: [johnnataslopes@univasf.edu.br](johnnataslopes@univasf.edu.br))  \nArq. Neuro-Psiquiatr. 2025;83(9):s-0045-1806831 .  \nDear Editor,  \nPeripheral vestibular hypofunction is a condition caused by the involvement of specific regions of the inner ear or the vestibular nerve, characterized by the functional loss of one or both peripheral vestibular systems, which can cause symptoms such as dizziness, vertigo, postural instability, oscillopsia, nausea, loss of balance, and proprioceptive defi cit.1 These symptoms can interfere with the quality of life of patients, making it difficult to perform daily activities. This dysfunction can increase the risk of falls, due to the impairment of balance and body perception, reinforcing the need for targeted strategies that promote functional recovery and prevent secondary complications.1  \nProprioceptive training has emerged as an alternative for the treatment of individuals with vestibular hypofunction, since it consists of using mechanical and somatosensory stimuli to improve skills that depend on sensorimotor integration, through exercises that challenge postural control and body perception.2 This process is influenced by neural factors that are important for the consolidation of motor learning, such as the function of the cerebellum and primary cortex, which, when combined with different somatosensory stimuli, produce proprioceptive adaptations.3  \nIn this context, the study by Özaltın et al.4 presented relevant findings regarding the vestibular rehabilitation of individuals with peripheral vestibular hypofunction. However, some issues related to the clinical usefullness of the results and their applicability, in addition to statistical significance, require further exploration to strengthen their practical implications.  \nWhen analyzing the data and calculating the measures of clinical effect,5 it was observed that groups 1 and 2 present statistical similarity in some variables but generate distinct clinical effects. This may be attributed to a sampling problem, resulting in type-II error.  \nMeasures of clinical effect were calculated, including Cohen’s d, Cohen’s U3, number needed to treat (NNT), and probability of superiority (PS).5 In dynamic balance, assessed by the Tinneti Gait and Timed Up and Go (TUG) tests, Cohen’sdvalues were 0.93 and 􀀁0.99, respectively, indicating a large clinical effect of group 1, compared to group 2 . These results show that 82 .4%(Cohen’s U3) of the individuals in group 1 surpassed the mean of group 2 in the Tinneti Gait test, with a probability of superiority of 74.5% and an NNTof 2.98. Similar findings were observed for the TUG test ( ►Table 1 ).  \nIn the sensation avoiding item, the clinical effect between the groups was also high (d¼􀀁0 .95). This implies that 82.9% of the individuals in group 1 are above the mean of group 2, with 63.5% overlap between the groups, and a 74.9% probability of superiority for group 1 . Furthermore, to achieve a more favorable outcome in group 1 compared with group 2, it is necessary to treat, on average, 2.9 individuals ( ►Table 1 ) .  \nThe greatest clinical effects of group 1 over group 2 were observed in items shoulder posture (d ¼􀀁4 .22), quality of Life (d ","cbCailcUoNPPFee9","https://ap.wps.com/l/cbCailcUoNPPFee9","pdf",304107,"English","# Vestibular hypofunction and clinical impact\n# Proprioceptive training in vestibular rehabilitation\n# Clinical effect calculations and comparisons\n## Effect sizes, NNT, and probability of superiority\n## Balance and gait outcomes (Tinetti, TUG)","[{\"question\":\"What condition is addressed in this letter?\",\"answer\":\"The letter focuses on peripheral vestibular hypofunction, characterized by functional loss of one or both peripheral vestibular systems and symptoms such as dizziness, vertigo, and postural instability.\"},{\"question\":\"Which clinical effect metrics are calculated?\",\"answer\":\"Measures include Cohen’s d, Cohen’s U3, number needed to treat (NNT), and probability of superiority (PS) to interpret group differences beyond statistical significance.\"},{\"question\":\"How were groups compared in balance and gait tests?\",\"answer\":\"Group differences were assessed using Tinetti balance, Tinetti Gait test, and Timed Up and Go (TUG), with effect estimates indicating larger clinical effects for group 1 in key dynamic balance outcomes.\"}]","Measures of clinical effect in vestibular rehabilitation - Letter 1 | PDF",1790676102]