Over the last 25 years, intensive efforts by physicians, physical therapists, and occupational therapists have developed integrative rehabilitation regimens that can alleviate balance disorders associated with neurological disease, trauma or weightlessness. A special issue of NeuroRehabilitation: An Interdisciplinary Journal provides an up-to-date review of the underlying scientific principles and latest clinical advances in the treatment of vestibular problems commonly encountered in neurorehabilitation. The journal is celebrating its 20th anniversary of publication this year.

"Clinical advances have been facilitated by three major developments," explains Michael E. Hoffer, MD, FACS, of the Spatial Orientation Center in the Department of Otolaryngology at the Naval Medical Center San Diego, Guest Editor of this issue along with Carey D. Balaban, PhD, Departments of Otolaryngology, Neurobiology, and Communications Sciences and Disorders, and Bioengineering at the University of Pittsburgh. "First, more sensitive and sophisticated quantitative tools for measuring balance function provide validated and robust metrics to assess and document clinical outcomes. A second development was the recognition that balance rehabilitation does not 'belong' to a single group of practitioners in medicine or in the allied health professions. A better result is achieved by a team to ameliorate the physical, neurological, perceptual, and psychiatric features of balance disorders. A third development has been the spread of specialized training in the theory and practice of vestibular rehabilitation in physical therapy and allied health degree programs around the world." The issue covers such topics as the neurophysiology underlying vestibular rehabilitation; application and interpretation of vestibular tests; "prehabilitation" to ameliorate the effects of sudden vestibular loss; principles of physical therapy rehabilitation; vestibular rehabilitation after MTBI; assessment of functional outcomes in patients after rehabilitation; behavioral aspects of vestibular rehabilitation; and sensorimotor reconditioning before and after space flight.

"It is safe to say, at this point, vestibular rehabilitation is recognized as one of the most valuable techniques in treating patients with balance disorders," concludes Dr. Hoffer.