Profile of patients attending private vestibular physiotherapy clinics in Spain: A cross-sectional study.

Abstract

Background Despite its proven efficacy, access and referrals to vestibular physiotherapy remain limited. Objective Our primary aim was to characterise the demographic, clinical, and healthcare utilisation profiles of patients attending private vestibular physiotherapy clinics in Spain. Design Multicentre cross-sectional study through an online survey (Feb-Jun 2025). Setting Private vestibular physiotherapy clinics in Spain. Participants Physiotherapists specialising in vestibular rehabilitation were first recruited and then consecutively invited eligible patients attending their clinics for vertigo, dizziness, or unsteadiness, with or without a prior medical diagnosis, to complete an online questionnaire including patient characteristics, clinical and functional data. Physiotherapists contributed limited descriptive information about their own training, and the main unit of analysis was the patient. Results We included 616 patients (67% women; median age 57 years, IQR 46-59). Vertigo was the predominant symptom (59%), usually of sudden onset (68%) and recurrent (66%). Common triggers were head movements (74%) and postural changes (66%). Positional testing identified nystagmus compatible with BPPV in 40% of patients. Applying Bárány Society criteria, 55% presented episodic vestibular syndrome, 36% chronic and 5% acute vestibular syndrome. Mean Dizziness Handicap Inventory score was 46 (SD 21). Thirty per cent required sick leave, and 68% were taking medications. Only 20% had been referred by a general practitioner or specialist. Conclusions Patients attending private vestibular physiotherapy in Spain showed predominantly female predominance, middle age, multimorbidity, episodic vestibular syndromes with BPPV features, low primary care referral, informal access routes, and substantial functional impairment. These patterns suggest opportunities to optimise vestibular patient management pathways. CONTRIBUTION OF PAPER.