Perception, Knowledge, and Attitude of Medical Doctors in Pakistan About the Role of Physiotherapists in Vestibular Rehabilitation: A Cross-Sectional Survey
Main Article Content
Abstract
Background: Vestibular rehabilitation is an evidence-informed intervention for dizziness, vertigo, imbalance, gait instability, and other vestibular disorders. Physiotherapists can contribute to vestibular care through assessment, rehabilitation, balance retraining, gaze-stabilization exercises, habituation training, patient education, and functional recovery planning; however, doctors’ awareness of this role may influence referral behavior and multidisciplinary care. Objective: To evaluate the knowledge, attitudes, and perceptions of medical doctors in Pakistan regarding the role of physiotherapists in vestibular rehabilitation. Methods: A cross-sectional observational survey was conducted among 196 practicing medical doctors in Pakistan using a structured, pre-tested Knowledge, Attitude, and Perception questionnaire adapted from previous literature. Participants were recruited through non-probability convenience sampling. Data were analyzed using IBM SPSS Statistics version 26, and descriptive statistics were reported as mean ± standard deviation for continuous variables and frequencies with percentages for categorical variables. Results: The mean age of participants was 38.44 ± 6.78 years; 53.6% were male and 46.4% were female. Most respondents (76.0%) had seen patients with vestibular disorders. BPPV was the most commonly reported vestibular disorder (49.0%). Only 13.8% selected physical therapists as suitable providers of vestibular rehabilitation, 25.5% believed physiotherapists were trained in vestibular rehabilitation, and 2.0% believed physiotherapists could treat vestibular disorders. Conclusion: Surveyed medical doctors frequently encountered vestibular disorders but showed limited recognition of physiotherapists’ therapeutic role in vestibular rehabilitation, indicating a need for interprofessional education, clearer referral pathways, and improved communication between doctors and physiotherapists
Article Details
Issue
Section
This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
References
1. Roy B, Sur M, Nath P, Roy SD, Singha P. Exploring the role of psychological factors in vestibular rehabilitation: navigating equilibrium for enhanced outcomes: a narrative review. Int J Orthop Physiother. 2024;6:25-9.
2. Azeez SS, Nada EH. Persistent postural-perceptual dizziness: a review of current knowledge on vestibular rehabilitation. Egypt J Otolaryngol. 2025;41(1):13.
3. Tramontano M, Haijoub S, Lacour M, Manzari L. Updated views on vestibular physical therapy for patients with vestibular disorders. Healthcare. 2025.
4. Strupp M, Dlugaiczyk J, Ertl-Wagner BB, Rujescu D, Westhofen M, Dieterich M. Vestibular disorders: diagnosis, new classification and treatment. Dtsch Arztebl Int. 2020;117(17):300.
5. Tam S, Perera K. Neurologic problems. In: Reichel’s Care of the Elderly: Clinical Aspects of Aging. 2022. p. 189.
6. Mitchell MB, Bhattacharyya N. Balance disorder trends in US adults 2008-2016: epidemiology and functional impact. OTO Open. 2023;7(2):e58.
7. Hung SH, Xirasagar S, Dang LH, Chen YC, Cheng YF, Lin HC, et al. Trends in the incidence of peripheral vestibular disorders: a nationwide population-based study. Front Neurol. 2023;14:1322199.
8. Smith LJ, Pyke W, Fowler R, Matthes B, de Goederen E, Surenthiran S. Impact and experiences of vestibular disorders and psychological distress: qualitative findings from patients, family members and healthcare professionals. Health Expect. 2024;27(1):e13906.
9. Dieterich M, Brandt T. Perception of verticality and vestibular disorders of balance and falls. Front Neurol. 2019;10:172.
10. Shi S, Wang D, Ren T, Wang W. Auditory manifestations of vestibular migraine. Front Neurol. 2022;13:944001.
11. Alyahya D, Kashoo FZ. Perception, knowledge, and attitude of medical doctors in Saudi Arabia about the role of physiotherapists in vestibular rehabilitation: a cross-sectional survey. PeerJ. 2022;10:e13035.
12. ALShammari M, ALSharif DS, Aldaihan MM, Whitney SL. Vestibular rehabilitation in Saudi Arabia: practice, knowledge, and beliefs of physical therapists. J Clin Med. 2025;14(7):2295.
13. Ferri N, Morone G, Piermaria J, Manzari L, Turolla A, De Tanti A, et al. Knowledge, barriers, and future directions of vestibular rehabilitation practice in neurorehabilitation: an Italian survey. Healthcare. 2025;13(1):22.
14. Meldrum D, Burrows L, Cakrt O, Kerkeni H, Lopez C, Tjernstrom F, et al. Vestibular rehabilitation in Europe: a survey of clinical and research practice. J Neurol. 2020;267(1):24-35.
15. Sung YH. Awareness about the necessity of vestibular rehabilitation education in Korean physical therapists. J Exerc Rehabil. 2020;16(2):197-203.
16. Ilyas MB, Afridi R, Ahmed F, Eyman Z, Bakht K, Khan M. Exploring knowledge, attitude, and perception of ENT specialists towards the role of physiotherapy in vestibular rehabilitation. Pak J Med Cardiol Rev. 2026;5(2):452-62.