Repetitive Transcranial Magnetic Stimulation for Dizziness, Balance, and Postural Stability in Adult Patients With Chronic Peripheral Vestibular Dizziness
In brief
rTMS plus rehab reduces dizziness score by 2 points and raises balance by 6
In a double-blind trial of 56 adults with chronic vestibular dizziness, adding 10 Hz rTMS to standard vestibular rehabilitation improved the Visual Vertigo Analogue Scale by about 2 points and the Berg Balance Scale by roughly 6 points over eight weeks, outperforming sham stimulation. The large effect sizes suggest a meaningful clinical benefit, but longer-term outcomes and broader applicability remain to be clarified.
- Journal
- Archives of physical medicine and rehabilitation (Q1)
- Published
- 5 August 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Reham Ali Mohamed Ahmed, Ayman A Mohamed, Ahmed Youssef, Ebtesam Fahmy, Hussein Sherif Hamdy, Hesham Nafia, et al.
- PMID
- 42559786
- DOI
- 10.1016/j.apmr.2026.02.005
Why clinicians should know about it
- Picked for Rehabilitation (top studies of the week, 9 August 2026).
Abstract
OBJECTIVE: To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on dizziness, balance, and postural stability in adult patients with chronic vestibular dizziness. DESIGN: A double-blind randomized controlled trial. SETTING: Outpatient clinic. PARTICIPANTS: Fifty-six adults with chronic vestibular dizziness were randomly assigned to study group and control groups. Baseline symptoms had persisted for a mean of (14.3mo), median (14mo), and range (6-28mo; N=56). INTERVENTION: The study group received rTMS and vestibular rehabilitation (VR), whereas the control group received sham stimulation as rTMS and VR. The treatment period lasted for 8 weeks. The rTMS was applied at a frequency of 10 Hz and 90% of the resting motor threshold. The rTMS and VR were implemented 3 sessions per week (24 VR sessions per participant). MAIN OUTCOME MEASURES: The primary outcome measures included Visual Vertigo Analogue Scale (VVAS) and Berg Balance Scale(BBS). The secondary outcome measures included computerized dynamic posturography (somatosensory component, visual component, vestibular component, preference component, and total equilibrium composite). RESULTS: After 8 weeks, the study group showed significant improvements more than the control group in all outcomes measures, including VVAS, BBS, and all domains of computerized dynamic posturography (P<.05). Notable effects included VVAS (-2.1; 95% confidence interval [CI], -2.8 to -1.4; d=1.02), BBS (+6.3; 95% CI, 4.2-8.4; d=1.15), and total equilibrium composite (+6.9; 95% CI, 4.7-9.1; d=1.10), indicating large clinical impact. Clinically meaningful changes included: VVAS reduction of 2.1 points (95% CI, -2.8 to -1.4; Cohen's d=1.02, large effect), BBS improvement of 6.3 points (95% CI, 4.2-8.4; Cohen's d=1.15, large effect). These effect sizes represent clinically significant improvements in symptom severity and balance function. CONCLUSION: These findings suggest that rTMS may enhance VR outcomes and support its potential as a clinical application in patients with chronic vestibular dizziness.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.