We describe the treatment of two patients with peripheral vestibular d
ysfunction using a novel, staged exercise program. Response to treatme
nt was documented The first patient, a 62-year-old woman with unilater
al vestibular dysfunction (UVD) and a 6-month history of disequilibriu
m following herpes zoster oticus resulting in damage to the right inne
r ear, was treated with an 8-week course of vestibular physical therap
y. During the 8 weeks, the patient attended weekly physical therapy se
ssions and was trained to perform vestibular adaptation exercises on a
daily basis at home. The second patient, a 53-year-old woman with pro
gressive disequilibrium secondary to profound bilateral vestibular hyp
ofunction (BVH), was treated with a 16-week course of vestibular physi
cal therapy. During the first 8 weeks, the patient attended weekly phy
sical therapy sessions and was trained to perform vestibular adaptatio
n and substitution exercises on a daily basis at home. During the seco
nd 8 weeks, the patient continued performing vestibular physical thera
py exercises at home independently. Vestibular function (sinusoidal ve
rtical axis rotation testing), postural control (clinical tests and po
sturography), stability during the performance of selected activities
of daily living (ADLs), and self-perception of symptoms and handicap w
ere measured prior to and at the conclusion of treatment for both pati
ents and at the midpoint of treatment for the patient with BVH. After
8 weeks of treatment, both patients reported improvements in self-perc
eption of symptoms and handicap and demonstrated objective improvement
s in clinical balance tests, posturography, and several kinematic indi
cators of stability during the performance of selected ADLs Further im
provements were noted in the patient with BVH after 16 weeks of treatm
ent Improvements in postural control were noted after 8 weeks of treat
ment for the patient with UVD and after 16 weeks for the patient with
BVH. Vestibular function improved during the course of treatment for t
he patient with UVD only. These case reports describe two different in
dividualized treatment programs and document self-reported and laborat
ory-measured functional improvements in two patients with vestibular d
eficients-one with unilateral damage and one with bilateral damage.