Abstract
INTRODUCTION: This study investigates how physical activity and fear avoidance beliefs change over time in patients with acute/subacute unilateral vestibulopathy (UVP), compared to those with chronic UVP. It also explores which baseline factors influence activity changes and the relationship between physical activity and fear avoidance beliefs over time. MATERIALS AND METHODS: In this prospective cohort study, adults with UVP were followed over 10 weeks. Physical activity was measured using accelerometry, and fear avoidance beliefs were assessed via the Vestibular Activities Avoidance Instrument. Subgroup analyses compared acute/subacute and chronic UVP, as well as high- and low-risk groups for persistent complaints. Mixed model analysis identified factors associated with changes in physical activity, and correlations assessed the relationship between activity and fear avoidance beliefs. RESULTS: Acute/subacute UVP patients increased physical activity significantly over time (+198 min/week), while the chronic group showed no substantial change. Factors such as time since onset, baseline fear avoidance, and etiology influenced activity changes. At baseline, higher fear avoidance was moderately associated with lower activity, though this link weakened at follow-up. Within the acute/subacute group, those at low risk for persistent complaints had consistently higher activity levels than both high-risk and chronic patients. DISCUSSION: The findings highlight a connection between fear avoidance beliefs and physical activity, particularly in acute/subacute UVP. These insights underscore the importance of evaluating fear avoidance in early stages and suggest a role for psychological factors in designing tailored treatment strategies.