Bilateral vestibular loss (BVL) is a chronic condition of which the causes can be ototoxic, infectious, traumatic, autoimmune or congenital. However, in approximately 30–50% of the cases no cause can be found [
1]. The prevalence of severe BVL has been estimated at 81 in 100,000 persons, corresponding to 500,000 patients in Europe and the United States, and as many as 3 million worldwide [
2,
3]. Due to a limited medical expertise and poor diagnostics worldwide, there is a substantial underestimation of the prevalence of BVL in the general population and a substantial delay before the diagnosis BVL is established [
2]. BVL prevalence increases with age (presbyo-vestibulopathy), which becomes very apparent in developed countries with progressive aging of the populations. Patients with BVL complain mainly of imbalance, oscillopsia and a reduced dynamic visual acuity (DVA) [
1,
4]. Various options to reduce symptoms have been studied [
5‐
15]. There is robust evidence that vestibular rehabilitation can be effective in vestibular pathology and also in BVL [
5,
10]. However, in severe BVL patients (including patients with bilateral areflexia), the impact of VR remains unfortunately limited in daily life balance and patients experience a sustained reduced quality of life [
16]. Not many BVL patients improve in the long term [
1‐
3]. In 2012 we implanted the first vestibular implant in humans [
4,
16] to create a treatment option for the reduced DVA and imbalance in patients with severe BVL. But this approach is invasive, and still need substantial research to be clinically available. Already many years, research focussed on the development of non-invasive devices to restore balance per se, especially using feedback. Feedback by electrical, visual or auditory cues have been evaluated by several studies to improve balance in patients with severe vestibular deficits [
17‐
25]. Electro-tactile feedback on the tongue has been evaluated extensively to restore imbalance [
17,
22]. However, this is quite inconvenient for permanent chronic use. Auditory and visual feedback [
18‐
20] for restorage of imbalance, interfere with the primary function of these senses. Continuous noisy galvanic stimulation at the level of the temporal bone (bilateral, retro-auricular) also provides a treatment option, which is suggested [
25] to optimize residual vestibular resources in BVL by lowering the vestibular threshold to elicit balance-related reflexes. This intervention is only effective in the presence of a residual vestibular functionality, which applies for many patients with BVL. Vibrotactile feedback [
21,
23,
24,
26,
27] can be used to increase somatosensory input to balance control. Vibrotactile feedback through the trunk is to this respect an intuitive approach and has been successfully used to reduce the need for visual navigation for special military forces, police officers and fire brigades, and to support spatial orientation for blind people [
26,
28] and in industrial tele-manipulators [
29]. Therefore, vibrotactile feedback to the body might be the best option to restore balance next to an implant. We, therefore, developed an ambulatory vibrotactile balance belt to increase and improve the proprioceptive perception of verticality in daily life, based on the same laboratory-based approach used by Wall III and colleagues [
21,
26,
27]. The impact of continuous vibrotactile feedback in daily life is studied and evaluated in this study.