Yes, Virginia. Dizziness and Vertigo are costly

I had a Parkinson’s pt that came in this morning and had fatigue (more than usual) related to a recent onset of dizziness. He was trying to figure out why and It got me to thinking about the metabolic costs of disequilibrium.

A quick pub med search found me having to try multiple search terms and all I was able to turn up was a few papers on the topic. I found that surprising, considering the prevalence of fatigue complaints with dizziness and vertigo.
It makes sense to think of as proprioception is impaired (or altered), it would have a greater energy cost to get normal tasks done. I was able to turn up a few full text papers (below), and yes, the short answer is it does cost more to have impairment. 

Gait Posture. 2015 Feb;41(2):646-51. doi: 10.1016/j.gaitpost.2015.01.015. Epub 2015 Jan 24.Metabolic cost of lateral stabilization during walking in people with incomplete spinal cord injury.Matsubara JH1, Wu M2, Gordon KE3.

Arch Phys Med Rehabil. 2013 Nov;94(11):2255-61. doi: 10.1016/j.apmr.2013.04.022. Epub 2013 May 20.Effect of balance support on the energy cost of walking after stroke.Ijmker T1, Houdijk H, Lamoth CJ, Jarbandhan AV, Rijntjes D, Beek PJ, van der Woude LH.