Vestibular Rehabilitation

Many people suffer from dizziness and impaired balance. These symptoms can occur suddenly, by way of accident (trauma), or gradually develop over time. As a result, the vestibular system, more commonly known as the "inner ear," can be negatively affected. This system aids in the control of balance and the awareness of one's body in relation to their environment. While many believe these changes to be normal, there is much to be done to resolve ongoing symptoms.

Vestibular Rehabilitation is a specific type of therapy designed to overcome symptoms of, or related to, vertigo, dizziness, light headedness, and impaired balance. Vestibular physical therapy aids in retraining the vestibular system to accommodate to these specific physical changes. Most importantly, it equips individuals with the proper training to restore balance within the body and return to their prior way of life.

Vestibular Physical Therapy Can Address:

  • Symptoms related to vertigo, dizziness, and light headedness
  • Balance and gait deficits
  • Benign Paroxysmal Positional Vertigo (BBPV)
  • Post-concussion symptoms and Return-to-Play Program
  • Fall Assessment and prevention
  • Musculoskeletal related neck pain
  • Dizziness related to head turning, walking, and daily mobility
  • Decreased coordination and body control

What is vestibular rehabilitation?

Vestibular rehabilitation is an exercise-based program designed to improve balance and reduce dizziness-related problems.

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The inner ear.
The brains' 'balance center.'

At your appointment, a physical therapist will evaluate your symptoms and review your medical history. He or she will identify any problems with your balance, your gait (how you walk), neck motion, visual stability, as well as examine other potential problem areas. Based on the findings, a plan of care is developed. The goal of your treatment plan is to improve any deficits that were identified. This, in turn, will improve your ability to function in activities of everyday living, reduce your risk for falling, and ultimately, improve your quality of life.

Who benefits from vestibular rehabilitation?

Patients who are typically referred for vestibular rehabilitation therapy are those diagnosed with dizziness, imbalance, vertigo, Meniere’s syndrome, benign paroxysmal positional vertigo (BPPV), neck-related dizziness and migraines. Other candidates are patients who have had a stroke or brain injury or who frequently fall.

How is dizziness defined?

Dizziness is defined as feelings of unsteadiness; wooziness (swimming feeling in head); lightheadedness; feelings of passing out; and sensations of moving, spinning, floating, swaying, tilting, or whirling (sensations known as vertigo).

These sensations can occur when standing still, lying down or when changing positions. The symptoms can last from seconds to minutes to days. For some people the symptoms are constant; others experience only short episodes of symptoms.

What causes dizziness?

Each year over 10 million patients visit a physician due to dizziness. It is the most common complaint of patients over the age of 75, but can occur in patients of any age.

Dizziness is generally not serious, but is often a sign of a mechanical problem. Dizziness can be due to an inner ear disorder, a side effect of medications, a sign of neck dysfunction, or it can be due to a more serious problem such as a brain or a heart problem.

What are some examples of the types of exercises I will learn?

Some examples of exercises you might learn include: vision stability training, posture training, stretching and strengthening exercises, balance retraining, walking, neck motion exercises, and if needed, general fitness exercises. Ergonomic advice may also be given. (This advice is given so that workplace furnishings can be adjusted to improve a person’s posture and decrease any discomforts.)

No two exercise treatment plans are exactly alike. Your exercise program is developed by identifying your deficits. For example: if your symptoms have been linked to an inner ear problem, you will also learn how to do some self-treatment exercises. Continuing an exercise plan at home can help prevent and/or treat new dizziness and balance episodes.

How long is a typical vestibular rehabilitation program?

Some patients may be seen for only 1 to 2 sessions; other patients may need continued treatment for a few months. The therapist makes individualized recommendations based on the needs of the patient, severity of symptoms, and response to therapy.

What type of recovery/outcome can I expect from vestibular rehabilitation?

Expected vestibular rehabilitation outcomes include:

  • Decreased fall risk
  • Decreased dizziness symptoms
  • Improved balance
  • Improved ability to stabilize vision/gaze
  • Increased body strength
  • Return to prior level of movement/function
  • Increase in confidence in ability to maintain balance
  • Improved neck motion, reduced symptoms

How successful is vestibular rehabilitation therapy?

Many times vestibular rehabilitation therapy will be the only treatment needed. Other times, it is a part of the presurgery/postsurgery treatment plan. In most cases, if patients continue to perform the exercises they have learned, balance and dizziness problems decrease significantly or completely disappear.