Vestibular rehabilitation

Vestibular rehabilitation may help to relieve symptoms of dizziness, disequilibrium, imbalance, and vertigo. There are many reasons why a person may have these symptoms, and a physical therapist can help to determine the cause of your symptoms. Through manual techniques and specific exercises, a physical therapist can help your body learn to compensate for inner ear deficits and other causes of dizziness and imbalance.

The inner ear system coordinates eye movements and balance, and receives input on where your body is in space. When the system is not working properly, symptoms of light headedness, dizziness, imbalance, and/or vertigo (sensation where you or your surroundings are spinning) may occur.

Some diagnoses that may be treated with vestibular rehabilitation include benign paroxysmal positional vertigo (BPPV), Meniere’s disease, vestibular hypofunction, acoustic neuroma, vestibular migraine, cervicogenic dizziness.

Many times vestibular rehabilitation exercises may make a person feel an increase in their symptoms initially. This is normal and necessary to promote vestibular compensation so that the brain becomes less sensitive to the movements, restoring normal daily activity. It is important to perform the exercises as indicated by your therapist, which may be up to five times a day or even hourly, depending on your condition.

There is dizziness that can be caused by vestibular disorders, and dizziness that is not caused by a vestibular disorder. Your physician and your physical therapist can help to identify the cause of your symptoms.

Individuals who have not responded well to medical management may benefit from vestibular rehabilitation.

Your physician may run a series of tests to help diagnose a vestibular condition. These tests may include ENG/VNG, rotational chair testing, computerized dynamic posturography (CDP), vestibular evoked myogenic potential (VEMP), auditory testing, MRI, or CT.

When a person is diagnosed with BPPV, a common procedure to treat the condition is the Epley Manuever, or canalith repositioning technique. Proper evaluation with vestibular video ocuolography goggles will help diagnose which canal in the inner ear is affected to determine with appropriate procedure for treatment. The canalith repositioning procedures are a series of movements of the head and body that are guided by your physical therapist, with the intent to move the calcium carbonate crystals through the canal and back to their original location. Once the maneuver successfully removes the crystals from the canal, vertigo symptoms may resolve immediately or within the next 1-2 days. Multiple treatments may be necessary to resolve all symptoms, and treatment is specific to the right or left ear, and to which canal is involved.

Treatment for dizziness that does not involve BPPV may include exercise for balance, eye movements, head movements, and repeated movement exercises.

The physical therapists at Advanced Physical Therapy have been trained in and have extensive experience in treating vestibular disorders. If you are experiencing dizziness, vertigo, imbalance, or disequilibrium, speak to your physician or physical therapist regarding starting a vestibular rehabilitation or balance program.