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Vestibular Rehabilitaion

Vestibular rehabilitation is an evidence-based approach to managing dizziness, vertigo, motion sensitivity, balance, and postural control issues that arise from vestibular dysfunction. Patients with vestibular impairment typically face challenges with gaze stability, motion stability, balance, and postural control, so the rehabilitation focuses on addressing these areas of pathology or dysfunction. The specific treatment approach varies depending on the pathology and each patient’s unique presentation, emphasizing the importance of a detailed understanding of the vestibular system in treating this patient group. This specialized form of physical therapy targets the vestibular system responsible for balance and spatial orientation, commonly used to treat individuals with vestibular disorders. The goal is to improve symptoms and restore function by promoting central nervous system compensation, enhancing gaze stability, improving balance, and reducing dizziness and vertigo. Treatment techniques, including specific exercises and maneuvers, aim to promote adaptation and habituation, along with balance training and tailored functional activities. Typically provided by physical therapists or other healthcare professionals with specialized training in vestibular disorders and rehabilitation, treatment plans are customized based on a thorough assessment of the individual’s symptoms, impairments, and functional limitations.

Signs and Symptoms of Vestibular Disorders:

  • Nystagmus (involuntary eye movement)
  • Vertigo
  • Dizziness
  • Imbalance or ataxia
  • Compromised gaze stability (decreased visual acuity with head movement, affecting the vestibular ocular reflex (VOR))
  • Nausea, vomiting, fatigue
  • Neck tightness, stiffness and/or pain
  • Brain fog, difficulty concentrating, mild memory issues

Can any physiotherapist do vestibular physiotherapy?

You should seek a physiotherapist with specific training in vestibular rehabilitation. Physiotherapists offering this approach typically have a special interest in vestibular rehabilitation and undergo specialized courses during professional continuing education programs.

What type of problem can be treated with vestibular physiotherapy?

Balance issues, including dizziness in busy, complex, or contrasting visual environments, and positional vertigo, are typically well treated with vestibular physiotherapy.

How does vestibular physiotherapy work?

Vestibular rehabilitation exercises are commonly included in the treatment of positional vertigo and are designed to train the brain to use alternative visual and proprioceptive cues to maintain balance and gait. It has been shown that these exercises improved nystagmus, postural control, movement-provoked dizziness, the ability to perform activities of daily living independently, and levels of distress. While no single vestibular rehabilitation exercise has been shown to reduce the symptoms of positional vertigo, a program of therapies that can include self-administered repositioning maneuvers, gaze stabilization exercises, falls prevention training, and patient education may be beneficial in reducing the symptoms of positional vertigo and improve quality of life.