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What is Vestibular Rehabilitation and How Can it Help You?

Vestibular rehabilitation is a type of physical therapy that helps you improve your balance and coordination by retraining your brain to recognize and respond to your body's position in space. 

What is Vestibular Rehabilitation Therapy?

Vestibular rehabilitation therapy (VRT) is a type of physical therapy used to treat and improve symptoms caused by a variety of vestibular disorders. It involves manual maneuvers and exercises designed to strengthen the vestibular system. 

The vestibular system helps provide a sense of balance, position, and motion. This system allows for the detection of a change in this information in relation to the body's position that allows for the response of motion or externally generated forces. The system is made up of inner ear organs, the vestibular centers of your midbrain and cerebellum, and the peripheral vestibular nerves. 

Patients typically referred for Vestibular Rehabilitation use the therapy to treat vestibular conditions. The conditions that can benefit from this form of therapy include, but are not limited to:

  • Neurological Conditions
  • Meniere's Disease
  • Vestibular Migraines
  • Mal de Debarquement (MdDS)
  • Persistent Postural Perceptual Dizziness (PPPD)
  • Benign Paroxysmal Positional Vertigo (BPPV)
  • Vestibular Neuritis/Labyrinthitis
  • Unilateral Vestibular Hypofunction (UVH)

While this therapy is most commonly used to treat a diagnosed vestibular condition, it can also be used to treat common symptoms related to the vestibular system. Some of these undiagnosed symptoms that can be aided through this form of therapy include, but are not limited to:

  • Vertigo
  • General dizziness or lightheadedness
  • Balance issues
  • Nausea, vomiting, fatigue
  • Neck tightness, stiffness
  • Headaches
  • Frequent falls
  • Brain fog
  • Vision issues

Who can Benefit from Vestibular Rehabilitation?

In general, vestibular rehabilitation therapy can benefit individuals with both diagnosed vestibular conditions and those struggling with symptoms associated with the vestibular system. This therapy may help people cope with symptoms and conditions of the vestibular system that can cause a daily strain on life.

Types of Vestibular Rehabilitation Exercises:

Every patient's vestibular rehabilitation program is unique to their individual conditions and needs. This is not only because there are a variety of vestibular conditions and symptoms but because the way they affect everyone is different. While no two cases are identical, there are common exercises utilized to treat patients. Each of these vestibular rehabilitation exercises allows for central brain compensation to occur, which works to realign impairments to the vestibular system. Some of these exercises include, but are not limited to:

  • Adaptation
  • Habituation
  • Substitution
  • Gaze Stabilization
  • Balance Training

Additional vestibular rehabilitation therapy exercises could include visual targeting and tracking exercises, convergence exercises for near and far visual shifting, gait or walking, mobility exercises, neck stretching, core strengthening, dual or multiple stimuli coordination postural training, and education on ergonomics. As stressed earlier, no two vestibular rehabilitation exercise programs are exactly alike. 

What Should Patients Expect from Vestibular Therapy?

Vestibular conditions or symptoms affect the daily lives of millions of Americans. An estimated 90 million Americans (42% of the current population) experience dizziness at least once in their lifetime (Medscape). A patient must be appropriately assessed or diagnosed with a vestibular condition or symptoms before partaking in vestibular therapy. Once assessed, a patient can begin vestibular rehabilitation therapy and make strides toward improving their vestibular conditions or symptoms. 

Each patient's treatment length is highly variable, as every individual's conditions and symptoms differ. Mild cases can often be treated within a few visits, while more chronic conditions can require continuous management over years. Based on an assessment of a patient's condition or symptoms, an individual plan can be developed, including the types of exercises performed and the span in which they must be done to experience an effective outcome. The effectiveness of a patient's outcome is reliant on their adherence to their individual treatment plan. The most common reason for the delay in recovery is inconsistency with exercises or an inability to follow their treatment plan.

Each patient's experience with vestibular therapy is unique in addition to their outcome. However, some outcomes that can be expected through vestibular rehabilitation include, but are not limited to:

  • Decreased nausea or vomiting
  • Decreased risk of falling
  • Less fatigue and improved sleep
  • Decreased dizziness symptoms
  • Improved focus or memory 
  • Improved balance in standing or sitting
  • Decreased anxiety and depression
  • Increased confidence 
  • Improved neck mobility

Frequently Asked Questions

What is Gaze Stabilization? 

Gaze stabilization is the ability of the eye to fixate on a stable point when the head is moving. Gaze stability is often impaired in peripheral vestibular loss patients. Therefore, gaze stabilization exercises are often prescribed as a means to facilitate the compensation of gaze stability.  

What is Habilitation? 

Habilitation is the diminishing of a physiological response to a frequently repeated stimulus. This allows a patient to gradually desensitize themselves to vestibular movement and stimulation after repeated exposure. Habilitation exercises are used to treat symptoms related to head motion or visual stimuli.  

What is Balance Training? 

Balance training is a form of exercise that is a staple of vestibular rehabilitation therapy. These exercises are used to improve the steadiness of a patient so that they can more successfully participate in daily activities by improving an individual's overall balance and stability.  

Does Vestibular Rehab Help Vertigo? 

Vestibular rehabilitation therapy involves an assortment of exercises that can help manage symptoms of dizziness and imbalance. These symptoms can result from a variety of conditions, including vertigo. While each patient's treatment will be personalized based on the severity of the symptoms experienced, vestibular rehabilitation is a valid means of treatment for patients diagnosed with vertigo. 

Does Vestibular Rehab Help BPPV? 

Benign Paroxysmal Positional Vertigo (BPPV) is a common cause of vertigo. It is important first to be properly diagnosed to begin treatment for this condition. Once diagnosed, a vestibular physiotherapist can enact repositioning maneuvers that are used to treat the specifics of each patient's diagnosis. If general symptoms of dizziness or imbalance persist after repositioning maneuvers have been conducted, habilitation exercises and or balance training may be an appropriate form of long-term treatment. 

Where can I get Vestibular Therapy? 

At PRN we have over 200 clinics across our brands and most of those clinics offer Vestibular Rehabilitation services. Our licensed physical therapists have been specifically trained in vestibular rehabilitation and can conduct a wide range of tests to determine the most appropriate type of physical therapy intervention that is specific to your individual needs.

Request an appointment for Vestibular Rehabilitation today!

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