Vestibular Rehabilitation

What is Vestibular Physical Therapy?

Vestibular rehabilitation is a treatment approach used by physical therapists to help people suffering from dizziness or imbalance caused by dysfunction of the vestibular system.

Our balance is controlled by three systems that send information to our brain about where our body is in space.  Those three systems are:

  • Vision (our eyes)
  • Vestibular (our inner ear)
  • Proprioception (sensors in our joints)

When the brain receives contradictory or delayed information from these systems and/or our bodies are not able to integrate and react appropriately to the nerve impulses, a feeling of dizziness or imbalance occurs.

Common conditions that may impact the vestibular system include:

  • Benign Paroxysmal Positional Vertigo (BBPV)
  • Meniere’s disease
  • Infections
  • Head trauma including concussions
  • Aging

One common condition that affects the vestibular system and causes extreme dizziness is Benign Paroxysmal Positional Vertigo (BPPV).  With this condition, one ear is sending a signal of movement, while the other ear is not and the brain does not know how to respond.  As a result, individuals can experience a sense of spinning, falling motions, or nausea as the brain responds inappropriately to the mixed signals.  This condition is easily treated in just one or two physical therapy visits.

With normal aging processes there is a gradual decline in balance.  Receptors in our joints and inner ears become less sensitive and the brain does not get the information it needs to help us maintain our balance.  Also, if the joints and muscles are too stiff, they cannot physically react fast enough to make postural changes making it even harder to keep our balance  Vestibular rehabilitation therapy and manual physical therapy are designed to address these specific problems to improve balance and decrease risk of falling.

Who would benefit from Vestibular Physical Therapy?

  • People suffering from dizziness or vertigo
  • People suffering from BPPV or any other problem with the vestibular system
  • People who have had a concussion
  • People who frequently fall
  • People who feel their balance is not as good as it could be
  • People who have stiff joints and muscles that limit their ability to react quickly

What are the benefits of Vestibular Physical Therapy?

  • Decrease symptoms of dizziness or vertigo
  • Improve postural stability
  • Decrease risk of falling
  • Return to prior level of movement/function
  • Increase in confidence in ability to maintain balance

What to expect during treatment

Each patient will be evaluated by a physical therapist who will observe and measure posture, balance and gait, and compensatory strategies.  Compensatory strategies are the ways your brain and body try to “make up” for a deficiency in one or more of the 3 balance systems.  The assessment may also include eye-head coordination tests that measure how well a person’s eyes track a moving object with or without head movement. Other assessments may be used, such as a questionnaire measuring the frequency and severity of symptoms and associated lifestyle changes. Once the evaluation is completed, your therapist will develop a complete treatment program and prescribe an individual program of exercises and activities to help manage symptoms of dizziness and improve balance and stability.

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