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Vestibular rehabilitation is a special program designed to treat and minimize dizziness, motion sensitivity, vertigo, and balance disorders. Most of us take for granted our ability to get out of bed or turn our head while walking without getting dizzy or losing our balance, but when we have vestibular dysfunction, our quality of life and ability to perform normal daily tasks becomes very difficult. Equilibrium, balance and moving around smoothly within a changing environment are due to our vestibular system, our vision and proprioception or ability to feel the ground under our feet.
Vestibular rehab works to restore our equilibrium through a series of position changes and exercises that aid the brain in learning to adapt to the aggravating stimuli, make changes to use other sensory pathways or learn to get used to the change in vestibular input to the brain.
At GPT, a physical therapist certified in Vestibular Rehabilitation will perform an evaluation of your vestibular system based on your history and complaints, as well as administer a series of tests to assess balance, postural control, tolerance to movement and reflexes. Then they will determine your cause of dizziness and develop a treatment plan to address your symptoms and get you feeling better.
There are several types of dizziness and vertigo that can be treated with vestibular rehab. Benign Paroxysmal Positional Vertigo (BPPV) is the most common type of vertigo, and occurs in the inner ear when crystals become dislodged from the otolith organs and travel into one of the three semicircular canals, causing a immediate sense of vertigo. The therapist will determine which canals these crystals are in, then take the patient through a series of position changes called canalith-repositioning maneuvers to restore the crystals to their proper resting place. Treatment for BPPV is typically very quick and can often be treated in the first visit or two.
Vestibular rehab is also used to treat dizziness and motion sensitivity cause by vestibular neuritis, peripheral vestibular loss, Meniere’s disease, labyrinthitis, cervicogenic dizziness and migraine related dizziness. In these cases, the therapist will craft an individualized exercise program consisting of adaptation, habituation and substitution exercises. Adaptation exercises work to strengthen the vestibulo-ocular reflex (VOR) and help to jump start the connection between our ears, eyes and brain. Substitution exercises are aimed at training the body to use input from our visual field and other joints in our body to give us information about our body and environment so that, as our head moves, our eyes can focus on a target. Habituation exercises are to expose the patient to an aggravating stimulus multiple times to fatigue the vestibular system and reduce the severity of the vestibular dysfunction with each repeated exposure to the stimulus. Treatment for vestibular dysfunction, not BPPV, can take anywhere from a couple weeks to a few months in some cases. Vestibular rehabilitation can fully eliminate symptoms for some disorders and can help to minimize and manage symptoms for other disorders.
Common symptoms patients might complain of are: dizziness, vertigo, light headedness, blurry vision, disequilibrium, headache, light and sound sensitivity, tinnitus, hearing loss, anxiety, nystagmus, fear of falling, feeling of being pulled to one side, unsteadiness, and depression.