May 21, 2019

Vestibular Rehabilitation

By Morgan Kriz, DPT

What is Vestibular Rehabilitation?

The vestibular system is a part of the inner ear that helps to control balance. If your inner ear is damaged by disease or injury, you may benefit from vestibular rehabilitation. Vestibular rehabilitation is an exercise-based therapy program used to treat balance and dizziness disorders. It is based on the body’s natural ability to compensate for balance problems through optimizing the brain’s connection from your inner ear; eyes and body.

A therapist will evaluate each patient and perform tests in order to develop an individualized treatment plan which may include:

  • Balance retraining and balance strategies: helping the body to regain balance through a variety of exercises and techniques
  • Sensory organization techniques and gaze stabilization strategies: helping the body to use its senses to overcome dizziness and decreased balance
  • Oculomotor examination to properly diagnosis peripheral vs central vestibular impairments
  • Habituation exercises: helping the body to decrease dizziness by repeatedly exposing it to a stimulus
  • Canalith Repositioning maneuver: a maneuver performed by the therapist to manipulate the calcium crystals called otoliths found in the inner ear. This is what causes “room spinning vertigo” called Benign Paroxysmal Positional Vertigo or “BPPV”
  • Individualized home exercise program: an exercise program patients can do at home, based on each patient’s individual needs

Who Will Benefit From Vestibular Rehabilitation?

The Vestibular Rehabilitation Program offers treatments for a wide variety of conditions that result in balance problems and dizziness.

Some of these include:

  • Labyrinthitis: inflammation of the labyrinth (the inner part of the ear that controls balance).
  • Benign Paroxysmal Positional Vertigo (BPPV): caused by calcium crystals floating in the ear as the result of a blow to the head or weakened and collapsed hair cells that release calcium crystals into the ear.
  • Unilateral or bilateral hypofunction: reduction or loss of vestibular function on one side or both sides resulting in difficulty 
 maintaining balance, especially when walking in the dark or on uneven surfaces and decreases one’s ability to see clearly during head movements.
  • Perilymph Fistula: caused by intense pressure in the inner ear, or a blow to the head, which results in a hole between the middle and inner ear. This may also need to include a physician’s intervention.
  • Drug-Induced Ototoxicity: damage to the hair cells of the inner ear, caused by long-term intravenous use of certain types of drugs.
  • Acoustic Neuroma: slow-growing tumor of the eighth cranial nerve, which can be corrected by surgery.
  • Meniere’s Disease: over-accumulation of fluid in the inner ear that causes attacks of vertigo, ringing in the ear, and fluctuating hearing loss.
  • Migrainous Vertigo: dizziness associated with the auras (light and sound sensitivities) of a migraine headache.
  • Persistent Postural Perceptual Dizziness (3PD): symptoms include persistent sensations of rocking or swaying unsteadiness without vertigo that tend to be provoked by environmental or social stimuli (crowds; grocery stores).
  • Cervicogenic Dizziness: dizziness; heavy headedness associated with symptoms from the cervical spine. Symptoms may or may not include neck pain and headaches.
  • Mal de Debarquement: literally means sickness of disembarkment. It is the illusion of movement felt as an after effect of travel on water by ship or boat; airplane, automobile and train as well as situations with novel movement patterns.