VESTIBULAR REHABILITATION

Vestibular Rehab

Vestibular Rehabilitation Therapy (VRT) is an exercise-based treatment program designed to promote vestibular adaptation and substitution. The goals of VRT are to:

enhance gaze stability
enhance postural stability
improve vertigo
improve activities of daily living

What is the vestibular system?

Vestibular system provides us with information about our head position in space. There is an

‘external’ or peripheral component in the inner ear which senses when our head is moving. It relays

this information to our brain which then tells us to move our body or eyes to maintain our balance.

What causes vestibular problems?

When a part of this system isn’t working correctly, it can tell your brain false or confused

information which then causes symptoms such as;

Nausea or vomiting

Dizziness/ feeling like you are on a boat

Vertigo (room spinning when you are still)

Mental fatigue

Sore eyes

Headaches

Some conditions which cause these symptoms and are treated by physiotherapy are

Benign Paroxysmal Positional Vertigo (BPPV – known as crystals in the ear)

Meniere’s

Vestibular Migraine

Labyrinthitis

Vestibular Neuritis

Acoustic Neuroma

What does physiotherapy do?

There are a number of vestibular conditions each with a different cause. An initial assessment will help to identify the cause and the best treatment. The initial assessment includes:

Eye tests (how the eyes move, not how well you see)

Balance tests

Tests of the vestibular canals (positional tests)

Gait analysis

If any of these tests find something wrong we will attempt to correct the issue. Some treatments are very effective quickly, some take more time and effort to improve.

Below are some treatment options:

Habituation:

Habituation exercises are used to treat symptoms of dizziness that arise due to self-motion or because of visual stimuli. Basically these are useful exercises for people who have increased dizziness when they move around or change head position quickly. The goal with this form of exercise is to reduce dizziness through repeated, graded exposure to whatever provokes the persons dizziness. Examples of who may benefit from habituation exercises are people who report increased dizziness in shopping malls supermarkets, watching faced paced TV shows/programmes, walking over patterned carpets.

Gaze Stabilisation:

Gaze stabilisation exercises are used when people have difficulty seeing the world clearly because their vision is jumping especially when moving. These exercises involve moving your head in multiple directions while keeping your eyes focused on a object.

Balance retraining

Balance retraining is for clients who are experiencing falls or are having difficulty with feeling off balance. This can take on many forms. By practicing balance exercises you strengthen the input from the balance sensors which feeds in correct information to override incorrect messages from the vestibular system

BPPV

BPPV is treated with a number of special manoeuvres depending on exactly which part of the vestibular system the crystals are located. This can include the Epley manoeuvre, Semont, Casani, Gufoni, or the BBQ Roll. Each of these involves a specific series of movements to relocate the crystals.

How do I prepare for my vestibular assessment?

To prepare for your Vestibular Physio Treatment, start paying attention to which movements cause your symptoms and exactly what you are feeling. This may be bending down, rolling over in bed, or looking to the side and may feel like you/the world is spinning or that you are on a boat. Pay attention to which direction causes the most vertigo symptoms. This will help us diagnose the problem. Please organise to have someone drive you to and from your Physio appointment. Assessing your inner ear can sometimes cause you to feel nauseated, so it’s best to have someone to make sure you get home safely.

VESTIBULAR REHABILITATION