What is Vestibular Rehabilitation?
Vestibular physical therapy can address a variety of conditions including but are not limited to diagnoses such as BPPV, visual vertigo, Meniere’s Disease, inner ear hypofunction, generalized motion sensitivity, concussion, and poor balance. The patient will be guided through a carefully designed plan of care specifically tailored to meet the needs of each individual patient. Each plan of care will include in-person rehabilitation within the clinic to practice specific skills, in addition to an individualized home exercise program to ensure patient autonomy in managing and improving their deficits.
METHODS OF EXERCISE
Habituation exercises are appropriate for patients who report increased dizziness when they make quick head movements, change positions, and are in visually stimulating environments. This involves repeated exposure to specific movements or visual stimuli that provoke dizziness, in a controlled manner.
Gaze stabilization exercises are used to improve control of eye movements so vision remains clear during head movement. Patients maintain focus on an object as they move their head side to side and up/down for a designated period of time.
Balance training exercises are used to improve steadiness on feet so daily activities for self-care, work, and leisure can be performed successfully. The therapist will alter visual or somatosensory cues, such as performing exercises with eyes closed or on compliant surfaces like foam.
Canalith repositioning procedures are a series of coordinated movements/positions performed with the guidance of the therapist to treat those with benign paroxysmal positional vertigo (BPPV).
WHAT SHOULD PATIENTS EXPECT?
The therapist designs a treatment plan which includes supervised sessions and an individualized home program. Duration of treatment depends on the diagnosis and clinical symptoms; some patients may only be seen 1-2 visits while others may require 3-4 months.
FACTORS THAT CAN AFFECT RECOVERY
The type of vestibular disorder will greatly dictate overall rate of recovery. Some disorders are considered unstable or progressive, which may take longer and have more limited recovery. Conditions affecting both ears may require additional time to recover. Other factors that may impact recovery negatively include sedentary lifestyle, an unhealthy diet, pain/stiffness from osteoarthritis/other conditions, reliance on vestibular suppressant medications, and anxiety/depression. Engaging in strengthening exercise to improve overall fitness can help promote recovery.
WHERE CAN I FIND A VESTIBULAR REHABILITATION SPECIALIST?
The Vestibular Disorders Association (VEDA) provides a directory of health professionals who are specially trained to assess and treat vestibular disorders.