What is Vestibular Rehabilitation?
Vestibular rehabilitation is a specialized form of physical/occupational therapy to address dizziness, imbalance, difficulty maintaining clear vision, and functional decline as a result of vestibular disorders. A vestibular disorder can cause permanent deficits, so therapy is often designed to allow compensation. Compensation involves the brain learning to use the other senses (vision and somatosensory, i.e. body sense) to substitute for the deficient vestibular system.
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.