Vestibular Rehabilitation

Is a specialised form of exercise-based physiotherapy designed to alleviate both the primary and secondary symptoms of any peripheral or central vestibular disorder. Its goal is to reduce the sensation of vertigo, dizziness, improve balance and or prevent falls and improve vision (gaze stability). Usually the vestibular deficit that caused the vertigo, dizziness, imbalance etc... is permanent however the symptoms do not have to be. Vestibular Rehabilitation targets plain plasticity / adaption to reduce symptoms. When the health of the brain is compromised such as with a stroke or in Multiple Sclerosis vestibular rehabilitation is still beneficial but may take longer. Compensation is often a natural event after a vestibular pathology, but many people don’t fully recover or are slow to recover impacting on the long-term quality of life and ability to participate in daily tasks. 

VRT uses an individualised problem-based approach to promote this compensation. The exercises will be customised to each person’s specific problem set. Thus a comprehensive assessment is required to ensure the vestibular rehabilitation is targeting the patients specific needs. To achieve this the patient should be examined with infra-red goggles, digitised balance tools – such as pressure pads or force platforms, and video head impulse testing tools. The physiotherapist will then prescribe one or a combination of targeted exercises to optimise habituation of symptoms, improve gaze stability and balance. Sometimes other exercises including eye exercises, treatment to the neck and relaxation exercises will be added. 

What should a patient expect from Vestibular Rehabilitation?

VR is usually conducted daily from home / or work, although sometimes treatments will be completed in the clinic. Patients are seen by a licensed physiotherapist with advanced post-graduate training and examination in vestibular pathologies and rehabilitation. The VR is likely to make the patient a little dizzier or nauseas, however the treating physiotherapist should work closely to provide ongoing education and adaptions to ensure the exercises are not causing too much dizziness. Compliance is essential and with small ongoing bursts of VR daily improvements will slowly occur. 

 

Further reading on Vestibular Rehabilitation can be found on our Resources page.

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