Vestibular Rehabilitation


What is vestibular dysfunction? Is it a disease? Is Vertigo the same as vestibular dysfunction?

The vestibular system includes the inner ear and parts of the brain that help control our balance and eye movements. Damage to this system can result in the improper processing of signals received by your eyes and inner ear which is known as VD.

Vertigo is a common VD that causes an illusion of motion and a sense of spinning or dizziness. Dizziness is a collection of symptoms including light-headedness, imbalance and a sensation of passing out.

Have you experienced a spinning head while simply reading a book or going for a walk?
Have you experienced head throbbing and dizziness while moving your head?
Do you have difficulty maintaining your balance after a highly accelerated ride?
Have you experienced blurry visions followed by masqueraded head pains after a particular activity?

If you answered yes to the above questions, you may be suffering from Vestibular Dysfunction (VD). VD is a result of damage to our balance system which requires medical attention. Physiotherapy can often help treat these symptoms through Vestibular Rehabilitation Therapy.

When is the best time to start VRT?

The sooner you are seen by a vestibular physiotherapy, the shorter is your treatment span and the better you recover with maximum functional potential.

At Alleviate Physiotherapy, we recognize that your condition is unique and we are listening. We understand that the symptoms of VD can vary dramatically among people and it can have a significant negative impact on your everyday life. We are here to help you recover and get back to your life. For an assessment, please make an appointment with one of our excellent vestibular physiotherapists.

Apart from dizziness, what are other symptoms of VD? Along with dizziness, you may also experience

Ringing in your ears

Gaze instability

Visual changes

Sense of Imbalance (irregular terrains or in dark spaces)

Changes in your emotional state (feeling sad/depressed/angry)

Decrease in confidence and an increased fear of falls

You may experience all or some of these symptoms or other symptoms that are not listed above. Everyday is different in terms of how you may experience these symptoms.

We employ a 3 step process to gain excellent treatment results:

Our experienced practitioners are able to assess you by taking a thorough history of your problem and asking the right questions followed by the right clinical examination. A detailed assessment of the condition involves the following: vision screening, oculomotor system testing, vestibular ocular system testing, balance and gait assessment, motion sensitivity testing and Benign Paroxysmal Positional Vertigo (BPPV) assessment. (you may be referred to other health professionals if indicated during examination.)

After a thorough assessment, your vestibular physiotherapist will determine the best course of action which will include physiotherapy treatment in the clinic as well as home exercise program. The home exercise program includes habituation, adaptation and substitution. Habituation includes learning postures or head positions relative to speed that reduces symptoms. Adaptation includes exercises that improve gaze along with rectified postural stability. Substitution includes learning cues other than the vestibular cues to improve balance and position sense as indicated.

Vestibular rehabilitation therapy will help you enhance postural stability, improve impaired gaze and ultimately improve the quality of your life.

What do you mean by vestibular? And how is it related to dizziness and balance?

Vestibule refers to a canal; in the case of the vestibular system, it specifically refers to the inner ear which is composed of 3 semicircular canals. These canals play an important role in maintaining our sense of position, balance and movement. Whenever you move, these structures make it possible for you to manage your balance and respond to sudden movement changes and any disturbance in the processing of this function can lead to symptoms of dizziness and imbalance.

What causes vestibular dysfunction?

The most common causes of vestibular dysfunction are aging, viral infection of the ear, and head injury (concussion). It may also be caused by environmental factors such as food and temperature changes and side effects of certain medications.

How can I confirm if I have vestibular dysfunction?

A confirmed diagnosis of VD can be done by a certified therapist. Therefore, if you are experiencing the symptoms mentioned earlier, please consult a vestibular physiotherapist for a thorough examination.

What are the treatment options for VD?

Depending on the severity, a range of treatment protocols are available including dietary adjustments, surgery, medications and vestibular rehabilitation therapy.

What is BPPV?

BPPV stands for Benign Paroxysmal Positional Vertigo. It is one of the most commonly diagnosed VD and causes a sudden sensation of spinning and dizziness with movement. Subtle movements like turning in bed or changing the position of the head can trigger vertigo symptoms and nausea. The symptoms do not normally last for more than a minute but they are frequently repeated causing extreme discomfort, confusion, and emotional distress. Major risk factors for BPPV are aging and minor head injuries. With care and treatment, BPPV usually resolves within 1-2 weeks.

How is BPPV diagnosed?

To diagnose BPPV, state of the art diagnostic tools and educational models can be used which contribute to the detailed understanding and accurate assessment of your problem. The following are examples of such tools:

    • Infra-red video goggles: used to monitor and record eye movement
    • 3D model of vestibular organ: used to understand BPPV, semicircular canals and their impact on balance
    • Video Head Impulse Test; to evaluate semicircular canal function

Vestibular dysfunctioning is emotionally damaging and leads to physical harm. You could fall as a result of constant dizziness. But, you do not need to keep suffering! A vestibular rehabilitation therapist at Alleviate Physiotherapy can help prevent falls and improve your emotional wellbeing. For more information, please contact us and we will be happy to assist you with your Vestibular Dysfunction.

Vestibular Rehabilitation Therapy at Alleviate Physiotherapy

At Alleviate Physiotherapy, we have a highly trained and experienced group of therapists with an extensive knowledge and hands-on experience in treating VD including vertigo, nystagmus, dizziness and headache.

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