Over 10 million patients annually will visit a physician due to dizziness. It is the most common complaint for patients over the age of 75, but can occur in patients of all ages. Patients describe their dizziness in many ways. Some examples of dizziness include lightheadedness, vertigo (spinning), wooziness (swimming feeling in head), imbalance (unsteadiness), and syncope (the feeling of passing out). These symptoms can last in duration from seconds to days and may also vary in frequency from daily to intermittently.
Dizziness can stem from many sources. The vestibular system is often the primary source of symptoms, but the heart and the brain may also contribute to the symptoms. When a vestibular problem exists, a patient may avoid head movements because it may increase their dizziness and/or symptoms. Due to the lack of head movements, the patient may also suffer from neck tightness and pain. Patients with vestibular disorders may feel the need to hold onto objects when walking due to imbalance. They may also experience blurry vision when moving their head.
Who is vestibular rehabilitation for?
Patients diagnosed with dizziness, imbalance, vertigo, frequent falls, Meniere’s, benign paroxysmal positional vertigo (BPPV), neck related dizziness, migraines and patients with stroke or brain injuries.
What does vestibular rehabilitation involve?
Once evaluated by a physician who specializes in vestibular disorders, the patients may be referred to vestibular rehabilitation/ physical therapy. Impairments, functional limitations and disabilities will be identified by the physical therapist on the initial visit. Once the patient’s problems are identified, the physical therapist develops a specialized plan of care that will help focus on improving these deficits.
The goal of physical therapy for vestibular disorders is to get the patient comfortable moving their head to reintegrate the vestibular system and to prevent any unnecessary falls due to their symptoms. Physical therapy may also include: posture education, ergonomics, strengthening, stretching, balance retraining and promoting generalized fitness.
At Cleveland Clinic, vestibular physical therapists are an integral part of the vestibular team. The vestibular team consists of physicians, nurses and physical therapists. Monthly meetings and discussions are organized to assist in improving communication about patient treatment and overall outcomes. The team meetings also assist in updating members on recent vestibular research.
How long will vestibular rehabilitation take?
Patients are typically seen 1-2 times each week for 6-8 weeks but this varies based on the patient’s diagnosis, severity of symptoms, and response to therapy. Some patients may be seen for only 1-2 sessions whereas other patients may need continued treatment for a few months. The therapist makes individualized recommendations based on the needs of the patient.
What type of recovery/outcome can I expect from vestibular rehabilitation?
Expected vestibular rehabilitation outcomes include:
- Decreased fall risk
- Decreased dizziness/symptoms
- Increased balance
- Increased gaze stabilization
- Increased strength
- Return to prior level of movement/function
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