What is vestibular rehabilitation?
Vestibular rehabilitation is an exercise-based program, designed by a specialty-trained vestibular physical therapist, to improve balance and reduce problems related to dizziness.
How is dizziness defined?
Dizziness can be described as:
- Feelings of unsteadiness
- Wooziness (swimming feeling in head)
- Feelings of passing out
- Sensations of moving
- Whirling (sensations known as vertigo)
These feelings or sensations can occur when you are standing still, lying down or changing positions. The symptoms can be constant or episodic in nature, only lasting seconds, minutes or hours.
What causes dizziness?
Each year, more than 10 million patients visit a physician due to dizziness. It is the most common complaint of patients over the age of 75, but it can occur in patients of any age.
Dizziness is generally not serious, but is often a sign of a mechanical problem. Dizziness can be due to an inner ear disorder, a side effect of medications, a sign of neck dysfunction, or it can be due to a more serious problem such as a brain or a heart problem.
Who benefits from vestibular rehabilitation?
Patients typically referred for vestibular rehabilitation therapy are those diagnosed with dizziness, imbalance, vertigo, Meniere’s syndrome, benign paroxysmal positional vertigo (BPPV), neck-related dizziness and migraines. Other candidates are patients who have had a stroke or brain injury or who frequently fall.
Common symptoms that can be helped with vestibular rehabilitation include:
- Dizziness or blurry vision with head movements
- Neck tightness, stiffness and/or pain
- Imbalance or the need to hold onto objects when walking
- Frequent falls
- Generalized “dizziness, wooziness and foggy head” feelings
At your appointment, a physical therapist will evaluate your symptoms and review your medical history. Your assessment will include all or part of the following areas:
- Balance and/or leg strength/flexibility
- Gait (how you walk)
- Visual stability and mobility
- Neck mobility and neck and arm strength
- Positional testing, including an inner ear exam
Based on the findings, a plan of care is developed. The goal of your treatment plan is to improve any deficits that were identified. This, in turn, will improve your ability to function in activities of everyday living, reduce your risk for falling and ultimately, improve your quality of life.
How successful is vestibular rehabilitation therapy?
Many times, vestibular rehabilitation therapy will be the only treatment needed. Other times, it is a part of the presurgery/postsurgery treatment plan. In most cases, if patients continue to perform the exercises they have learned, balance and dizziness problems decrease significantly or completely disappear.
What are the types of exercises I will learn in a vestibular rehabilitation program?
Examples of exercises you might learn include:
- Vision stability training
- Posture training
- Stretching and strengthening exercises
- Balance retraining
- Walking exercises
- Neck mobility/stretching exercises
- General fitness exercises
- Ergonomic training (This advice is given so that workplace furnishings can be adjusted to improve a person’s posture and decrease any discomforts.)
No two exercise treatment plans are exactly alike. Your exercise program is developed by identifying your deficits. For example, if your symptoms have been linked to an inner ear problem, you will also learn how to do some self-treatment exercises. Continuing an exercise plan at home can help prevent and/or treat new dizziness and balance episodes.
How long is a typical vestibular rehabilitation program?
Patients are typically seen 1 to 2 times each week for 6 to 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 to 2 sessions; other patients may need continued treatment for a few months.
Recovery and Outlook
What type of recovery/outcome can I expect from vestibular rehabilitation?
Expected vestibular rehabilitation outcomes include:
- Decreased risk of falling
- A decrease in dizziness symptoms
- Improved balance
- Improved ability to stabilize vision/gaze
- Increased body strength
- Return to prior level of movement/function
- Increase in confidence in ability to maintain balance
- Improved neck motion, reduced symptoms