Vestibular Rehabilitation Therapy

Vestibular rehabilitation therapy, also called vestibular rehabilitation, is exercises that help you manage dizziness and balance issues (imbalance).

You may have this treatment if you have conditions like:

• Vertigo
• Ménière’s disease
• Benign paroxysmal positional vertigo (BPPV)
• Labyrinthitis
• Vestibular neuritis
• Migraine headache
• Stroke
• Traumatic brain injury
• Falling risk

Vestibular therapy starts with tests to check your specific symptoms. For example, an audiologist may do a vestibular test battery. A physical therapist will evaluate your balance, how you walk, and your arm and leg strength and flexibility.

How does vestibular rehabilitation therapy work?

Dizziness and balance problems can go together. Dizziness happens when something affects your sense of balance. Your sense of balance relies on a strong connection and communication between your brain, eyes, ears and tissues, like your skin, muscles and joints:

• Eyes: Your eyes keep track of your surroundings. This helps your central nervous system know where your body is in relation to other objects like people and buildings.
• Inner ears: Healthcare providers may call this your vestibular system. It contains tiny organs and canals that sense motion and gravity.
• Tissues: Your tissues let your brain know about changes in pressure and movement that affect your sense of balance.

Injury or illness can affect the connections between your brain, eyes, inner ears or tissues. Issues that affect these connections may keep your brain from processing information correctly. Vestibular rehabilitation therapy helps restore those connections, reducing symptoms of dizziness and imbalance.

What happens during vestibular therapy?

Balance issues and dizziness may affect you in different ways. Your healthcare provider will tailor vestibular rehabilitation therapy to your specific needs. They’ll work with you in therapy sessions so you know how to do exercises at home. Specific exercises may include:

• Eye movement control: Gaze stabilization is an example of an eye movement control exercise. In gaze stabilization, you practice focusing on an object or target while slowly moving your head side-to-side or up-and-down.
• Balance retraining: As it sounds, this treatment helps you manage balance. Your provider may have you start by keeping your balance as you stand with your feet together, standing with one foot ahead of the other and then standing on one foot.
• Walking exercises: Your provider may have you perform walking tasks at different speeds, with head movements or even around obstacles.
• Stretching and strengthening: These could be exercises using your body weight to build muscle strength.

What are the potential benefits of rehabilitation therapy?

This treatment can:

• Reduce your symptoms of dizziness
• Improve your balance
• Help you stabilize your vision
• Reduce your risk of falling
• Increase your body strength

Are there any risks?

Vestibular rehabilitation therapy doesn’t cause physical risks. There’s always the chance therapy won’t completely resolve your dizziness or balance issues. This is particularly true if you’re not able to do the prescribed exercises on your own.

How long will I need this treatment?

Vestibular therapy takes time. Most people have six to eight weekly sessions. Some people may only need one or two sessions. Other people may need several months of ongoing treatment, including doing exercises on their own. But everyone’s situation is different. How much therapy you’ll need depends on why you have dizziness or balance issues and how you respond to therapy.

When should I call my healthcare provider?

Vestibular rehabilitation therapy rarely causes issues. But some people experience problems while doing exercises. Contact your provider right away if you’re doing exercises at home and experience symptoms such as:

• A sudden change or fluctuation in hearing
• Feeling pressure or a sense of fullness in your ear that’s painful or uncomfortable
• New or increased ringing in your ear
• Fluid coming from your ears
• Any pain or discomfort in your neck and back that happens while doing exercises