Vestibular Rehabilitation 2017-01-20T09:40:59+00:00

Vestibular Rehabilitation

Do you suffer from Vertigo, dizziness or disequilibrium?

About 40% of people will suffer from dizziness at some point in their life and half do not get a diagnosis. Like any condition – accurate diagnosis as to why these symptoms are occurring is most important. It is never normal to be dizzy, regardless of age. It is NOT an “inevitable part of aging”!

Dizzy symptoms and balance problems vary in severity from being annoying to being totally debilitating. No 2 dizzy patients are identical – each is as unique as their finger print. Daily life can be like walking on a tight rope. It can make working difficult, even to the point of having to stop. Socialising can become too challenging. Activities like driving may be next to impossible. As a result relationships can suffer and frustration, loss of self-confidence, anxiety and depression can ensue.

What is the vestbular system?

The vestibular system is made up of a balance organ in each inner ear, their connection to the brain via a nerve and the brain itself. This system controls balance and eye movements. If the system is damaged in any of these areas by disease, injury or ageing, vestibular disorders or balance difficulties can result.

What are the symptoms of a vestibular disorder?

Symptoms due to vestibular disorders vary in severity, frequency and duration depending on the condition. Symptoms typically can include:

  • Vertigo
  • Dizziness
  • Disequilibrium/unsteadiness
  • Light headiness/disorientation
  • Poor balance
  • Difficulty focusing, reading
  • Poor concentration
  • Headaches
  • Motion sensitivity
  • A foggy / muzzy headedness
  • Falling
  • Neck pain
  • Fatigue
  • Nausea
  • Poor tolerance of busy environments

What are the common vestibular disorders?

  • Benign Paroxysmal Positional Vertigo (BPPV) – dislodged debris in the inner ear.
  • Vestibular Neuronitis or Labyrinthitis – viral infection of the inner ear.
  • Meniere’s disease – a fluctuating disorder of the inner ear affecting hearing and balance.
  • Migraine Vestibulopathy – vestibular symptoms due to migraine.
  • Post-Traumatic Vertigo / Post Concussion Syndrome – dizziness after a head injury.
  • Cervical Vertigo / Cervicogenic dizziness – dizzy symptoms due to neck stiffness.
  • Acoustic Neuroma – benign tumour on the vestibular nerve.
  • Stroke
  • Auto toxicity – adverse reaction of the inner ear to certain medication.
  • Mal de Debarquement (MDD) – unsteadiness following a boat journey.
  • Perilymphatic fistula – a hole in a structure of the inner ear.

Following a comprehensive evaluation a diagnosis is made and the appropriate treatment for that condition is initiated.

If Benign Paroxysmal Positional Vertigo (BPPV) is the diagnosis, then Canalith Repositioning Therapy (CRT) is done to relocate the displaced debris in the inner ear back to their correct place. 95% of patients are asymptomatic following one manoeuvre.

Vestibular Rehabilitation Therapy (VRT) is an exercised based programme designed to promote central nervous system re-training for vestibular deficits. This may include gaze stabilisation exercises that train the eyes to maintain focus while the head moves, balance training or habituation exercises. VRT is grounded in evidence-based medicine and has been extensively researched. It is now considered to be the most successful management approach for people with dizziness and balance problems associated with disorders of the vestibular system.

At your initial assessment a thorough medical history is taken relating to your symptoms and their severity, frequency and duration.

The pattern of your symptoms including triggers and the impact these symptoms have on your life will be identified. A physical assessment subsequently will evaluate your functioning vestibular system using infra-red goggles. Objective testing of balance, gait and musculoskeletal system will be carried out do determine the source of your symptoms.

Once an accurate diagnosis has been made, an individualised treatment plan will be commenced. This will either include canalith repositioning treatment or a customised home exercise programme.

All treatments are one to one. You will be re-assessed both subjectively and objectively. Your feedback with regard to your symptoms is always most informative and this along with objective re-testing allows progress to be identified. Exercises will then be progressed as appropriate. The number of appointments vary depending on the condition and the individual.