vestibular rehab

Vestibular Rehabilitation

Dizziness is one of the most common complaints heard at appointments with medical professionals. It is estimated that as many as 35% of adults aged 40 years or older in the United States—approximately 69 million Americans—have experienced some form of vestibular dysfunction1. Dizziness and other related symptoms can be debilitating and uncomfortable, leading to social isolation and decreased quality of life.

What is the vestibular system?

Your vestibular system is a series of organs and nerves located in your inner ear. It is comprised of three semi-circular canals filled with fluid. When you move your head, the fluid in these canals shifts and stimulates hair receptors within to send information on where your head and body are positioned in space. The brain then processes this information to maintain your balance.

When the vestibular organs are damaged with disease or injury, the brain can no longer rely on this system for accurate information regarding equilibrium and motion. This can lead to symptoms such as vertigo, dizziness, nausea, headaches, a sensation of imbalance, or difficulty maintaining an upright position. The damage can occur from an illness (including the common cold and flu), viral or bacterial infection, head trauma, and often from unknown causes.

One common cause of vertigo is a condition known as benign paroxysmal positional vertigo (BPPV). This occurs when small crystals within the ear become displaced into the semi-circular canals. If this occurs, you will feel a sensation of the room spinning around you as the crystals flow through the fluid within the canals. When the crystals settle at the bottom of the canal, the vertigo terminates. Vestibular therapy can help shift the crystals out of the canals to help resolve your symptoms and get you back on track.

What is vestibular rehabilitation therapy?

Vestibular rehabilitation therapy is an exercise based program designed to promote central nervous system compensation for inner ear deficits. The goal of therapy is to retrain the brain to recognize and process signals from the vestibular system in coordination with the visual system and balance/proprioception system. This often involves desensitizing the vestibular system to movements that provoke symptoms of vertigo, dizziness, nausea, or a sensation of imbalance.

Who can benefit from vestibular rehabilitation therapy?

At Athalon, we treat a variety of vestibular disorders. Conditions treated may include:

  • Benign Paroxysmal Positional Vertigo (BPPV)
  • Unilateral or Bilateral Vestibular Hypofunction
  • Vestibular Neuritis
  • Acoustic Neuroma
  • Labyrinthitis
  • Meniere’s Disease
  • Cerebellar degeneration and age-related multisensory deficits
  • General dizziness or vertigo
  • General balance deficits

What to expect at your physical therapy appointment?

Diagnosis

At the initial evaluation, your physical therapist will do a thorough examination to determine the cause of your dizziness. The therapist will get a full history from you regarding your symptoms, aggravating positions or movements, recent illness, and current or prior medications. The therapist will perform a comprehensive neurological exam to determine if the cause of your symptoms in centrally located in the brain or peripherally located in the inner ear system. The therapist will also perform a balance assessment. Your PT will also perform tests to check for BPPV.

Treatment

At Athalon, we will design a custom treatment plan to treat your specific symptoms. Some techniques that may be used are:

  • Gaze stabilization training
  • Trunk or cervical repositioning
  • Balance re-training
  • Motion desensitization
  • Gait training

In addition, for the treatment of BPPV, the following maneuvers may be used depending on which canal is affected:

  • Epley
  • Modified Semont
  • Brandt-Daroff
  • Lempert (BBQ)

Research shows that the sooner physical therapy is starting following damage to your vestibular system, the better the outcomes. In the first few months following a vestibular deficit, your body has the best opportunity to heal. Vestibular rehabilitation therapy has been shown to be very successful and most patients find substantial relief with this method of treatment. A physical therapist can guide you through this process and ensure that you have all the tools you need to recover.

 


Sources
  1. https://vestibular.org/understanding-vestibular-disorder

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