Vestibular Rehabilitation: What You Need To Know

Vestibular Rehabilitation Therapy (VRT) emerges as a beacon of hope for individuals grappling with vestibular disorders, shedding light on a path towards improved balance, reduced dizziness, and a better quality of life. The therapy, a specialized branch of physical therapy, addresses the primary and secondary issues stemming from vestibular disorders, paving the way for a solid footing in a world that often seems shaky.

Vestibular disorders, a real challenge to one’s equilibrium, manifest through symptoms like vertigo, dizziness, gaze instability, and imbalance, often leading to falls​¹​​²​. These disorders can significantly impede daily activities, morphing simple tasks into Herculean challenges. However, hope is not lost; Vestibular Rehabilitation Therapy (VRT) beckons with a promise of amelioration.

What Do You Do In Vestibular Rehabilitation Therapy?

VRT is essentially a tailored exercise-based program aiming to alleviate the primary symptoms of vestibular disorders such as vertigo, dizziness, and gaze instability, as well as secondary impairments that result from these disorders​³​. The cornerstone of VRT lies in its customized approach, where exercises are meticulously crafted to meet the unique needs of each patient, thereby fostering an environment conducive to recovery.

The therapy embarks on a journey of rehabilitation with a comprehensive clinical assessment, encapsulating a detailed history of the patient’s symptoms, their impact on daily activities, and an evaluation of visual and vestibular systems among other assessments. This thorough examination is pivotal in devising a personalized exercise regimen​³​.

Diving into the heart of VRT, we encounter three principal methods of exercises:

Habituation Exercises

Tailored for those who experience dizziness due to self-motion or visual stimuli, these exercises through repeated exposure to specific movements or visual stimuli, aim to reduce the intensity of dizziness over time​³​.

Habituation exercises employ specific techniques to gradually reduce the intensity of dizziness related to self-motion or visual stimuli. For individuals experiencing dizziness due to self-motion triggers, exercises often involve controlled and repetitive head movements. These movements start gently and become progressively more challenging to retrain the brain’s response. For instance, someone with BPPV might start with slow head tilts to one side and gradually increase the speed and range of motion. The key is systematic desensitization, where the brain learns to adapt to these movements over time, resulting in reduced dizziness.

Similarly, for those affected by visual stimuli, habituation exercises may incorporate controlled exposure to triggering visual patterns or scrolling on screens. Patients are exposed to these stimuli initially in a controlled and limited manner, and the exposure duration and intensity are gradually increased. Through this gradual and repeated exposure, the brain becomes less sensitive to these visual triggers, ultimately reducing the symptoms of dizziness.

Gaze Stabilization Exercises

Gaze Stabilization Exercises are a targeted therapeutic approach aimed at improving an individual’s ability to maintain clear and steady vision while their head is in motion. These exercises are particularly valuable for people who experience the sensation that their visual surroundings appear unstable, bouncy, or jumpy when they move their head. Such symptoms are often associated with vestibular disorders, inner ear problems, or head injuries, and can significantly impact an individual’s daily life. Gaze stabilization exercises work by training the eyes and the brain to cooperate seamlessly, allowing individuals to track objects or read text without the disorienting effects of blurred or shifting vision.

These exercises typically involve a range of eye movement patterns, with a focus on maintaining visual fixation on a target despite head movements. One common exercise involves the “fixate and follow” technique, where the individual is asked to fix their gaze on a stationary object and then track it smoothly with their eyes as they slowly move their head from side to side or up and down. Another exercise may include tracking a moving target, such as a finger or a visual pattern, while making controlled head movements. These exercises challenge the vestibulo-ocular reflex (VOR), which is responsible for coordinating eye movements with head movements. Over time and with regular practice, the VOR becomes more efficient, allowing individuals to stabilize their gaze and experience less visual disturbance during head motion.

Balance Training Exercises

Focused on improving steadiness, these exercises are crafted to address specific balance problems, facilitating the successful performance of daily self-care, work, and leisure activities​³​.

Balance training exercises are a crucial component of rehabilitation programs designed to enhance steadiness and stability in individuals who may experience issues with balance due to various factors such as aging, injuries, or medical conditions. These exercises are carefully crafted to target specific balance problems and improve an individual’s ability to perform essential daily activities with confidence. They focus on enhancing neuromuscular coordination, proprioception (awareness of body position), and overall postural control. For instance, balance exercises may include standing on one leg, walking in a straight line, or performing weight shifts while maintaining proper posture. These exercises aim to strengthen the muscles that support the core and lower body, which play a pivotal role in maintaining balance.

Each type of exercise within the VRT realm addresses distinct challenges posed by vestibular disorders, weaving a tapestry of rehabilitative strategies aimed at restoring a sense of balance and reducing the risk of falls​⁴​.

Vestibular Rehabilitation is more than just a series of exercises; it’s a guided voyage towards reclaiming stability and enjoying a life less interrupted by the whims of a vestibular disorder. The therapy, underpinned by evidence-based practices, is a testament to the strides of medical science in mitigating balance and postural control issues, igniting a ray of hope for those tethered to the disorienting world of vestibular dysfunction​⁵​.

FAQ’s About Vestibular Rehabilitation

How do you calm vestibular dizziness?

Finding a quiet, dark place and using ear plugs or headphones can help calm vestibular dizziness. Medications acting as antihistamines and vestibular suppressants could also be useful in calming the overactive balance centers in your inner ear​¹​.Techniques like meditation and mindfulness can help by calming stress and anxiety which can exacerbate symptoms, and also by training the brain to use information from the body for orientation instead of relying on vision​²​.

What is a natural remedy for the vestibular system?

Home remedies and exercises such as the Epley maneuver, staying hydrated, gingko biloba supplements, ginger tea, and dietary modifications like a low-salt diet can be beneficial​³​​⁴​​⁵​.

Does vestibular dizziness ever go away?

Vestibular dizziness may go away on its own depending on the underlying cause. For instance, benign paroxysmal positional vertigo (BPPV) might resolve on its own over time, but certain treatments can expedite recovery​⁶ ​​⁷​​ ⁸ ​​⁹​.

How do you sleep with vestibular disorder?

Adjusting your sleeping position, like propping your head up with an additional pillow or a wedge pillow, can be helpful. It’s also advisable to keep a consistent sleep schedule and sleep in a cool room. Sleep disturbances are common with vestibular disorders, and maintaining a good sleep hygiene might alleviate symptoms​¹⁰​​ ¹¹ ​​^{12 13}​.

Is vestibular a neurological condition?

Vestibular disorders encompass conditions affecting the inner ear and parts of the central nervous system involved in maintaining balance. These disorders can be categorized into peripheral and central causes based on the anatomy involved, implicating a neurological aspect to these conditions​¹⁴​​ ¹⁵​​ ¹⁶ ​​¹⁷​.

How Long Does Vestibular Rehabilitation Take To Work?

Vestibular rehabilitation therapy (VRT) typically lasts 6 to 8 weeks, with 1 or 2 weekly sessions. However, some patients with mild or specific issues can see rapid improvements in just 1 or 2 sessions, often experiencing reduced symptoms within 48 hours. The duration and effectiveness of VRT vary based on the individual’s condition and response to treatment.

What Is The Success Rate of Vestibular Therapy?

The success rate of vestibular therapy sits around 80%. Although this therapy is not successful for all participants, consistency and frequency are large contributing factors to the success of this therapy. In other words, the more dedicated you are to the therapy, the more likely it is to work.