Vestibular Rehabilitation

Vestibular Rehabilitation is the treatment of inner ear disorders by a physical therapist, which involves specific exercises and techniques designed to reduce the symptoms of vertigo, improve balance and restore function.

The vestiblar apparatus is located in the inner ear and its components detect the position and motion of the head. It is vital for coordination of head, eye and body movement. A few of the most common causes of vestibular disturbance are viral infection, stroke, motor vehicle accident, head injury, exposure to ototoxic chemotherapy agents and aging.

Nearly 40% of the population over 40 years of age will experience a balance or dizziness problem.

Vestibular dysfunction is second in frequency of occurrence only to the complaint of low back pain in the adult population. Some of the most common symptoms include dizziness, tinnitus, headaches, nausea, motion sensitivity, visual disturbance and falls. The symptoms associated with vestibular disturbances can be incapacitating, so patients are often unable to seek treatment during the first few days of vestibular crisis. Vestibular suppressant medication (Antivert, Meclizine) is typically the first line of action, and in some cases the vestibular disorder spontaneously remits in one to two weeks.

In 85% of individuals suffering from dizziness, the cause is a disturbance in the vestibular system.

What can be done for patients whose vertigo persists beyond the acute stage? How are these individuals supposed to perform activities of daily living or return to work? Vestibular rehabilitation includes a complete oculomotor, and somatosensory evaluation. Therapy, if appropriate, is based on the findings during the evaluation combined with any additional diagnostic test results (ENG, calorics, autorotation, audiography). Treatment consists of exercises to encourage habituation or accommodation to the symptoms. Patients may also be instructed on adaptive techniques and equipment to improve safety. Traditional physical therapy techniques for balance, gait, proprioception, flexibility and strength are also incorporated in the regimen to allow the patient to achieve his greatest functional potential.

Outcome studies of patient participating in vestibular rehab programs have revealed that almost 75% of patients demonstrate a significant improvement in balance and mobility. Further studies have shown a 30 -40% reduction in fall rates.

Benign Paroxysmal Positional Vertigo is the most common vestibular disorder. This is a result of displacement of otoliths in to the semicircular canals, which provide the brain with positional information about gravity via the 8th cranial nerve. Positional maneuvers, such as the Semont and Epley, are employed to move the displaced particles form the hair cells in to the body of the labyrinth where they appear to be absorbed by the lymphatics. Patients suffering from BPPV experience almost immediate relief from their symptoms.

Positional Maneuvers achieve resolution of vertigo in 80-90% of patients within 1 to 3 treatments.

The Therapy Department at The Wellness Complex offers vestibular therapy in all patient care settings including inpatient, outpatient and long term care. Please contact our therapists at 618-283-5548 to schedule an appointment.