What is Vestibular Rehabilitation?
Vestibular Rehabilitation is a specialized form of therapy that focuses on addressing the primary and secondary problems resulting from vestibular disorders. It is primarily an exercise-based rehabilitation program that addresses symptoms associated with vestibular disorders, such as vertigo, dizziness, imbalance, and visual disturbances. Consequently, it can help alleviate secondary problems, such as cognitive impairments (i.e. poor focus and concentration) and fatigue.
The mechanism of recovery provided by Vestibular Rehabilitation involves the return of function through compensation. Restoration of actual vestibular function is quite minimal, but through compensation of the other sensory systems (visual and somatosensory), decreased vestibular function can be substituted by them. However, the function of other aspects of the nervous system is crucial in determining the extent of recovery that can be achieved through compensation. These crucial components include the brainstem, cerebellum and visual and somatosensory systems, as they are intricately interconnected with the vestibular system.
The main goal of Vestibular Rehabilitation is to develop an individualized active-based exercise program to promote compensation. It is important for the exercise program to be customized to the individual to address their specific problems, as well as minimize the risk of significant symptom provocation that may prolong their recovery. Therefore, a comprehensive clinical examination by a trained vestibular therapist is recommended to accurately identify the problems to be addressed.
There are 3 main exercises prescribed in a Vestibular Rehabilitation program:
Gaze Stabilization Exercises
The goal of Gaze Stabilization exercises is to improve the control of eye movements during head movements so that vision can be clear. Common symptoms that indicate that an individual would benefit from Gaze Stabilization exercises are oscillopsia (bouncing vision) and dizziness when moving your head around, such as when you are looking from shelf to shelf while walking down a grocery aisle.
Gaze Stabilization exercises consist of addressing the ability to maintain focus on a target while moving the head. The parameters of the exercise are chosen based on the person’s specific issues, symptoms provoked when performing the exercise, and treatment goals.
Habituation Exercises
The goal of Habituation exercises is to reduce the dizziness produced from specific movements and/or visual stimuli. Common symptoms that indicate that an individual would benefit from Habituation exercises are increased dizziness when changing positions and moving a certain way and increased dizziness or difficulty tolerating specific visually-stimulating environments (i.e. traffic, grocery store).
Habituation exercises consist of addressing the dizziness provoked by the specific movements and visual stimuli by mildly provoking the person’s symptoms during the movement or watching the visual stimuli. The intensity of dizziness will decrease as the brain learns to read the abnormal signals it receives from the vestibular system.
Balance and Gait Training
The goal of Balance and Gait Training is to improve the sensation of unsteadiness and disequilibrium during daily activities. Common symptoms that indicate that an individual would benefit from Balance and Gait Training are feeling unsteady on their feet, the fear of falling, and issues with walking, such as staggering or drifting to one side.
Balance and Gait Training consists of addressing the balance issues by manipulating the therapeutic environment to challenge the individual’s balance. Parameters that can be adjusted include visual and somatosensory cues, using static and/or dynamic movements, enhancing balance strategies, and including cognitive tasks during balance activities.
A comprehensive Vestibular Rehabilitation program that is closely monitored and gradually progressed over time will result in positive outcomes that will allow the individual to return to their normal functioning!
