Vestibular Rehabilitation

for dizziness and vertigo treatment

 

Vestibular Rehab

 

is a specialized form of therapy that treats symptoms related to vestibular disorders and injuries that can include vertigo, dizziness, blurred vision, balance issues, and difficulties standing and walking straight.

The vestibular system anatomy in Toronto Ontario

Most commonly diagnosed vestibular disorders:

The outer ear of a person to depict the vestibular system in Toronto Ontario

Less common vestibular disorders:

  • Superior semicircular canal dehiscence

  • Acoustic neuroma

  • Bilateral vestibular hypofunction

  • Ototoxicity

  • Neurotoxic vestibulopathy

  • Enlarged vestibular aqueduct

  • Mal de Débarquement

  • Autoimmune inner ear disease

  • Cholesteatoma

  • Persistent Postural Perceptual Dizziness (PPPD)

Stars rotating quickly across the sky to depict vertigo in Toronto Ontario

Common symptoms:

  • Vertigo - a sensation of movement, whether it’s yourself or the world around you, when the movement is not actually occurring

  • Dizziness - a vague sensation of lightheadedness, floating, or rocking

  • Imbalance or unsteadiness

  • Oscillopsia - blurred or bouncing vision

  • Nausea

  • Hearing changes

  • Feelings of anxiety and depression

  • Lack of coordination

  • Problems with concentration and memory

The goal of Vestibular Rehabilitation is to use a problem-solving approach to promote the healing of the vestibular system through the process of compensation. Compensation happens as the brain learns to recalibrate conflicting information from the vestibular and other sensory systems (vision and proprioception, i.e. body awareness). When there is conflicting sensory information going to the brain, symptoms, including dizziness, vertigo, and imbalance can occur. Vestibular rehab can be helpful to treat those symptoms, help you move better, and get you back to work, school, sports, and your daily activities. It’s important that vestibular exercises are customized to your specific issues so that you achieve optimal results. That means using specific treatment techniques and exercises that trigger your dizziness and vertigo. Successful treatment depends on finding the positions and movements that bring on your dizziness so that the exercises can help you gradually get back to doing them again. Because of that, your symptoms may become worse initially, but with the right treatment, they will get better!

Infrared video goggles are one component of a comprehensive vestibular assessment. These goggles allow me to observe your eyes closely, help my evaluation to be more effective, and guide my treatment planning. Vestibular issues can result in nystagmus, which is abnormal involuntary eye movements. There is a strong connection between the vestibular system and the eye movement (oculomotor) system. Therefore, observing patterns of eye movements can help me determine whether your problem is related to your inner ear (peripheral vestibular system) or brain (central nervous system).

If you’ve had your vestibular issues for a while, you can often compensate by using your eyes for stability in room light. You can’t use visual fixation in the infrared video goggles, making the nystagmus more obvious.

Vestibular Rehabilitation

  • Teaching balance exercise with eyes closed in Toronto Ontario

    Balance training exercises

    are used to improve steadiness so that it can feel easier to do your daily activities. Balance exercises involve integrating inputs from your visual, vestibular, and proprioceptive systems to work better together and allow you to feel more stable and in equilibrium.

  • Performing a maneuver for bppv vertigo treatment in Toronto Ontario

    Canalith repositioning maneuvers

    are used to treat Benign Paroxysmal Positional Vertigo (BPPV), the most common cause of vertigo. You may feel this type of vertigo when you look up, lie down or turn in bed. This type of vertigo is due to “loose crystals” in the inner ear. Treatment involves performing maneuvers that involve a sequence of head and body movements to guide the displaced “ear crystals” back to the part of the vestibular system where they should be.

  • Teaching a gaze stabilization vestibular exercise for dizziness in Toronto Ontario

    Gaze stabilization exercises

    are used to improve control of the eyes during head and body movements, and this is related to the vestibulo-ocular reflex. Specific exercises are prescribed to treat blurred vision that happens when moving around.

  • Teaching a habituation exercise for dizziness in Toronto Ontario

    Habituation exercises

    are used to treat dizziness that is related to movement. Depending on the positions or movements that trigger your dizziness, specific habituation exercises are prescribed. Habituation exercises aim to reduce the intensity of your dizziness so that it feels easier for you to move around.

  • Teaching a vestibular exercise for visual motion sensitivity in Toronto Ontario

    Visual motion sensitivity training exercises

    are used to improve your dizziness triggered by visual stimulation and excessive motion. Treatment involves exposing yourself to the triggering visual or motion stimuli until the symptoms improve. This type of exercise works for dizziness related to visually stimulating environments, like shopping malls and grocery stores, watching action movies or TV, or walking through environments with patterned walls or floors.