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.

Most commonly diagnosed vestibular disorders:

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

  • Secondary endolymphatic hydrops

  • Perilymph fistula

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 feeling that your sense of space or balance is off, without a false sense of movement (for example, feeling lightheaded, woozy, or foggy)

  • Imbalance or unsteadiness

  • Oscillopsia - the illusion that the world is bouncing or jumping, often when you move your head

  • Blurred vision during head movement

  • Nausea

  • Hearing changes

  • Feelings of anxiety and depression

  • Lack of coordination

  • Problems with concentration and memory

The goal of vestibular rehabilitation is to help your brain compensate for a vestibular problem. Through neuroplasticity, your brain can recalibrate how it responds to vestibular input (adaptation), rely more on other senses such as vision and body awareness (substitution), and become less sensitive to the movements and environments that trigger your symptoms (habituation). When these sensory systems send conflicting signals to the brain, it can lead to symptoms like dizziness, vertigo, and imbalance.

Vestibular rehabilitation can be effective in treating these symptoms, helping you move better, and enabling you to return to work, school, sports, and daily activities. It’s essential that the vestibular exercises are tailored to your specific issues for optimal results. This involves using particular treatment techniques and exercises that may initially trigger your dizziness and vertigo.

Successful treatment hinges on identifying the positions and movements that provoke your dizziness so that exercises can help you gradually re-engage with them. As a result, your symptoms might worsen at first, but the goal is for your symptoms to ease over time as your brain adapts and your exercises are progressed.

Infrared video goggles are an important part of a thorough vestibular assessment. These goggles enable me to closely observe your eye movements, making my evaluation more effective and helping to inform my treatment plan. Vestibular issues can lead to nystagmus, which is characterized by abnormal and involuntary eye movements. There is a strong connection between the vestibular system and the eye movement (oculomotor) system. Patterns of eye movements help me tell whether your symptoms are more likely coming from your inner ear (peripheral vestibular system) or your brain (central nervous system), and whether you should be referred to a physician.

Nystagmus from an inner ear problem is often hidden in a well-lit room, because your brain can suppress it when you focus your eyes on something. Infrared video goggles block your vision so you cannot focus, which makes this nystagmus visible.

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 gradual, repeated exposure to your visual or motion triggers, at a level you can tolerate, so your brain becomes less sensitive to them over time. This type of exercise can help with 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.