Vestibular Rehabilitation

Dizziness is the second most common complaint heard in the doctor’s office, and the number one malady of people older than 70. Over the years, people who experienced bouts of dizziness of balance problems had nowhere to turn. There was no treatment. They were often told, “You will have to live with it.” Today, we can help you overcome that helpless feeling through an alternative form of therapy called Vestibular Rehabilitation.

Let’s back up a moment and explain how the balance system works. Three sensory systems gather information regarding the body’s position or movement in space. These are the visual, vestibular (semicircular canals and otoliths) and somatosensory (touch, joint and muscle receptors) systems which transmit information to the brain’s central processor in the cerebellum. The balance response is carried out by the motor system. The right and left vestibular system are key in maintaining balance. It provides the brain with information regarding head movement and position. Disease in one vestibular system will produce misinformation to the brain and cause vertigo or imbalance. Vision helps orient the body in space by referencing vertical and horizontal axes of objects around them. The somatosensory system gives the brain information regarding support surfaces and motion of body segments between each other. Balance can be maintained with a loss of one of the three sensory systems. The brain can compensate for the loss, however, when more than one system is lost, balance difficulties will occur.

Dizziness of disequilibrium can strike anyone. Over 76 million Americans will suffer from spinning vertigo. Those who suffer most often have inner ear disorders, positional types of vertigo, or have had surgery involving the inner ear.

How Does Vestibular Rehabilitation Work?

There are three basic concepts of vestibular rehabilitation. The first is habituation. This means, continually repeating the actions that bring on the sense of dizziness or vertigo and eventually acclimating the body to those actions. The second process involves balance retraining exercises which help to reduce unsteadiness and imbalance. The third aspect deals with head-eye coordination exercises which help reduce gaze-induced dizziness.

Specific exercises customized to your particular needs

Specific exercises customized to your particular needs will help decrease dizziness, increase balance function and also increase your general activity levels.

Diagnosing Vestibular Disorders

A physician will diagnose your particular problem by performing a complete medical history, a neurotologic examination and tests of hearing and balance function. Tests for allergies, autoimmune inner ear disease (immune reactions to your own ear tissue), or hormonal imbalance may also be necessary. In addition, an ultrasound test which evaluates the blood circulation around the brain, imaging studies with CT or MRI and a consultation with a neurologist or cardiologist might be indicated. Once a diagnosis is made, the physician (neurotologist) will be able to ascertain if vestibular rehabilitation therapy is a program which may benefit you. In some cases, this can be used as an alternative to medication or surgery.

Results have been rewarding, even in the elderly.

The Vestibular Rehabilitation Therapist

Helping create winning program for your particular problem is performed by the vestibular rehabilitation therapist. A discussion of your symptoms begins the session. An assessment is made of your musculoskeletal system by testing the strength, coordination, and range of movement of your arms and legs. Your balance and gait is evaluated by observing if you need to touch objects or fix your eyes on stationary objects, and by observing what hip and ankle strategy you use to maintain your balance.

After careful analysis, the vestibular rehabilitation therapist designs a specific home exercise program suited to your particular needs. At home, you keep a weekly log of your progress which is evaluated by the physician and the vestibular rehabilitation therapist. You will meet with the therapist once or twice a week, as needed, for several months and will continue the exercises at home.

It is important for you to understand that your symptoms may become worse before they improve.

Therapy should continue in order to overcome the problems. Remember, “no pain, no gain.”

Benefits of Vestibular Rehabilitation Therapy

The benefits of vestibular rehabilitation vary depending on the cause of your problem and how well your central nervous system compensates. If your condition does not improve within three months, the therapy is usually discontinued. The vestibular rehabilitation program at ENTAA Care has already helped many people. It has given us the opportunity to provide help to many patients who previously were told there was no hope – they would “have to live with it.” Most rewarding are the psychological benefits of vestibular rehabilitation allowing patients to return to a normal lifestyle, free of the fear of failing, and being able to take control of your body once again.