What is Vestibular Rehabilitation Therapy?

Vestibular Rehabilitation Therapy (VRT) is an exercise-based program designed to promote central nervous system compensation for inner ear deficits. VRT can help with a variety of vestibular problems, including Benign Paroxysmal Positional Vertigo (BPPV) and unilateral or bilateral vestibular hypofunction (reduced inner ear function on one or both sides) associated with Ménière's disease, labyrinthitis and vestibular neurotis. Even individuals with long-term unresolved inner ear disorders who have undergone a period of medical management with little or no success may benefit. VRT can also help people with an acute or abrupt loss of vestibular function following surgery for vestibular problems.

VRT is a type of therapy intended to alleviate both primary and secondary impairments caused by vestibular disorders.

Primary: vertigo, primary generalized dizziness/foggy head, visual disturbance, and/or imbalance and frequent falls.

Secondary: nausea/vomiting, decreased ability to concentrate/focus, fatigue, decreased QDL, anxiety/depression, decreased vertical ROM, decreased strength, stiffness/pain.

Depending on the vestibular-related problem(s) identified, three principal methods may be utilized:

• Habituation
• Gaze Stabilization
• Balance Training

These will be used in conjunction with treatment needed to decrease secondary impairments as well.

Assessment:
VRT begins with a comprehensive assessment of patient history, symptoms, daily activities and how their symptoms affect daily activities.

The assessment also includes a visual and vestibular screen to observe how well eye movements are being controlled, as well as assessments for sensation, muscle strength, extremity and spine ROM, coordination, posture, balance and walking ability.

Balance is assessed as well. Three systems make up our balance: vestibular, proprioception, and vision. If one of these is impaired, balance will be affected.

Treatment:
A customized treatment plan is then created with the clinical assessment, results from lab testing, imaging studies, and input from patients about their goals from rehab. A customized home exercise program is also administered that can be performed regularly at home to increase outcomes. Outcomes will be assessed regularly to detect changes that may need to be made to the treatment plan and/or progress made by the patient.

For patients with BPPV, the clinician must first identify the type of BPPV and perform repositioning to correct. After BPPV has been treated and spinning symptoms resolved, some patients will report continued dizziness (symptoms other than spinning) and /or general imbalance. In these cases, other treatments may be utilized.

If you have any questions regarding Vestibular Rehabilitation Therapy, please contact our Outpatient Department at (225) 231-3107.