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Vestibular Physiotherapy

Vestibular Physiotherapy

As health care shifts to a more inclusive, whole body approach, there has been a realization that we are lacking information and treatment for the vestibular system.

The vestibular system is one of the smallest systems in our body – there are two symmetrical organs that sit deep in each ear that make up the hardware of the vestibular system. This system is responsible for providing our brain with sensory information about our surroundings including where we are located in space and how gravity is affecting our body. Additionally, the vestibular system communicates with several areas of the brain to mediate reflexes including the cerebellum (control of the limbs and muscles of head and trunk in relation to gravity), the cranial nerves (control of the eyes in relation to visual stability during movement and visual focus when the head is moving), the reticular formation (control of posture and postural control), and the spinal cord (control of limb movement to maintain balance).

Due to the number of reflexes that rely on a healthy vestibular system, it is easy to understand how vestibular dysfunction can present with a diverse group of seemingly unrelated symptoms. Even more so, it is important that any dysfunction of the vestibular system is properly assessed and treated in a timely manner such that the brain does not learn how to compensate with maladaptive (unhelpful) strategies.

What symptoms can be appropriately assessed and treated by vestibular therapy?

  • Dizziness
  • Vertigo
  • Unsteadiness
  • Balance disturbances
  • Unexplained falls
  • Difficulty reading or watching TV
  • Gaze instability with head or body movement

Additionally, you will benefit from Vestibular Rehabilitation Therapy (VRT) if you have been diagnosed with:

  • Vertigo
  • Visual vertigo
  • Vestibular migraines
  • Vestibular Neuritis
  • Cervicogenic Dizziness
  • Concussion
  • Age-related dizziness and imbalance
  • Bilateral Vestibular Hypofunction
  • Mal de Debarquement
  • General Vestibulopathy
  • Persistent Postural Perceptual Dizziness
  • Pediatric Vestibular Disorders
  • Vestibular Paroxysmia
  • …and more!

What does Vestibular Rehabilitation Therapy (VRT) look like?

The vestibular system interacts with many different systems in the body including balance and vision. Therefore, treatment and therapy will target three different areas: the vestibular system, the balance system and the visual system.

The Vestibular System
  • Canalith Repositioning Maneuver
  • Habituation
  • Desensitization
The Balance System
  • Static and dynamic balance
  • Anticipatory and non-anticipatory balance tasks
  • Removal of visual and proprioceptive feedback
The Visual System
  • Gaze stability
  • Eye tracking
  • Isolating visual function from whole body movements

Your Responsibility

Research has shown that vestibular therapy is effective for a variety of vestibular conditions based on the neural plastic properties of the brain. This means that the more the brain practices, the quicker the brain will learn how to make corrections. Your vestibular therapist will make recommendations for the tasks/exercises that you should be doing at home – the repetitions will be HIGH (up to 10 times a day!). Your vestibular therapist will encourage you in completing the exercises; experience and research have shown that they are effective and a return to functional life is possible through perseverance!
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