Dysphagia
Vestibular Rehabilitation Therapy
December 20, 2022
Communikare Services
Vestibular Rehabilitation Therapy
Vestibular rehabilitation therapy (VRT) is a specialist form of physiotherapy designed to
treat and alleviate vestibular disease symptoms. It frequently involves manual head
maneuvers and/or a gradual exercise regimen meant to minimise vertigo and dizziness,
visual problems, and/or imbalance and falls.
After a vestibular system injury, the central nervous system is able to adjust for diminished
inner ear function. In essence, the brain adapts to the imbalanced vestibular impulses by
learning to rely more heavily on alternate signals from other systems of the body to maintain
vestibular balance. This can be accomplished through the numerous workout techniques
described below. When this central (or brain) compensation occurs, the patient’s symptoms
are eased and normal function is restored
Vestibular System
Your vestibular system allows you to react appropriately when it detects changes in head
position or motion.
- Your two inner ear organs make up this structure.
- Vestibular centers in the midbrain and cerebellum, and
- Peripheral vestibular nerves.
Vestibular organs in the inner ear operate as sensors that detect head rotation,
forward/backward, and up/down motions, as well as head tilt. Due to the numerous loops
of the semicircular canals included within, it is commonly referred to as a labyrinth. The
vestibular nerve connects the organ of the inner ear to the midbrain and cerebellum in the
back of the brain. These vestibular nerves send motion data from the inner ear to the brain
for processing.
Your brain processes information from the organs of your inner ear, but it also receives
backup information from other senses, including vision, joints, muscles, and tendons
throughout your body, hearing, touch, and even memory and emotion functions. It then
transfers nerve impulses to your eye, trunk, and limb muscles, allowing you to respond
appropriately to each situation.
Benefits of Vestibular Rehabilitation Therapy(VRT)
- Patients referred to Vestibular Rehabilitation often have been diagnosed with a vestibular
disorder, such as: - Benign Positional Paroxysmal Vertigo (BPPV)
- Neuritis of the Vestibule/Labyrinthitis
- One-sided Vestibular Hypofunction (UVH)
- Vestibular Migraine Persistent Postural Perceptual Dizziness (PPPD)
- Mal de Debarquement (MdDS)
- Cervicogenic Dizziness
- Post-Concussion Syndrome (PCS)
- Meniere’s Disease
- Neurological conditions (i.e. stroke, traumatic brain injury)
- Age-related or inactive vestibular deconditioning, as well as numerous other
vestibular diseases…
If you have not yet been evaluated or diagnosed with a vestibular disorder, vestibular
rehabilitation can help alleviate the following symptoms:
- Vertigo (feeling of spinning) (sense of spinning)
- Generalized vertigo or faintness
- nausea, vomiting, and tiredness
- Tightness, stiffness, and/or discomfort in the neck
- Unsteadiness and trouble walking
- Headaches
- Frequent falls
- Vision issues Double vision, unstable vision while moving the head, difficulties
focusing, and poor screen tolerance. - Brain fog, concentration difficulties, and mild memory impairments
Communikare’s Vestibular Rehabilitation Therapy(VRT)
The exercises for vestibular rehabilitation are not difficult to master, but require a high level
of patient persistence for effectiveness. Frequently, we recommend that the exercises be
completed a minimum of two to three times per day, which might be tedious or difficult to
fit into a hectic schedule. We recommend that our patients establish a routine so that the
workouts can be more easily absorbed into their daily lives.
In the majority of situations, patients will see that vestibular rehabilitation exercises
exacerbate their symptoms. In most cases, this indicates that you are performing the
exercises correctly and stimulating your vestibular system effectively. However, with time
and constant effort, your symptoms should diminish until they become more manageable
and, in many cases, disappear entirely. We frequently use the comparison of weight lifting:
when you first begin lifting a certain amount of weight, it is difficult and your muscles are
sore. Over time, though, the weights become lighter and your muscles experience less pain
overall. Then, you are prepared to advance to larger weights or, in the case of vestibular
rehabilitation, to more difficult vestibular exercises.
NOTE: If you have been diagnosed with Benign Paroxysmal Positional Vertigo (BPPV),
repositioning the displaced inner ear crystals is the primary treatment. In some instances,
vestibular rehabilitation exercises must be performed at home as part of the manual
treatments required to improve BPPV.
Treatments in Vestibular Rehabilitation Therapy (VRT)
The vestibular rehabilitation exercise programme for every patient is unique. This is the case
not only because many types of vestibular deficits exist, but also because each type affects
individuals differently. There are never two identical cases. Our Communikare Therapy
Centre frequently sees patients with impaired function who have been given generic exercise
handouts or a general vestibular programme. Once the patient’s unique limitations were
taken into account AND appropriate modifications to the exercise programme were
implemented at the appropriate time during their rehabilitation, the patients reported
improvements once more.
BPPV Treatment
BPPV is a common vertigo cause. It is crucial that you get an accurate evaluation in order to
be diagnosed with this ailment. Your vestibular physiotherapist is trained to evaluate your
inner ear organs using positional testing, in which your head is positioned at various angles
in an attempt to duplicate your vertigo, while taking close note of any associated nystagmus
or eye reaction patterns. After the precise type of BPPV has been recognised, repositioning
movements are employed to treat it.
After BPPV has been successfully treated with repositioning methods, some patients
continue to experience persistent generalised dizziness or imbalance. In these instances, it
may be advisable to prescribe habituation exercise and/or balancing training.
BPPV treatments are discussed in length in the BPPV page system. Our belief is that BPPV
should almost always be treated with vestibular rehabilitation utilising particular techniques
for the type of dizziness experienced by the patient.
Habituation Exercises
Symptoms of vertigo brought on by head movement or visual stimulation are treated with
habituation exercises. These patients generally experience heightened vertigo while rapidly
turning their heads or changing their position, such as bending forward to tie their shoes or
looking up. Patients who have trouble in extremely visually stimulating locations, such as
grocery stores and bustling gyms, as well as when viewing screens, may benefit from
habituation exercises. Through repeated exposure to certain movements or visual stimuli
that induce dizziness, the primary goal of a habituation exercise is to alleviate symptoms.
The purpose of these exercises is to induce modest symptoms so that the central nervous
system can progressively “habituate” to the stimuli. The rise in symptoms should be
transient and revert to baseline within 15 to 20 minutes. As the brain learns to ignore the
erroneous signals it is receiving from the inner ear system, the intensity of dizziness
associated with these exercises should diminish with time and perfect programme
compliance.
Gaze Stabilization Exercises
The purpose of gaze stabilisation exercises is to enhance visual clarity and stability during
head movements. Patients who report that their visual world appears to wriggle, shake,
shift, or move while reading, walking, changing posture, or attempting to identify things in
the surroundings are advised to perform these exercises. Fixating on an item while moving
your head back and forth or up and down repeatedly for many minutes is a classic exercise
for enhancing gaze stability.
Balance Conditioning Workouts
Balance training exercises are a cornerstone of vestibular therapy and are intended to
improve patients’ steadiness so they can engage in everyday living, employment, leisure,
and physical activities with greater success. Your physiotherapist will offer you with
exercises that are somewhat difficult but safe, so that you do not fall while practising them.
In the end, these balancing exercises should enhance your ability to walk outside, on uneven
terrain, and in the dark. A comprehensive balance training programme should enhance your
ability to keep your balance while sitting, standing, walking, turning, bending, and reaching.
The objective of vestibular physiotherapy is to assist you in returning to as many of your
preferred activities as possible, including running and sports.
Expected Recovery from Vestibular Rehabilitation Therapy (VRT)
The following are anticipated vestibular rehabilitation outcomes:
- Reduced vertigo symptoms
- Reduced nausea and vomiting
- Increased attention or concentration and memory Better standing or sitting balance
Reduced danger of falling - Improved ability to stabilize sight or vision, as well as the capacity to monitor or
focus on nearby and distant objects - Improved mobility, stiffness, and/or pain in the neck
- Less weariness and better sleep Decreased anxiety and despair
- Enhanced capacity to deal with stress
- Enhanced confidence to resume chosen activities and pastimes
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