What is vestibular rehabilitation?

Vestibular rehabilitation (VR) is a specialised form of therapy intended to symptoms due to vestibular disorders. It is an exercise-based program primarily designed to reduce vertigo and dizziness and/or reduce imbalance and fall risk as well as address any secondary impairments that are a consequence of the vestibular disorder.

For most people who have a vestibular disorder, the deficit is permanent because the amount of restoration of vestibular function is very small. However, after vestibular system damage, symptoms can reduce and function can improve because of compensation. This occurs because the brain learns to use other senses (vision and somatosensory – body sense) to substitute for the deficient vestibular system. For many, compensation occurs naturally over time, but for patients whose symptoms do not reduce and who continue to have difficulty returning to daily activities, VR can assist in recovery by promoting compensation.3

The goal of VR is to use a problem-oriented approach to promote compensation. This is achieved by customizing exercises to address the specific problem(s) of each individual. Therefore, before an exercise program can be designed, a comprehensive clinical examination is needed to identify problems related to the vestibular disorder.   

For patients with BPPV (dislodged crystal), the exercise methods described above are not appropriate to resolve this type of vestibular disorder. Through assessment, the type of BPPV is identified, and depending on the type, different repositioning maneuvers can be performed to help resolve the spinning that occurs due to position changes.

The most common conditions are :

  1. BPPV: benign paroxysmal positional vertigo
  2. Mesniere’s disease
  3. Peripheral vestibilar deficit
  4. Labyrinthitis & Vestibular Neuritis
  5. Vestibular migraine
  6. Vestibular schwannoma(acoustic neuroma) : benign tumour
  7. Vestibular paroxysmia(8th cranial nerve)