Vestibular rehabilitation therapy (VRT) is a specific form of physiotherapy designed to habituate symptoms, and promote adaptation to and substitution for various aspects of deficits related to a wide variety of balance disorders.VRT is effective in improving the functional deficits and subjective symptoms resulting from unilateral and bilateral peripheral vestibular hypo function as well as from central balance disorders.
By improving vestibular function and promoting mechanisms of central adaptation and compensation, VRT aims to do the following:
- Improve balance
- Minimize falls
- Decrease subjective sensations of dizziness
- Improve stability during locomotion
- Reduce overdependency on visual and somatosensory inputs
- Improve neuromuscular coordination
- Decrease anxiety and somatization due to vestibular disorientation
Substitution strategies use several techniques, including alternate sensory inputs to drive motor output, alternate secondary motor responses instead of primary motor responses, and incorporating strategies of prediction and anticipation of intended motor behavior. The cervical-ocular reflex (COR) may be developed as an alternate source of visual stability during head movements. This is an example of a substitution strategy for deficits in the VOR.
VRT also takes advantage of the adaptive and neuroplastic characteristics of the CNS to reestablish or possible neural mapping within the vestibular system. This results in increased VOR accuracy, refinement of oculomotor skills, improvement in postural control, and use of appropriate movement strategies. Adaptation serves to extinguish symptoms of dizziness provoked by motion or visual stimulation. Specifically tailored exercises promote adaptation and neuroplastic changes within CNS by altering the input-output relationships of the VOR, including gain, timing, and direction. These exercises have been shown to improve symptoms of patients who are post-surgery for resection of acoustic neuroma.
Goals of the therapy
- Improve pain free and dizzy free range of movement of neck
- Reduce frequency, intensity and duration of dizzy symptoms
- Improve balance and oculomotor function
- Develop compensatory strategies for coping with
Process and advantage of vestibular rehabilitation
- Non-invasive neuroplastic approach
- Qualified physiotherapist completes a comprehensive evaluation
- Measurement of posture, balance, mobility, coordination, flexibility, sensation, strength, gaze control and postural control strategies Personalized regimen of manual therapy and exercises prescribed to meet unique needs of each patient
- Monitoring and progression of program on an intermittent basis by physiotherapist
Who Will Benefit?
- History of Falls / Poor Balance
- Motion Sensitivity
- Stiff Neck
- Double Vision
- Vestibular and Balance Disorders symptoms
“Vestibular Rehabilitation is a scientifically based and clinically valid therapeutic modality for the treatment of persistent dizziness and postural instability due to incomplete compensation after peripheral vestibular of central nervous system injury. Balance Retraining Therapy is also of significant benefit for fall prevention after recovering from a multiple sensory and motor impairments.”
The American Academy of Otolaryngology-Head and Neck Surgery, Inc 2007
“Physiotherapy is the primary health care profession that promotes wellness, mobility and independent function. Physiotherapists have an understanding of how the body moves, what keeps it from moving well and how to restore mobility.”
Canadian Physiotherapy Association 2007