Vestibular Therapy

Vestibular Rehabilitation Therapy (VRT) is a specialized form of physical therapy used to treat dizziness and vertigo, and trouble with balance, posture, and vision. Despite it’s name, the vestibular system may not be the only system that is affected, or even at all. There are three main inputs that we rely on to keep us oriented:

Proprioception
Vestibular
Vision

Our senses of posture, balance, spacial awareness and up vs. down all emerge from the organization of these signals. Symptoms will arise whenever either (1) the inputs change or (2) the brain can’t put the whole picture together. Any disorder affecting these inputs can result in symptoms that VRT can treat, including:

Benign Paroxysmal Positional Vertigo (BPPV)
Menier’s Disease / Hydrops
Labrynthitis or Acoustic Neuritis
Concussion
Vestibular Migraine
Stroke
Multiple Sclerosis
Cortical or cerebellar degeneration
Peripheral Neuropathy
Physical Deconditioning
Cervicogenic Dizziness

It is also important to understand that the primary symptoms will often result in secondary symptoms such as nausea, fatigue, and lack of concentration. All symptoms of vestibular dysfunction can significantly decrease quality of life, introducing mental-emotional issues such as anxiety and depression, and greatly impair an individual, causing them to become more sedentary, and often isolated. Vestibular therapy retrains the neural pathways needed so it can make sense of the world around it.

Frequently Asked Questions

What’s the difference between dizziness and vertigo?

Dizziness encompasses a broad range of intensities but is typically described as a feeling of lightheadedness, being woozy, or just feeling “off.” This is commonly experienced as standing up too quickly or drinking too much alcohol. Vertigo refers to the experience of a distinct sensation of motion: either it feels like you are moving and/or it looks like the world is moving.

How long does it take to get better?

Unfortunately, “it depends” is always the default answer when it comes to the brain. Some conditions like BPPV will often resolve within 1-3 treatment sessions. Most conditions require 5-12 visits to progress exercises appropriately.

However, a “full recovery” may not happen over the same number of weeks. Progress is dictated by mastery. You can’t move on to the next level of exercises until you’re ready, and symptoms that improve slowly can be more challenging to gauge.

What Can I expect from Vestibular Rehabilitation?

Because of its highly variable nature, there is never a one-size-fits-all approach. Following a thorough evaluation, your therapist will recommend a specific progression of exercises that generally fall into one or more of three categories:

(1) Adaptation recalibrates your brain to the new levels of inputs following an injury.

(2) Habituation incrementally desensitizes your brain to provocative stimuli and/or

(3) Substitution teaches your brain to rely on other inputs when one goes completely offline.

Programs typically include exercises for vision, balance, and specific movement progressions that allow your brain to organize the world around you.

How long does it take?

Unfortunately, when it comes to the brain, “it depends” is always the default answer. Something like BPPV will often resolve within 1 or 2 treatment sessions. Some conditions will require 4-8 visits to appropriately progress exercises and other may take more. A “full recovery” may not happen over as many weeks, since you can’t teach the brain faster than it can learn.

Vestibular Therapy

Frequently Asked Questions

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