What is Vestibular Rehabilitation Therapy?
Vestibular rehabilitation therapy (VRT) is an exercise-based program designed to promote nervous system compensation for inner ear deficits. At Oahu Spine and Rehab we know that VRT can help with a variety of vestibular problems, even individuals with long-term unresolved inner ear disorders with little or no success may benefit. VRT can also help people with an abrupt loss of vestibular function following surgery and/or trauma.
Why is VRT needed?
When the vestibular system is damaged with disease or injury, the brain can no longer rely on them for accurate information about equilibrium/balance/motion, often resulting in dizziness, vertigo, balance problems, and other symptoms.
A person’s ability to maintain posture and coordinate balance may become overly dependent on input from the eyes (vision) and muscles and joints (proprioception). Unfortunately, these strategies can make vestibular compensation even more difficult, worsening symptoms and often causing headache, muscle tension, and fatigue.
The goal is to retrain the brain to recognize and process signals from the vestibular system in coordination with vision and proprioception. This often involves desensitizing the balance system to movements that provoke symptoms.
What happens during VRT?
A qualified physical therapist (PT) will first perform a thorough evaluation that begins with a medical history and includes observing and measuring posture, balance and gait, and compensatory strategies. The assessment may also include eye-head coordination tests that measure how well a person’s eyes track a moving object with or without head movement. Using the results, the therapist will develop an individualized treatment plan that includes specific head, body, and eye exercises to be performed both in the therapy setting and at home. These exercises are designed to retrain the brain to recognize and process signals from the vestibular system and coordinate them with information from vision and proprioception.
What are the effects of VRT and how does it help?
Some of the exercise and activities may at first cause an increase in symptoms as the body and brain attempt to sort out the new pattern of movements. Because of this, people sometimes give up on VRT, thinking it is making their vestibular disorder worse. However, in most cases balance improves over time if the exercises are correctly and faithfully performed. Muscle tension, headaches, and fatigue will diminish, and symptoms of dizziness, vertigo, and nausea will decrease or disappear. Many times, VRT is so successful that no other treatment is required.
At OSR we are able to evaluate your symptoms and create the best treatment plan in order to retrain your brain and remedy your vestibular damage.
Authors: Anne Shumway-Cook, PT, PhD, FAPTA; Professor Emerita, Department of Rehabilitation Medicine, University of Washington, Seattle, Washington (2014).