Qualified Vestibular Rehabilitation Therapy Practitioners

Vestibular Rehabilitation Therapy

Looking to restore your sense of balance? Our skilled physiotherapists provide specialized vestibular rehabilitation therapy services to help you regain stability and confidence.


Vestibular Rehabilitation Clinic In Surrey, Abbotsford, & Langley

Vestibular Rehabilitation Therapy (VRT) is available for individuals experiencing vertigo. We offer specialized Vestibular Rehabilitation to help restore balance and alleviate symptoms.

Vestibular Rehabilitation: An Effective Treatment for Vestibular Disorders

Evidence indicates vestibular rehabilitation therapy can effectively alleviate symptoms associated with various vestibular (inner ear) disorders. Individuals with these disorders often experience vertigo, dizziness, visual disturbances, and imbalance, which are the primary issues that rehabilitation targets. Secondary problems such as nausea, vomiting, reduced focus, concentration, and fatigue can also arise.

Vestibular disorders can significantly impact the quality of life, affecting economic and social participation and contributing to emotional issues like anxiety and depression. One common consequence of vestibular disorders is that individuals often adopt a sedentary lifestyle to avoid triggering or worsening their symptoms. This can lead to decreased muscle strength and flexibility, increased joint stiffness, and reduced stamina. Rehabilitation strategies can help address these secondary issues as well.

What is Vestibular Rehabilitation?

Vestibular rehabilitation (VR) is a specialized form of therapy designed to alleviate both primary and secondary problems caused by vestibular disorders. It is an exercise-based program aimed at reducing vertigo and dizziness, improving gaze stability, reducing imbalance and fall risk, and addressing any secondary impairments resulting from the vestibular disorder.

For many individuals with vestibular disorders, the deficit is permanent, as the restoration of vestibular function is minimal. However, symptoms can improve, and function can be enhanced through compensation, where the brain learns to use other senses (vision and somatosensory) to compensate for the deficient vestibular system. While compensation can occur naturally over time, VR can assist those whose symptoms persist and who struggle to resume daily activities by promoting this compensatory process.

VR aims to use a problem-oriented approach to encourage compensation by customizing exercises to address each individual’s specific issues. A comprehensive clinical examination is needed to identify these problems before designing an exercise program. Three principal exercise methods may be prescribed depending on the identified vestibular-related issues: Habituation, Gaze Stabilization, and Balance Training.

Vestibular Rehabilitation Clinic
Vestibular Physiotherapy And Rehabilitation

Three Principal Exercise Methods For Vestibular Rehabilitation

Habituation Exercise

Habituation exercises are used to treat dizziness caused by self-motion or visual stimuli. These exercises suit patients who experience increased dizziness when moving, making quick head movements, changing positions, or in visually stimulating environments like shopping malls or watching action movies. The goal is to reduce dizziness through repeated exposure to movements or visual stimuli that provoke the symptoms, leading the brain to learn to ignore the abnormal signal over time.

Gaze Stabilization

Gaze Stabilization exercises aim to improve eye movement control to ensure clear vision during head movements. These exercises are appropriate for patients whose visual world appears to bounce or jump, especially when reading or identifying objects while moving. Depending on the type and extent of the vestibular disorder, two types of eye and head exercises are used to promote gaze stability.

Balance Training Exercises

Balance training exercises are designed to improve steadiness, allowing individuals to successfully perform daily activities related to self-care, work, and leisure. These exercises should target each patient’s balance issues and be moderately challenging yet safe to prevent falls. Additionally, they aim to reduce environmental barriers and fall risks, enhancing abilities like walking on uneven ground or in the dark.

The above exercise methods are not suitable for patients with benign paroxysmal positional vertigo (BPPV). Instead, specific repositioning maneuvers are used based on the BPPV type, which can help resolve the spinning sensations caused by positional changes.

Are Vestibular Rehabilitation Exercises Difficult To Do?

While the exercises are not difficult to learn, they can be tedious and require commitment. Regular practice is vital for success. Initially, the exercises may worsen symptoms, but with time and consistency, symptoms should improve, enabling better participation in daily activities.

Factors That Can Impact Recovery

Several factors can influence recovery during VR. The type of vestibular disorder is significant; stable disorders like vestibular neuritis or labyrinthitis offer the best chance for symptom resolution. Progressive or fluctuating conditions, such as multiple sclerosis, migraine, or Meniere’s disease, pose more challenges for compensation and VR success. Additionally, recovery can vary based on whether one or both inner ears are affected or the issue lies within the brain’s vestibular parts.

Other factors that can limit recovery include:

  • Sedentary lifestyle
  • Pain
  • Presence of other medical conditions
  • Certain medications or multiple medications
  • Emotional concerns
  • Decompensation

Symptomatic relapses can occur due to brain decompensation, triggered by emotional or physical stressors like personal pressures, inactivity, illness, extreme fatigue, medication changes, or surgery. While consulting with a physician to rule out new issues is crucial, returning to the initial compensatory exercises can often promote quicker recovery compared to the first compensation period.

Vestibular Rehabilitation Exercises

What Should Patients Expect From Vestibular Rehabilitation?

Vestibular rehabilitation therapy (VRT) is typically performed on an outpatient basis. However, it can start in the hospital in some cases. A licensed physical or occupational therapist with advanced post-graduate training sees patients.

VRT begins with a comprehensive clinical assessment, including a detailed history of the patient’s symptoms and their impact on daily activities. The therapist will document the type and intensity of symptoms and discuss precipitating circumstances. Additional information about medications, hearing or vision problems, other medical issues, fall history, activity level, and living situation is gathered.

The assessment involves various tests to objectively evaluate the patient’s problems. Our Surrey physiotherapist will screen the visual and vestibular systems and assess sensation (including pain), muscle strength, range of motion, coordination, posture, balance, and walking ability.

A customized exercise plan is developed based on the clinical assessment findings, laboratory test results, imaging studies, and the patient’s rehabilitation goals. For example, a person with BPPV may undergo canal repositioning exercises. At the same time, someone with gaze instability and dizziness due to vestibular neuritis may be prescribed gaze stability, habituation, and balance exercises.

An essential part of VRT is establishing a home exercise program. Consistent adherence to this program is crucial for achieving rehabilitation goals. Along with exercises, patient and caregiver education is integral to VRT. Understanding the science behind their vestibular problems and how they affect daily functioning can reduce anxiety and improve coping.

Frequently Asked Questions For Vestibular Rehabilitation Therapy

What is Vestibular Rehabilitation?

Vestibular rehabilitation is a specialized therapy designed to alleviate symptoms associated with vestibular (inner ear) disorders. It involves a series of exercises to reduce dizziness, improve gaze stability, and enhance balance to decrease fall risk. This therapy helps patients compensate for vestibular deficits by retraining the brain to use other senses, such as vision and somatosensory input, to maintain balance and orientation. Vestibular rehabilitation is customized to each patient’s needs based on a thorough clinical assessment.

What Triggers Vestibular Balance Disorders?

Vestibular balance disorders can be triggered by various factors, including:

  1. Infections: Viral or bacterial infections affecting the inner ear or vestibular nerve, such as vestibular neuritis or labyrinthitis.
  2. Trauma: Head injuries or concussions can damage the inner ear or vestibular pathways in the brain.
  3. Aging: Age-related changes can affect the function of the inner ear structures and balance systems.
  4. Meniere’s Disease is a disorder characterized by episodes of vertigo, hearing loss, and tinnitus caused by fluid buildup in the inner ear.
  5. Benign Paroxysmal Positional Vertigo (BPPV) is a condition caused by dislodged calcium crystals in the inner ear. It leads to brief episodes of vertigo triggered by head movements.
  6. Migraines: Vestibular migraines can cause dizziness and balance problems.
  7. Medications: Certain medications can affect the vestibular system and cause dizziness or balance issues.
  8. Other Medical Conditions: Conditions like multiple sclerosis or stroke can affect the brain’s ability to process vestibular information.
What Are Red Flags for Vestibular Dysfunction?

Red flags indicating vestibular dysfunction include:

  • Sudden Onset of Severe Symptoms: Sudden and intense dizziness, vertigo, or imbalance.
  • Hearing Loss: Sudden or progressive hearing loss, especially if accompanied by dizziness or vertigo.
  • Neurological Symptoms: Symptoms such as double vision, difficulty speaking, numbness, weakness, or severe headaches.
  • Persistent Symptoms: Symptoms that persist for an extended period or progressively worsen.
  • Unusual Eye Movements: Involuntary eye movements (nystagmus) that occur with dizziness or imbalance.
  • Difficulty Walking: Severe imbalance or difficulty walking, especially if accompanied by other neurological signs.
  • Fainting: Episodes of fainting or feeling like you might faint.

If you experience any of these red flags, it is crucial to seek medical attention promptly.

How Do I Calm My Vestibular System?

To calm your vestibular system, you can try the following strategies:

  • Vestibular Rehabilitation Exercises: Perform exercises prescribed by a vestibular therapist to help your brain compensate for vestibular deficits.
  • Stay Hydrated: Dehydration can exacerbate dizziness, so drink plenty of water.
  • Avoid Triggers: Identify and avoid specific triggers that worsen your symptoms, such as certain head movements, bright lights, or crowded environments.
  • Reduce Stress: Practice stress-reducing techniques such as deep breathing, meditation, or yoga, as stress can worsen vestibular symptoms.
  • Healthy Diet: Maintain a balanced diet and avoid excessive caffeine, alcohol, and salty foods, which can affect fluid balance in the inner ear.
  • Medication: Use medications as your doctor prescribes to manage symptoms like nausea or dizziness.
  • Rest: Ensure you get adequate rest and avoid overexertion, which can exacerbate symptoms.
  • Stable Visual Environment: Focus on a stable visual point when feeling dizzy to help stabilize your balance.

Consulting with our Surrey Physiotherapy clinic for a personalized treatment plan is always recommended.