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Toronto Vestibular Rehabilitation
What is vestibular rehabilitation?
Vestibular rehabilitation is an exercise-based program, designed by a specialized physiotherapist, to improve balance and reduce dizziness-related problems.
At your appointment, a physiotherapist will evaluate your symptoms and review your medical history. He or she will identify any problems with your balance, your gait (how you walk), neck motion, visual stability, as well as examine other potential problem areas. Based on the findings, a plan of care is developed. The goal of your treatment plan is to improve any deficits that were identified. This, in turn, will improve your ability to function in activities of everyday living, reduce your risk for falling, and ultimately, improve your quality of life.
Who benefits from vestibular rehabilitation?
Patients who are typically referred for vestibular rehabilitation therapy are those diagnosed with dizziness, imbalance, vertigo, Meniere's syndrome, benign paroxysmal positional vertigo (BPPV), neck-related dizziness and migraines. Other candidates are patients who have had a stroke or brain injury or who frequently fall.
How is dizziness defined?
Dizziness is defined as feelings of unsteadiness; wooziness (swimming feeling in head); lightheadedness; feelings of passing out; and sensations of moving, spinning, floating, swaying, tilting, or whirling (sensations known as vertigo).
These sensations can occur when standing still, lying down or when changing positions. The symptoms can last from seconds to minutes to days. For some people the symptoms are constant; others experience only short episodes of symptoms.
What causes dizziness?
Each year over 10 million patients visit a physician due to dizziness. It is the most common complaint of patients over the age of 75, but can occur in patients of any age.
Dizziness is generally not serious, but is often a sign of a mechanical problem. Dizziness can be due to an inner ear disorder, a side effect of medications, a sign of neck dysfunction, or it can be due to a more serious problem such as a brain or a heart problem.
Common symptoms that can be helped with vestibular rehabilitation include:
- Dizziness or blurry vision with head movements
- Neck tightness, stiffness and/or pain
- Imbalance or the need to hold onto objects when walking
- Frequent falls
- Generalized "dizziness, wooziness and foggy head" feelings
What are some examples of the types of exercises I will learn?
Some examples of exercises you might learn include: vision stability training, posture training, stretching and strengthening exercises, balance retraining, walking, neck motion exercises, and if needed, general fitness exercises. Ergonomic advice may also be given. (This advice is given so that workplace furnishings can be adjusted to improve a person’s posture and decrease any discomforts.)
No two exercise treatment plans are exactly alike. Your exercise program is developed by identifying your deficits. For example: if your symptoms have been linked to an inner ear problem, you will also learn how to do some self-treatment exercises. Continuing an exercise plan at home can help prevent and/or treat new dizziness and balance episodes.
How long is a typical vestibular rehabilitation program?
Some patients may be seen for only 1 to 2 sessions; other patients may need continued treatment for a few months. The therapist makes individualized recommendations based on the needs of the patient, severity of symptoms, and response to therapy.
What type of recovery/outcome can I expect from vestibular rehabilitation?
Expected vestibular rehabilitation outcomes include:
- Decreased fall risk
- Decreased dizziness symptoms
- Improved balance
- Improved ability to stabilize vision/gaze
- Increased body strength
- Return to prior level of movement/function
- Increase in confidence in ability to maintain balance
- Improved neck motion, reduced symptoms
How successful is vestibular rehabilitation therapy?
Many times vestibular rehabilitation therapy will be the only treatment needed. Other times, it is a part of the presurgery/postsurgery treatment plan. In most cases, if patients continue to perform the exercises they have learned, balance and dizziness problems decrease significantly or completely disappear.