What is Vestibular Therapy?  Your doctor may have prescribed vestibular therapy for you because you have dizziness or balance problems.  Vestibular therapy is a special type of physical therapy that will help improve your symptoms or improve your balance.  

The vestibular system is the balance system in your inner ear.  There are times when this system is not functioning very well.  This can lead to symptoms including:

·        Dizziness

·        Tinnitus (noise in ears)

·        Dysequilibrium or a sense of being off balance

·        Balance problems

·        Vertigo-room is spinning or you are spinning

·        Sense of being “off” or “off balance”

·        Light headed

·        Wooziness

·        Fatigue

            What can cause dizziness?  Dizziness can have many causes.  Some of these

            Include:

·        Viral infections of the labyrinth-labyrinthitis or the vestibular nerve-vestibular neuronitis

·        Bacterial infection of the inner ear or brain that may spread to the inner ear

·        Head trauma

·        Exposure to ototoxins such as drugs that affect the inner ear

·        Degeneration of the hair cells of the inner ear

·        Meniere’s disease

·        Acoustic neuroma-benign tumor on the vestibular-cochlear nerve

·        Migraine headache

·        Mal de debarquement (sensation of rocking after a long plane ride or a cruise)

·        Autoimmune inner ear

            Your doctor will try to determine the cause of your dizziness or other symptoms. 

This is a diagram of your ear.  The vestibular system lives deep in your inner ear very close to the cochlea, the organ of hearing.  We have 2 vestibular systems, one in each ear.

The vestibular system provides your brain with information about how you are moving your head.  This helps keep us balanced and upright in space.

We have 2 additional systems of balance along with the vestibular system.  Our vision is a system of balance that gives the brain information on how we are upright in the environment.  The somatosensory system or joint receptor system tells the brain information on where our body is in relationship to the environment.  Because of the 3 systems of balance, we have quite a bit of information on how we are upright in space.  If one or more systems have problems, we can still balance and walk. 

Your doctor may have sent you for testing of your inner ear.  Based on the results of these tests, your doctor may want you to have some physical therapy or Vestibular Rehabilitation.  What should you expect with Vestibular Therapy?

·        The physical therapist (PT) will do an examination to determine how your 3 systems of balance are functioning.

·        Your initial examination will take 1 hour, but subsequent visits will only be 15-30 minutes. 

·        The PT will then develop a program for you to do at home to improve your balance, and decrease your symptoms.

·        Your home exercise program will take no more than 5 minutes to complete and it is done 2 times per day. 

·        Each time you see your PT your program will be changed to continue to decrease your symptoms and improve your balance.

·        You will be seen approximately every 3-4 weeks for about 6 visits. 

Why is it important to do Vestibular Therapy?

·        If you have a problem with any of the systems of balance, you are at risk for losing your balance and falling.  Vestibular therapy will help improve your balance.

·        Your symptoms of dizziness more than likely will not resolve without help.  Vestibular Therapy will help eliminate your dizziness.

·        The PT will teach you techniques to keep you doing the things that are important to you in your life. 

·        These symptoms do not have to slow you down and PT can help you get back to your normal life!

Bibliography

Vestibular Disorders Association: VEDA

Neil Bhattacharyya, MD et al. Clinical practice guideline: Benign paroxysmal

positional vertigo. Otolaryngology Head and Neck Surgery: 2008; 139:S47-S81.

Oya Topus et al. Efficacy of vestibular rehabilitation on chronic vestibular hypofunction. Clinical Rehabilitation: 2004;18: 76-83.