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Vestibular Rehabilitation

Vestibular Rehabilitation is a program of specialised exercises designed by a trained vestibular physiotherapist. The exercises aim to reduce dizziness, vertigo, visual blurring and unsteadiness and ultimately help you to regain control.

Recovery from a vestibular problem requires the remaining intact components of the vestibular system and the brain to compensate for the lost function caused by the vestibular problem.  Vestibular Rehabilitation encourages this process through different types of exercises:

  • desensitising (habituation) exercises help reduce or eliminate dizziness when you move your head e.g. when bending or turning around;
  • eye and head coordination (adaptation and substitution) exercises help to improve the fixation of your eyes on objects when your head moves, reducing visual blurring;
  • balance exercises challenge your balance in various ways to help improve your postural control when performing various tasks such as walking on gravel paths or reaching for an item on the top shelf.
Man doing an example of an eye-head coordination (gaze stabilisation) exercise, one type of exercise performed in a vestibular rehabilitation program.
Older woman balancing walking tightrope.

Some individuals may also need to include strengthening exercises of their arms, legs and core (trunk) in addition to general fitness activities, into their vestibular rehabilitation program.

Vestibular rehabilitation also involves the assessment and treatment for benign paroxysmal positional vertigo (BPPV) which is a unique vestibular condition.

Education is provided to help you understand how the vestibular system works and how the vestibular problem you have is causing your symptoms.  Advice on how to manage the vestibular problem such as recommended lifestyle changes and how to pace the exercises and other activities is also included.

Understanding that everyone with a vestibular problem is different, the specialised vestibular exercises are tailored to you.  This requires a thorough assessment of the vestibular problem to help address your specific needs.

What you can expect when attending Blissful Balance Physiotherapy

  • Obtaining a detailed history of the problem and how it is impacting on you day to day.
  • A comprehensive functional assessment of the vestibular and balance systems.
  • A tailored exercise program targeted to your specific goals and education about your vestibular problem in addition to advice to help you manage the condition.
  • Liaising with your medical and other allied health professionals for additional investigations and/or treatment when required.
  • Regular review appointments and ongoing support to monitor your progress and updates to your home exercise program accordingly to ensure your goals are being achieved.

The time it takes to improve with Vestibular Rehabilitation will vary for each individual.  For some it can be achieved relatively quickly, for others it may take some time and effort.  Recovery can be influenced by a number of factors including how long someone has had their symptoms, stress/anxiety, or other medical conditions.  Age is NOT a barrier to benefiting from Vestibular Rehabilitation.

Older man and young boy balancing walking along a kerb.
anatomical illustration of inner ear vestibular organ and cochlea, otoconia in utricle and saccule, otoconia from utricle displaced into semicircular canals causing benign paroxysmal positional vertigo.

BPPV is a unique vestibular condition.  It is a mechanical problem where the otoconia (calcium carbonate crystals) that are part of the otolith organs have become free either due to age, disease or trauma.  The otoconia are weighted and travel into one of the semicircular canals when the head changes position relative to gravity e.g. when bending forward or rolling over in bed, triggering vertigo.

Diagnosis of BPPV is achieved with positional tests that are performed during an in-rooms consultation.  A positive test will reproduce vertigo in addition to determining which canal the otoconia are in and if they are freely floating (canalithiasis) or stuck (cupulolithiasis).  BPPV requires treatment with repositioning manoeuvres to relocate the otoconia back to the vestibule where the otolith organs are, resulting in resolution of the positional vertigo.

Individuals who present with BPPV can be taught to do the appropriate repositioning manoeuvre as a home exercise.  If there is any motion-induced dizziness or unsteadiness persisting after successful treatment of BPPV then further Vestibular Rehabilitation is required.