Many patients who suffer from dizziness and/or imbalance receive tremendous benefit from a special type of physical therapy known as vestibular rehabilitation. Specific medical disorders that may benefit from vestibular rehabilitation include:
Vestibular Rehabilitation Therapy (VRT) has evolved significantly over the past two decades and much evidence-based knowledge as to what specific exercises are best for the various different types of vestibular disorders is now available. For example, the types of vestibular exercises that might benefit a patient with a unilateral (one inner ear nerve affected) vestibular loss are quite different than the types of vestibular exercises that might benefit a patient with bilateral (both inner ear nerves affected) vestibular loss.
Unfortunately, most physical therapy programs to not include much training regarding vestibular rehabilitation, therefore very few physical therapists are skilled in providing vestibular rehabilitation therapy (VRT). The physical therapist at BalanceMD, Stephanie Ford, PT, has completed additional vestibular rehabilitation therapy training through Emory University in Atlanta, GA, where a rigorous competency course in vestibular rehabilitation, directed by Susan Herdman, PhD, is offered once yearly. Stephanie Ford also has extensive experience in treating patients with vestibular system disorders as she evaluates and treats patients with dizziness, vertigo and imbalance on a daily basis, and has been doing so for many years.
Why is therapy needed?
If the brain cannot rely on the information it receives from the vestibular system, a person’s ability to maintain posture and coordinate balance can become overly dependent on vision or on the information received from the muscles and joints (proprioception).
This can lead to developing new patterns of movement to compensate for the change and to avoid head movements that are apt to create symptoms of dizziness and nausea.
Unfortunately, these types of adaptation can result in headache, neckache, muscle stiffness, general fatigue, and a decrease in the ability to retrain the brain to adjust to the vestibular problem, hence making the symptoms much worse.
Goal of Vestibular Rehabilitation Therapy
The goal of VRT is to retrain the brain to recognize and process signals from the vestibular system in coordination with information from vision and proprioception. This often involves desensitizing the balance system to movements that provoke symptoms. Please note that in order to receive maximum benefit from vestibular therapy, certain medications, such as meclizine (Antivert), diazepam (Valium) and promethazine (Phenergan), must be discontinued, as these types of vestibular system suppressant medications will prevent the brain from adjusting/adapting appropriately to the vestibular rehabilitation exercises.
What happens during vestibular therapy?
A qualified therapist will first perform a thorough evaluation and develop an individualized treatment plan that will include exercises to be performed both in the therapy department and at home that combine specific head and body movements with eye exercises. Treatment may also include increasing activities and exercise in order to strengthen muscles and increase tolerance for certain stimuli.
How does therapy help?
In most cases, balance improves 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, vestibular therapy is so successful that no other treatment is required.
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Stephanie Ford, PT
Vestibular Rehabilitation Therapy