Many people are affected by dizziness and balance disorders. The National Institute of Health has estimated that about 1 in 3 people will experience problems with dizziness or imbalance at some point in their lives. Dizziness can be a very scary and disabling symptom. It is important to know that you do not have to learn to live with dizziness, it can be treated.
What is vestibular rehab?
First, it is important to understand a bit about balance. We have three different sensory systems that help us maintain our balance.
Proprioception (sensors in our joints and muscles that tell our brain how we are positioned in space)
The vestibular system is located in your inner ear. It is made up of the vestibular nerve, three semi-circular canals, and two other organs (utricle and saccule) that sense movement and change in position of your head. Your vestibular system sends information regarding head position and movement to your brain. Your visual and proprioceptive systems also send inputs to the brain regarding balance and position. Your brain incorporates inputs from these three systems, and then sends signals to your body to maintain balance and posture. When there is a problem in the vestibular system, your brain gets mixed signals and is unable to provide your body with the proper feedback. This can result in many of the common symptoms of vestibular disorders, including: impaired balance, dizziness or vertigo, motion sensitivity, difficulty walking, difficulty concentrating, and difficulty seeing while moving your head.
The purpose of vestibular rehabilitation is to improve the brain’s ability to process the multiple inputs from your ears, eyes and joints. This is accomplished through a variety of exercises that include head/eye movement exercises, repeated position changes, strengthening and range of motion exercises, balance and walking exercises.
Who can benefit from vestibular rehab?
If you have symptoms of dizziness that are triggered by head movements, changes in position, or visual stimuli or if you experience unsteadiness or have fallen, vestibular rehab may be beneficial. The following are a list of conditions that may benefit from vestibular rehab:
Vestibular Neuritis or Labyrinthitis
Benign Paroxysmal Positional Vertigo (BPPV)
Migraine associated dizziness
Bilateral vestibular loss
Unilateral vestibular loss
What should you expect during your first vestibular rehab session?
You will meet with a skilled physical therapist, who is certified in vestibular rehab. They will ask you questions to get a detailed history of your symptoms. They will then perform a thorough assessment, which may include tests of position changes, mobility, posture, strength, balance, walking and vision to determine your specific limitations. The clinic uses state-of-the-art equipment including a computerized dynamic posturography device called the Smart Balance Master and computerized dynamic visual acuity testing software.
An individualized therapy program will be prescribed based upon the results of the assessment. It is important to realize that some of the exercises prescribed will initially make you dizzy. This is necessary to facilitate the compensation process. Emphasis is also placed on developing a regular exercise program which will speed up the rehabilitation process and maintain the improvements that you make once the therapy has ended. Vestibular rehabilitation can help to improve balance, decrease dizziness, and improve the ability to see clearly with head movements. Numerous studies have shown it to be effective in the treatment and management of dizziness and imbalance.
What is posturography?
Posturography identifies how well you use your different sensory inputs (visual, proprioceptive, and vestibular) to maintain your balance. You will be asked to stand on a special platform and maintain your balance under different conditions. Special precautions are taken to ensure your safety during testing. This information can be used to better understand your specific balance issues and develop an effective and efficient therapy program.
1) Vestibular Disorders Association: www.vestibular.org
2) Information about dizziness, balance and hearing: www.dizziness-and-balance.com
3) Neurocom International: www.onbalance.com/patient_info/index.aspx