VESTIBULAR PHYSIOTHERAPY

Vestibular Physiotherapy, also referred to as Vestibular Rehabilitation Therapy or VRT – is a specialized form of therapy intended to alleviate a variety of symptoms caused by vestibular disorders and dysfunction. Vestibular therapy is an evidence based approach designed to reduce vertigo and dizziness, reduce gaze instability, and/or reduce imbalance and fall risk as well as address any secondary impairments as a result of the vestibular disorder.

Unfortunately with most vestibular disorders, the deficit in the vestibular system is permanent. However, through vestibular rehab we can aim to decrease symptoms and improve function through neuro synaptic compensation and adaptation. Luckily the brain is very plastic, which means it has the ability to learn and use our other senses (vision and somatosensory – body sense) to compensate for the defective vestibular system. This compensation can occur naturally with time, however research has shown that vestibular rehab is very effective in assisting with recovery. It’s important to know that our brain is most plastic and best at learning these compensatory mechanisms early on after injury/illness. So it’s best to contact your vestibular physiotherapist sooner rather than later to maximize your recovery and return to daily activities as soon as possible. 

Your vestibular system is a sensory system that is responsible for providing your brain with information about motion, head position, and spatial orientation. Your vestibular system plays a key role in helping you to keep your balance as well as stabilizing your eyes, head and body during movement. 

The vestibular system includes the parts of the inner ear and brain that process sensory information involved with controlling balance and eye movements. If disease or injury damages these processing areas, vestibular disorders can result. Vestibular disorders can also result from or be worsened by genetic or environmental conditions, or occur for unknown reasons.

First and foremost vertigo is a symptom, not a diagnosis. Vertigo is the incorrect perception that you or the room around you is spinning or moving. People are often diagnosed with vertigo when health care providers don’t know what else to say, this is why finding a specialist is so important. Vertigo is a symptom of vestibular dysfunction (as well as other conditions). If you have vertigo, you know it, what a vestibular physiotherapist can help with is figuring out WHY you have vertigo! The journey to a diagnosis can be a challenging one, but we’re here to help and support you along the way. 

Anyone experiencing new or long standing dizziness or vertigo with head or body movements – ie. rolling in bed, doing burpees, looking up etc.

Anyone who has experienced a recent head or neck injury, or been in a car accident. 

Anyone experiencing an increase in falls or “near misses”. 

When you book your appointment your physiotherapist will send you an intake form to gather information about your symptoms, current triggers, past medical history and what you’re looking to gain from Vestibular Physiotherapy. You’ll be sent this form ahead of your first appointment to allow you time to complete it without triggering your symptoms or to have a friend or loved one help you. 

Your Initial Assessment will be approximately 40-60minutes long. During which your physiotherapist will ask a variety of questions about your current history to help inform which objective tests are most indicated. 

Based on the information you provide, your physiotherapist will assess any of the following: Vision, gaze stability, visual tracking, spatial awareness, specific positional testing and reflexes, neck mobility and strength, gait, and balance. 

Your physiotherapist will then provide you with a summary of their findings, hands on treatment as indicated, education and exercises for you to do at home as well as an outlined treatment plan for going forward. 

The answer to that question is “it depends”. Something like BPPV can often be treated in as little as 1-2 sessions. The literature is saying 4-6 weeks on average to treat labyrinthitis or neuritis. While more chronic conditions like Post-Concussion Syndrome (PCS) or VM can take 4-6 months. 

A common vestibular disorder that causes sudden, short term (up to 1 minute) vertigo triggered by head position changes, as a result of displaced crystals (otoconia) within the inner ear. BPPV can be very scary, but luckily it is easily treated! 

Also referred to as a mild Traumatic Brain Injury (mTBI), is the result of direct trauma to the head OR rapid acceleration-deceleration of the head (ex. whiplash injuries). Trauma to the brain can result in abnormal vestibular system function and should be assessed by a VRT specialist. 

Vestibular disorders resulting from an infection that inflames the inner ear or the vestibulo-cochlear nerve. Neuritis results in dizziness but does not affect hearing, where as labyrinthitis results in both dizziness and hearing changes.  

A vestibular disorder that produces a recurring set of symptoms as a result of excessive fluid (endolymph) collecting in the inner ear. The exact cause of Ménière’s disease is not known. The four classic symptoms are vertigo, tinnitus (ringing in the ear), a feeling of fullness or pressure in the ear, and fluctuating hearing.

Approximately 40% of individuals with migraines have some accompanying vestibular syndrome causing imbalance and/or dizziness.  A large portion of individuals with migraines actually have no head pain and instead their predominant symptom is vertigo. VM requires a multidisciplinary approach including a combination of medical management and comprehensive testing and rehab.