Vestibular & Neurological Rehabilitation

Vestibular Rehabilitation

For people with problems associated with dizziness and loss of balance

About 4 in every 10 people will suffer from dizziness at some stage in their life and it is important to get an accurate diagnosis so that conditions can be treated effectively.

Vertigo, dizziness, and imbalance are mostly caused by a disorder of the inner ear. This is where your vestibular system is situated. The role of your vestibular system is to assist you to maintain your balance and orientation. If the vestibular system is damaged due to disease, injury or ageing, vestibular disorders or balance difficulties can result.

Symptoms of a vestibular disorder

Symptoms associated with a poorly functioning vestibular system may vary in severity, duration and frequency depending on the condition. The term ‘vertigo’ describes a symptom and is not a condition. It describes a sensation of the true spinning of your environment and is associated with many conditions involving the vestibular system.

Symptoms can include:

  • Vertigo – a sensation of true spinning of your environment.
  • Dizziness/light headiness/disorientation
  • Loss of balance/disequilibrium/unsteadiness
  • Difficulty concentration and reading
  • Headaches
  • Light, sound or motion sensitivity
  • A fuzzy/muzzy head
  • Nausea
  • Fatigue
  • Neck pain
  • Sensitivity to busy environments such as supermarkets.

These symptoms can vary from being annoying to being very debilitating. They can have a large impact on your ability to function and the quality of your daily life. It is very common that people lose their confidence and report feelings of anxiety and low mood.

The most common vestibular conditions

  • Benign Paroxysmal Positional Vertigo (BPPV) – results when calcium carbonate crystals are dislodged from their resting place to a canal in the inner ear.
  • Vestibular Neuritis or Labyrinthitis – caused by a viral infection in the inner ear. Labyrinthitis results in hearing loss and this allows it to be differentiated from vestibular neuritis.
  • Migraine Vestibulopathy – a migraine with symptoms involving the vestibular system.
  • Meniere’s disease – a long-standing fluctuating condition that results in aural fullness, hearing loss, disequilibrium and vertigo.
  • Post-Concussion Syndrome – dizziness that persists beyond ten days after a head injury.
  • Cervicogenic dizziness – dizziness, lightheadedness and disequilibrium originating in the neck where pain or restriction is present. This is very common after a whiplash injury.
  • Acoustic Neuroma – a benign tumour on the vestibular nerve.

Treatment

Following a comprehensive assessment an accurate diagnosis is made. The assessment involves the use of video frenzel goggles, assessment of eye movements and balance. This allows the development of an individualized treatment plan for the condition identified.

Vestibular rehabilitation therapy involves an exercise-based programme for reducing the symptoms associated with poor balance and dizziness/vertigo. The main goal of vestibular rehabilitation is to improve the coordination of eye and head movements, balance and walking function. This treatment is evidence based and have been shown to yield great results for patients with vestibular disorders. It is very helpful post Vestibular Neuritis or Labyrinthitis, Migraine Vestibulopathy, Post-Concussion Syndrome and following a flare up of Meniere’s disease.

BPPV requires canalith repositioning therapy to remove the calcium carbonate crystals. Cervicogenic dizziness requires treatment of the cervical spine to release tight muscles and stiff joints along with training neck structures to sense where the neck and head are in space. A walking programme is supplied to each individual patient along with a static and dynamic balance programme to ensure they reach an age appropriate level of balance.

All treatments are one to one in a private treatment room and dedicated balance gym setting. You will be re-assessed both subjectively and objectively after each visit. Your feedback with regard to your symptoms is always most informative and patients are encouraged to keep a diary of their daily symptoms. This along with objective re-testing using measurement tools allows patient progress to be monitored. Exercises will then be progressed or altered as appropriate to meet individual needs. The number of appointments can vary depending on the presenting condition and each individual response to treatment.