Balance and Vestibular Rehabilitation
Vestibular rehabilitation is an exercise-based therapy program used to treat balance and dizziness disorders. These disorders can result from damage to the vestibular system (part of the inner ear that helps to control balance) as a result of disease or injury. A focused exercise program can strengthen the body’s natural ability to compensate for balance problems and help patients improve their balance while decreasing their dizziness.
A therapist will perform a thorough evaluation of each patient and develop an individualized plan of treatment which may include:
- Habituation exercises: helping the body to decrease dizziness by repeated exposure to a stimulus
- Canalith repositioning maneuver: manual manipulation of head position to move the calcium crystals out of the semi-circular canals
- Balance and Gait training: helping the body to regain balance and a safe walking pattern through a variety of techniques
- Compensatory adaptations and strategies: teaching patients how to minimize risks and use other senses to replace the vestibular system if necessary
- Gaze stabilization exercises: helping the body to retrain the senses to overcome dizziness and balance problems
- Environmental and home modifications to reduce fall risk: changes to the patient’s surroundings to promote safety
- Individualized home exercise program: an exercise program the patient can do independently based on individual patient needs
What Diagnostic Tests are Performed?
A therapist trained in vestibular rehabilitation evaluates:
- Functional limitations: day-to-day activities a person is unable to complete
- Oculomotor function: eye movements/reflexes
- Gaze stability: the ability of the eyes to focus during head movements
- Static and Dynamic balance: the ability to balance with and without movement
- Positional testing: testing a patient’s response to a series of positions
- General Musculoskeletal exam: range of motion and strength of neck, trunk, upper and lower extremities
What are the Goals of Vestibular Rehab?
- Decrease frequency, intensity and duration of vertigo symptoms (dizziness, nausea, lightheadedness, etc)
- Improve balance and gait quality
- Increase independence in daily life, overall function and well-being
- Develop compensatory strategies for coping with dizziness, imbalance and anxiety
Who Will Benefit from Vestibular Rehabiliation?
There are a wide variety of conditions that can result in balance and dizziness problems. Some of the diagnoses which may benefit from vestibular rehabilitation include:
- Benign Paroxysmal Positional Vertigo (BPPV)
- Persistent/Positional Vertigo
- Poor balance/history of falls
- Motion sensitivity
- Migrainous vertigo
- Drug-induced ototoxicity
- Acoustic neuroma
- Post-surgical imbalance
- Meniere’s disease
- Perilymph fistula
What is Balance Rehabilitation?
Balance problems are prevalent in elderly fallers, patients suffering from neurologic disorders including Parkinson’s disease, multiple sclerosis, stroke and head injury, as well as those suffering from vestibular loss and dizziness problems. Risk factors associated with falls:
- Being older
- Difficulty with balance or walking
- Poor vision
- Leg or trunk weakness
- Pre-existing medical conditions including Parkinson’s disease, stroke or diabetes
- Use of an assistive walking device
- A past history of falls
Falls among the elderly are prevalent, dangerous, and can diminish their quality of life and independence. Approximately one in three seniors above age 65 will fall at least once this year, often with disastrous consequences. The most important thing a senior citizen can do to prevent falls is maintain a high level of physical activity. Physical therapists can help prevent falls via implementation of specific, individualized treatment plans including exercises and activities with an emphasis on strength, flexibility and proper gait.
Fall Risk Screening
Our Biodex Balance System SD can identify a potential fall candidate in just two minutes. The software compares the balance test results to age- and gender-dependent normative data consistent with the American Geriatrics Guidelines for Fall Risk Assessment. Once a client is identified as being at high risk for falls, the client’s physician will be contacted for a referral for further treatment as appropriate.