What is Vestibular Rehabilitation and Balance Retraining?
A movement/exercise approach with the goals of:
Decreasing or eliminating dizziness/vertigo
Improving balance function and safety
Improving visual motor control and tolerance of motion
Increasing activity levels
Reducing falls or risks for falls
What are the Symptoms of Inner Ear Vestibular Pathology?
Visual motor disturbances/nausea
Because the vestibular system interacts with so many other parts of the nervous system,
secondary symptoms of memory problems, muscular stiffness/imbalance/weakness, fatigue,
headaches and anxiety may be experienced.
What are some of the Causes of Inner Ear Vertigo and Imbalance?
Benign positional vertigo
Who would benefit from vestibular rehabilitation and balance retraining?
Persons suffering from vertigo and imbalance that do not demonstrate a spontaneous
resolution of symptoms within 3-4 weeks.
What is involved in the therapy?
A thorough evaluation process is conducted to determine a comprehensive problem list
affecting the person's ability to function. 4 main areas are addressed:
Visual Motor Assessment - measured by infrared video goggles and visual
Balance Assessment - measured by standardized tests and a computerized
Specific goals for the patient are developed and the exercise/movement program is
* Vestibular habituation/adaptation exercises:
Specific movements or positions that provoke the patient's dizziness are provided and
the patient is asked to repeat these movements until the brain habituates the response or
adapts to the conflicting information. This process resolves the conflict between the
brain and the ear.
* Visual motor exercises:
The ear nerve has a connection that goes to the eye muscles and can affect the person's
ability to maintain their gaze and focus. If dysfunction is identified in this mechanism,
visual motor exercises for gaze stabilization and eye-head coordination are included.
* Canalith Repositioning Procedures for Benign Positional Vertigo:
A specific maneuver involves moving the patient's head in a sequence of
positions for a certain time period in order to move the "ear rocks" or otoconia
around the semicircular canals to reposition them into the proper place in the inner ear. This
procedure is 95% effective in eliminating benign positional vertigo in 1-4 visits.
* Balance retraining exercises:
Exercises designed to improve coordination of muscle responses as well as the
organization of sensory information from eyes, ears and tactile/muscle receptors for
balance control (measured by a computerized forceplate).
Patients are typically seen on an outpatient basis once every 1-2 weeks and provided a
specific daily home program that is upgraded as appropriate. This program
addresses the specific
problems and goals of the individual patient.
* Outcomes of Vestibular Therapy at the Atlanta Ear Clinic
Benign Positional Vertigo 95%
Vestibular neuronitis 75%
Disequilibrium of Aging 85% (N=500, includes fall reduction)