Vestibular Rehabilitation Therapy

Vestibular Rehabilitation Therapy (VRT) is an exercise program created to help the central nervous system compensate for inner ear problems. The Vestibular system includes parts of the inner ear responsible for balance, pathways that lead to the brain and the brain regions that control balance and eye movement.

Disease, aging, and injury can all cause damage to the vestibular system. When the vestibular organs are damaged, the brain can no longer rely on them for information about balance and motion, often creating symptoms such as dizziness, vertigo, blurry vision, imbalance, difficulty concentrating, nausea, and inconsistent hearing. Often, after a few weeks, people recover on their own as their brain adapts with a process called vestibular compensation.

When vestibular compensation does not occur, the individual may become dependent on vision and muscles and joints (proprioceptive system), to maintain posture and balance. Often new patterns of head and body movement develop in an attempt to avoid dizziness and nausea. These strategies can exacerbate the symptoms and cause headache and fatigue.

VRT is used to help retrain the brain to manage the information from the vestibular organs, vision and the proprioceptive system (proprioceptive information tells us where our bodies are in space and how they are moving).

In the initial VRT session, a physiotherapist or occupational therapist will perform a full evaluation including medical history and analysis of posture, balance, gait and compensatory movements. Eye-head coordination may also be used to measure how a person’s eyes track an object.

An individualized treatment plan is developed with exercises involving the head, body and eyes. These exercises are performed at home and during therapy sessions. The goal is to retrain the brain to understand and process signals from the vestibular system and coordinate them with vision and proprioception.

Symptoms may worsen when the VRT program is started. However, sticking with the program and performing the exercises, will result in the body and brain sorting out the new pattern of movements and symptoms will diminish or disappear.

Consult a registered physiotherapist or occupational therapist for more information on vestibular rehabilitation therapy.