Vestibular Rehabilitation Therapy (VRT)

‘Restore equilibrium and balance in life again’

 Vestibular rehabilitation therapy (VRT)

Vestibular rehabilitation therapy (VRT) is treatment for vestibular disorders, evidence has shown that VRT can be effective in decreasing symptoms from many vestibular disorders.  Vestibular disorders commonly cause dizziness, vertigo, and balance problems.  These symptoms occur when there is a mismatch or deficit in information from the vestibular system to our brains.  Other symptoms including nausea/vomiting, deceased memory, concentration problems, and anxiety are secondary symptoms.  

Specific postgraduate training is required for physiotherapists to treat vestibular conditions, this is something Ann has started doing and is planning on completing further advanced training.

Causes

There are various causes of vestibular problems, common ones include Benign Paroxysmal Positional Vertigo (BPPV), labyrinthitis, meniere’s disease, and vestibular neuritis.  Vestibular issues are also associated with neurological conditions and migraines. 

What is vestibular rehabilitation therapy (VRT)?

A healthy balance system is one where the brain is able to process all of the information from our inner ears, eyes, muscles and joints (proprioceptive information) to enable us to maintain effective equilibrium and see clearly when moving our heads. When the vestibular system is not working well the brain gets a mismatch or deficit in information which creates symptoms.  The brain needs to relearn and adapt, this can happen automatically over time but when it doesn’t specific VRT is needed.  VRT is an exercise based programme aimed at retraining the brain to effectively recognise and process information from the vestibular system in coordination with vision and proprioception.  

A detailed clinical assessment is performed for vestibular rehabilitation, this usually includes assessment of posture, balance, movement, eye movements, a test for benign paroxysmal positional vertigo (BPPV), and compensatory strategies.  You will be provided with education & advice along with an individualised exercise programme.  The exercise programme may include specific head and body movements, eye exercises, balance and walking exercises, or specific exercises to reposition fragments in the inner ear (BPPV) if this is deemed necessary after having done a manoeuvre for this in clinic.  General exercises for strength and overall fitness may also be included. 

Initially there can be an increase in symptoms until things start to desensitise and the brain adjusts to the new patterns of movement.  But with time and regular repetitive effort the systems will start to coordinate more effectively together improving symptoms and function.

Evidence has shown that vestibular rehabilitation can successfully change dizziness and balance problems.