Vestibular rehabilitation involves the treatment of patients with vertigo (the feeling that the room is spinning), dizziness, and results in poor balance. Vestibular disorders that can be assisted with physical therapy can be broken down into three categories: positional vertigo, peripheral vestibular injury (inner ear), or central vestibular injury.Positional vertigo: Position vertigo [also known as Benign paroxysmal positional vertigo (BPPV)] occurs when crystals called otoconia inappropriately float around in canals within your inner ear causing the sensation of vertigo (room spinning). Treatment consists of the Epley maneuver or Canalith Repositioning treatment or other maneuvers to assist with returning the crystals to their appropriate location in the inner ear. Treatment is specific to the canal involved and usually this condition is resolved with 3 treatment sessions.
Peripheral vestibular injury: This can occur in one or both sides leading to vertigo and a sense of being off balance. A patient will commonly have vertigo or dizziness when moving his/her head quickly to one side, moving quickly in general, changing positions quickly, and may have difficulty focusing on words while he/she is reading. For peripheral injuries, we work on adaptation exercises (allowing the brain to adapt to information from the balance senses) to decrease the sense of vertigo/dizziness and improve one’s balance. Our physical therapist will work on improving your balance to your limits of stability. With this diagnosis, it is imperative that a patient follow his/her home exercises program as repeated brain stimulation is required for adaptation to occur. Recovery is expected after 2-3 months of physical therapy attending 3 times per week.
Central vestibular injury: Occurs when one has spinal injury as in a stroke or spinal cord injury. In this case information does not reach the brain from the peripheral vestibular system resulting in dizziness. Exercises consist of habituation exercises to allow the brain to interpret normal movement as normal; thus, decreasing dizziness. The motion sensitivity quotient (MSQ) is used as a guide for prescribed exercises and as a baseline measurement of a patient’s motion sensitivity. Sample motions included in the MSQ are: lying on one’s back from sitting, rolling right and left from the back, etc… Recovery can be anywhere from 2 months to 6 months or more. A patient will be discharged with a home exercise program once he/she can independently perform more advanced exercises.
Jon M. Morrissette, DPT,MTC is certified in vestibular rehabilitation and is qualified to evaluate and treat patients with vestibular disorder. We have treated many patients successfully with vestibular disorders and would like to help you.
Call us as 704.504.2194 to set up an initial evaluation and take your first step towards decreasing your vertigo/dizziness.
We also offer a 15 minute free screen if you would like to talk to us prior to committing to treatment.