How Vestibular Rehabilitation Therapy is beneficial in reducing the severity of bouts of Vertigo.

Vertigo is often thought of as a sensation of spinning or turning and this is a very common type, but vertigo can actually be any false sensation of movement. Amongst many other things this may include a feeling of being pushed or a sensation that the body continues to move after it has stopped.

It is common for people to think that vertigo is a disease, particularly if they have been told that they have had vertigo. But it is actually a symptom. It may be caused by cardiovascular or neurological problems, but many cases of vertigo stem from a problem with the vestibular system – the part of the inner ear responsible for balance.

Vertigo can be a debilitating and dangerous condition, as symptoms such as nausea, dizziness, visual disturbance and headaches can diminish quality of life and impact all aspects of daily living. Vertigo also increases falls risk and the associated dangers of falls. Fortunately, exercise can assist to reduce and even completely remove vertigo symptoms.

The main technique to achieve this is Vestibular Rehabilitation Therapy. VRT is a specialised form of therapy intended to alleviate symptoms of vertigo. The goal of VRT is to promote compensation of other sensory systems such as the visual and somatosensory systems to substitute for the deficient vestibular system. For some, compensation can occur naturally but for those whose symptoms do not reduce, VRT can be used to promote compensation. VRT has 3 principle methods: Gaze Stabilisation, Habituation, and Balance Training.

Gaze Stabilisation exercises are used to improve control of eye movements so vision can be clear during head movement. These exercises are appropriate for patients who report problems seeing clearly because their visual world bounces or jumps arounds, especially when moving. Gaze Stability exercises consist of fixating the patients gaze on an object while they move their heads up and down, side to side and back and forth. The other Gaze Stability exercise consists of shifting gaze to different targets. These exercises use the visual and somatosensory systems as the compensatory mechanism. It is ideal for people with low to no vestibular function.

Habituation exercises aim to reduce dizziness through repeated exposure to specific movements and stimuli that provoke the patient’s dizzy spells. These exercises are designed to induce mild to moderate vertigo symptoms for the patient. The increase should only be temporary and should cease completely before continuing to other tasks. Over time the intensity of the symptoms should reduce as the brain learns to ignore the abnormal signals it is receiving from the inner ear.

Balance Training for vertigo is no different to regular balance training except that any onset of symptoms needs to cease before continuing exercise. They are used to improve stability while standing or performing ADLs. Exercises are designed to be specific to each patient’s needs. Being able to steady yourself and control your movements during a bout of vertigo reduces the risk of falls and falls related injuries.

An example of balance training to overcome the symptoms of vertigo.

At Restart, Duncan recently saw a 79 year old woman for 4 Medicare referred appointments to treat Vertigo. Upon presentation to the initial assessment, the client suffered dizziness and nausea with changes in motion and going from sitting to standing. After the 4 sessions performing VRT as well as being compliant with a home exercise program, the client no longer has any Vertigo symptoms and is amazed at how effective the interventions have been. This is a demonstration of the effectiveness of VRT for treating vertigo.

Reference: Yardley, L., Beech, S., Zander, L., Evans, T., Weinman, J. (1998). A randomized controlled trial of exercise therapy for dizziness and vertigo in primary care. British Journal of General Practice. 48, 1136-1140.