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Vestibular Rehabilitation Therapy is a specialized form of therapy intended to alleviate problems caused by vestibular disorders, primarily vertigo and dizziness, gaze instability, imbalance and falls.

Symptoms due to vestibular disorders can diminish quality of life and can impact all aspects of life from economic to social participation as well as can contribute to emotional problems, like anxiety and depression.

For most people who have a vestibular disorder, the deficit is permanent because the amount of restoration of vestibular function is very small. However, after vestibular system damage, symptoms can reduce and function can improve because of compensation. This occurs because the brain learns to use other senses (vision and somatosensory – body sense) to substitute for the deficient vestibular system. For many, compensation occurs naturally over time, but for patients whose symptoms do not reduce and who continue to have difficulty returning to daily activities, VR can assist in recovery by promoting compensation.

In your initial appointment, your physiotherapist will take a detailed history of your symptoms and review any relevant medical history, some examination also will be done as visual stability, oculomotor function, standing balance, stability with walking and neck mobility and tenderness. Treatment includes some exercises such as habituation exercises, gaze stabilization exercises, balance training exercises, eye movements, stretching and strengthening exercises and general fitness exercises. We also use the most recent evidence-based tools and modalities that will help you keep your balance.

The goal of VR is to use a problem-oriented approach to promote compensation. This is achieved by customizing exercises to address the specific problem(s) of each individual. Therefore, before an exercise program can be designed, a comprehensive clinical examination is needed to identify problems related to the vestibular disorder. Depending on the vestibular-related problem(s) identified, three principal methods of exercise can be prescribed: 1) Habituation, 2) Gaze Stabilization, and/or 3) Balance Training.

What are the types of exercises I will learn in a vestibular rehabilitation program?

Every patient’s vestibular rehabilitation exercise program is different from each other. This is not only because there are different types of vestibular impairments, but each type affects everyone differently. No two cases are identical. Our Cornerstone Dizziness Clinics are often see poorly functioning patients that were given generic exercise handouts or put through a general vestibular program. Once the patient’s specific impairments were considered AND proper changes to the exercise program introduced at the right time in their recovery, the patients reported improvements again.

Vestibular rehabilitation exercises allow for central brain compensation to occur, which realigns the function of your vestibular system’s impairments. This compensation can typically be divided into three categories
Adaptation
This is a process where nerve impulses in the brain are able to shift or “adapt” to the incorrect signals from the damaged vestibular system. This gradual shift allows your brain to recalibrate itself.
Habituation
This process allows you to gradually desensitize yourself to vestibular movement and stimulation if you are repeatedly exposed to it.
Substitution
This recovery principle uses other body functions or strategies to replace the missing vestibular function

Here are some examples of common vestibular exercises used in vestibular rehabilitation.

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