Vestibular issues including balance retraining

Physiotherapy plays a central role in treating vestibular disorders, including balance retraining. The goal is to reduce dizziness, improve balance, and help the brain adapt to inner ear changes. Here’s how physiotherapists approach this:

🔄 1. Vestibular Rehabilitation Therapy (VRT)

A specialized form of therapy that uses exercises to address:

✅ Habituation

  • For people who get dizzy with movement or visual stimuli.

  • Repeated exposure to motion that provokes symptoms reduces sensitivity over time.

  • Example: Rapid head turns while focusing on a stationary object.

✅ Gaze Stabilization

  • Improves control of eye movements so vision remains stable during head motion.

  • Common exercises:

    • VOR x1: Head moves side-to-side while focusing on a stationary target.

    • VOR x2: Both head and target move in opposite directions.

✅ Balance Training

  • Targets improvement in steadiness and coordination while standing, walking, or changing positions.

  • Exercises are tailored to the individual’s needs and may include:

    • Static standing on different surfaces (firm, foam, eyes closed)

    • Dynamic walking (turning, head turns, uneven surfaces)

    • Dual-task training (e.g., walking while counting)

🧠 2. Compensation Strategies

  • The brain learns to use other senses (vision, proprioception) to compensate for inner ear deficits.

  • Therapists may guide patients in relying more on visual cues or tactile feedback.

🪜 3. Functional Training

  • Reintegrates balance and vestibular control into daily activities.

  • Can include stairs, bending, reaching, and community navigation.

🧍‍♀️ 4. Fall Prevention

  • Assessment of fall risk

  • Home safety modifications

  • Education on safe movement techniques

📋 5. Individualized Exercise Plan

Based on thorough assessment:

  • Eye-head coordination

  • Gait and balance

  • Motion sensitivity

  • Functional mobility

Common Conditions Treated:

  • Benign Paroxysmal Positional Vertigo (BPPV) – treated with repositioning maneuvers like Epley

  • Vestibular neuritis or labyrinthitis

  • Meniere’s disease

  • Bilateral vestibular loss

  • Post-concussion vestibular dysfunction

⏱️ Timeline for Improvement

  • Most patients show improvement in 4–8 weeks of consistent therapy.

  • Early intervention often leads to better outcomes.