What is Vestibular Physiotherapy?

• Benign Paroxysmal Positional Vertigo (BPPV): A condition characterized by brief episodes of vertigo triggered by changes in head position.
• Vestibular Neuritis: Inflammation of the vestibular nerve, leading to symptoms such as severe dizziness and imbalance.
• Labyrinthitis: Inflammation of the inner ear structures responsible for balance and hearing.
• Meniere’s Disease: A disorder of the inner ear that causes episodes of vertigo, hearing loss, and tinnitus.
• Concussion: Vestibular rehabilitation may be part of the recovery p
• rocess for individuals with vestibular symptoms following a concussion.

Post-surgical Vestibular Dysfunction: After certain surgical procedures involving the ear or brain, individuals may experience vestibular issues.

• Age-related Vestibular Decline: As individuals age, changes in the vestibular system may contribute to balance problems.

• Comprehensive Assessment: Physiotherapists conduct a detailed evaluation to assess the patient’s symptoms, medical history, and perform specific tests to identify the underlying vestibular issue.
• Canalith Repositioning Maneuvers: For conditions like BPPV, physiotherapists may use specific maneuvers to reposition displaced particles within the inner ear, alleviating vertigo.
• Gaze Stabilization Exercises: These exercises aim to improve the ability to maintain clear vision during head movements, helping reduce dizziness.
• Balance and Coordination Training: Targeted exercises to enhance balance, coordination, and stability.
• Habituation Exercises: Gradual exposure to movements or positions that provoke symptoms to help the brain adapt and reduce sensitivity to these triggers.
• Education: Providing information about the vestibular system, the nature of the disorder, and strategies for managing symptoms.
• Home Exercise Programs: Prescribing exercises and activities for patients to perform at home to reinforce gains made during in-clinic sessions.

Benign Paroxysmal Positional Vertigo (BPPV):

•  Strong Evidence: Vestibular physiotherapy, particularly canalith repositioning maneuvers (e.g., Epley maneuver), has strong evidence for the treatment of BPPV
  • Example:A systematic review published in the Cochrane Database of Systematic Reviews in 2014 concluded that canalith repositioning maneuvers are effective in treating BPPV.

Unilateral Peripheral Vestibular Disorders:

• Evidence of Effectiveness: Vestibular physiotherapy has been shown to be effective in improving symptoms and function in individuals with unilateral peripheral vestibular disorders, such as vestibular neuritis or labyrinthitis. 
  • Example:A systematic review and meta-analysis published in the Journal of Neurology in 2015 found that vestibular rehabilitation had positive effects on balance and dizziness in patients with vestibular neuritis.

 Ménière’s Disease:

• Limited Evidence: The evidence for the effectiveness of vestibular physiotherapy in Ménière’s disease is limited, and the role of physiotherapy may depend on the specific symptoms and individual factors.
  •  Example: Some studies suggest that vestibular physiotherapy may help manage symptoms such as imbalance and dizziness in individuals with Ménière’s disease, but more research is needed.

 Post-Concussion Syndrome:

• Emerging Evidence: Vestibular physiotherapy is increasingly being used in the management of post-concussion syndrome, with emerging evidence suggesting potential benefits for reducing symptoms such as dizziness and imbalance.
  •  Example: A systematic review published in the British Journal of Sports Medicine in 2018 found that vestibular rehabilitation had positive effects on symptoms in patients with persistent post-concussion syndrome.

 Central Vestibular Disorders:

• Limited Evidence: The evidence for the effectiveness of vestibular physiotherapy in central vestibular disorders (e.g., cerebellar disorders) is limited, and the approach may differ from that used for peripheral vestibular disorders.
  • Example: Vestibular rehabilitation exercises tailored to the specific needs of patients with central vestibular disorders may be beneficial, but more research is needed.

 General Balance and Fall Prevention:

• Evidence of Effectiveness: Vestibular physiotherapy, as part of a comprehensive program, may contribute to improvements in balance and reduce the risk of falls in older adults and individuals with balance impairments.
  •  Example: A systematic review and meta-analysis published in Physical Therapy in 2017 found that vestibular rehabilitation was associated with improvements in balance and fall risk in older adults.

Vestibular physiotherapy is often provided by physiotherapists with specialized training in vestibular rehabilitation. The goal is to help individuals with vestibular disorders reduce symptoms, improve their ability to perform daily activities, and enhance overall quality of life. The treatment approach is individualized based on the specific diagnosis and needs of the patient.