Vestibular...what does it mean? The vestibular system relates to the vestibule, which is known as the inner ear. How does that relate to physical therapy (PT) though? Well, our inner ear is responsible for our balance and sensory orientation-- how we coordinate movement with balance. Equilibrium, the state of physical balance, plays a huge role in a movement efficiency. If we are not balanced, then we might fall over or overcompensate muscles or ligaments and injure ourselves. This is also why it is more commonly known as vestibular rehabilitation therapy (VRT). It is essentially a combination of orthopedic and neurological physical therapy to reach the patient's functional goals.
A few dysfunctions treated by these PTs can include dizziness, imbalance, spacial
disorientation, benign paroxysmal positional vertigo (BPPV), and vestibular neuritis. All of these dysfunctions essentially relate to the ability or to balance on your own. If you can’t balance on your own then there is obviously a risk that you could fall and injure yourself. It has been recorded that about 90 million Americans have experienced dizziness in their lifetime, so these signs are common! Of course, it’s more common for elderly people to be at risk of falling due to a vestibular dysfunction, but younger patients are included in this population as well.
At your initial appointment, a physical therapist will evaluate your symptoms and review your medical history. Assessment will include balance/leg strength/flexibility, gait, visual stability and mobility, neck mobility/strength, and positional testing (including an inner ear exam). Based on the findings, your PT will develop a program for you to follow. Based on the initial evaluation conducted by the PT, lab tests, and imaging studies a unique exercise plan is developed for each patient. The goal of the treatment plan is to improve any dysfunctions, to eventually improve your ability to participate in everyday activities, and to decrease your chances for falling. Some of the general exercises may include: vision stability training, posture training, neck mobility, stretching exercises, balance retraining, etc. An example of a more specific type of exercise is gait stabilization. The aim of this type of treatment is to improve vision and the ability to focus on a stationary object while the head is moving.
Another example is canalith repositioning procedures (CRPs). The aim of CRPs is to treat patients with benign paroxysmal positional vertigo (BPPV). CRPs involve a sequence of head and upper body movements that may be able to alleviate any dysfunctions associated with the diagnosis. A vestibular rehabilitation program’s length can vary dramatically depending on the patient’s diagnosis, severity of symptoms, and individual reactions to therapy. Patients are typically seen 1 to 2 times each week for 6 to 8 weeks, while other patients may need treatment for a couple of months.
Overall, a vestibular PT treats patients just as any other PT, but they specialize in balance and sensory orientation. If you or someone you know is experiencing dizziness or lightheadedness due to an injury, it might be a good idea to seek VRT or check out TheVertigoDoctor.com run by Dr. Oak. Dr. Madison Oak is a vestibular PT and has all things vestibular on her site, from symptoms and diagnoses to treatment options such as the best exercises to alleviate your symptoms.
Sources:
https://vestibular.org/article/diagnosis-treatment/treatments/vestibular-rehabilitation-therapy-vrt/
