Vestibular Therapy Hudson, Manchester, Merrimack, & Nashua, NH

Vestibular and Balance Rehabilitation Therapy

Feeling light-headed, dizzy, or off-balance affects many of us occasionally.  For those with Vestibular Disorders, these symptoms can be a frequent and often debilitating occurrence.

  • As many as 35% of Americans over 40 experience some form of vestibular dysfunction
  • 80% of Americans over age 65 experience dizziness

What is the Vestibular System?

The vestibular system helps detect head position and motion and it allows you to properly react when it senses changes to it. It is made up of 1) your two inner ear organs 2) the vestibular centers of your midbrain and cerebellum and 3) your peripheral vestibular nerves.

The vestibular organs in your inner ears are composed of three canals and two sacs filled with fluid which act like sensors that measure head rotation, forward/back and up/down motions, and head tilt. The vestibular nerve connects your inner ear organ to the midbrain and cerebellum towards the posterior of your brain. These vestibular nerves transmit the motion information from the inner ears to your brain for processing.

Your brain processes information from your inner ear organs along with information from other senses such as your vision, hearing, touch, joints, muscles, and tendons throughout your body. It then sends out nerve impulses to the muscles in your eyes, trunk, and limbs so that you react appropriately to maintain balance and eyes stay focused in each situation.

Problems in any part of the vestibular system occur when this information transmission is disrupted causing dizziness, headaches, vertigo, and an increased risk of falling.  

What is Vestibular and Balance Rehabilitation Therapy, also known as VRT?

Vestibular rehabilitation therapy (VRT) is a specialized form of physical therapy prescribed to treat and improve the symptoms caused by vestibular disorders. It often involves manual head maneuvers and/or a progressive program of exercises designed to reduce vertigo and dizziness, visual issues, and/or imbalance and falls.

After an injury to the vestibular system occurs, the central nervous system can compensate for reduced function of the inner ears. Essentially, the brain copes with the imbalanced signals coming from the vestibular system by learning to rely more heavily on alternative signals coming from other systems in the body to maintain vestibular balance. This can be achieved through various exercise strategies outlined below. When this central (or brain) compensation occurs, the patient’s symptoms can be alleviated and allow them to return to normal function.

Who benefits from Vestibular and Balance Rehabilitation Therapy?

Anyone feeling dizzy, off-balance, nauseous, or having a sense of spinning can benefit from Vestibular and Balance Rehabilitation.  Physical therapy can be a critical tool for most vestibular and balance issues.  Vestibular conditions that are successfully treated with physical therapy include:

  • Benign Paroxysmal Positional Vertigo (BPPV)
  • Vestibular Neuritis/Labyrinthitis
  • Unilateral Vestibular Hypofunction (UVH)
  • Vestibular Migraine
  • Persistent Postural Perceptual Dizziness (PPPD)
  • Mal de Debarquement (MdDS)
  • Cervicogenic Dizziness
  • Concussion Post Concussion Syndrome (PCS)
  • Meniere’s Disease
  • Neurological conditions (i.e. stroke, traumatic brain injury)
  • Vestibular deconditioning from aging or inactivity
  • and other vestibular conditions….

If you have not yet been assessed or diagnosed with a vestibular condition, common symptoms that can be helped with vestibular rehabilitation include:

  • Vertigo (sense of spinning)
  • General balance problems including dizziness or lightheadedness
  • Motion sickness
  • Nausea, vomiting, fatigue
  • Neck tightness, stiffness, and/or pain
  • Imbalance and difficulty walking
  • Headaches
  • Frequent falls
  • Vision issues (double vision, shaky vision with head movement, difficulty focusing, poor tolerance to screens)
  • Brain fog, difficulty concentrating, mild memory issues

How Does Vestibular and Balance Rehabilitation Therapy Work?

Vestibular and Balance Rehabilitation is a therapeutic, neurological, and exercise program managed by a vestibular trained Physical Therapist. CPTE’s Vestibular and Balance Rehabilitation programs are customized to meet individual patient needs. There are different types of vestibular impairments and each type affects everyone differently.  Each patient’s specific impairments are considered and the appropriate therapeutic interventions are introduced at the right time in recovery resulting in treatment success. 

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: The process by which the nerve impulses in the brain are able to “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 technique uses other body functions or strategies to replace the missing vestibular function.

Specific treatments protocols may include: 

  • Vision targeting, tracking, and stability training 
  • Gaze stabilization 
  • Habituation Activities
  • Repositioning maneuvers such as Epley and Modified Epley technique
  • Inner ear retraining
  • Coordination and proprioception neurological facilitation
  • Balance Training
  • Walking/gait activities and exercises
  • Neck mobility/stretching exercises
  • Postural Training
  • Ergonomic training

Your therapeutic program is best developed by a vestibular trained physical therapist who has identified your specific impairments and the challenges and limitations based on your lifestyle and occupation.

What outcome or type of recovery is expected from Vestibular and Balance Rehabilitation

  • Decreased risk of falling
  • Decreased dizziness symptoms
  • Decreased nausea or vomiting
  • Improved focus, concentration, and memory
  • Improved balance in sitting and standing
  • Improved ability to stabilize vision/gaze and track or focus on objects near and far
  • Increased mobility and strength
  • Optimized level of movement/function
  • Increased confidence in maintaining balance
  • Improved neck mobility, stiffness and/or pain
  • Less fatigue and improved sleep
  • Decreased anxiety and depression and better ability to cope with stress
  • Increased confidence to return to desired activities and hobbies

For more information or to schedule an evaluation, contact the Center for Physical Therapy and Exercise today at any of our facilities in HudsonManchesterMerrimackConcord and Nashua.