Balance Management

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Vestibular Rehabilitation Therapy

If someone has a balance disorder, the brain cannot rely on the information that it is receiving from the vestibular system. A person’s ability to maintain posture and coordinate balance can become overly dependent on vision or on the information received from the muscles and joints (proprioception).

This leads to a compensatory pattern of movement to avoid the positions that are apt to create the symptoms of dizziness or nausea. For example, instead of turning the head to look right or left, a compromised individual will swivel their entire body, they might adopt an exaggerated hip sway as a method of balancing, or they may just always look down at the floor to avoid the swirling confusion of activity that occurs whenever they look up.

This method of adaptation usually results in headaches, neckaches, muscle stiffness, and generalized fatigue from “bracing” all of the postural stabilizing muscles to prevent falling. This also can decrease the brains ability to adjust to the vestibular problem, hence making the symptoms much worse over time.

The goal of Vestibular Rehabilitation Therapy (VRT) is to retrain the brain to recognize and process the signals from the vestibular system and coordinate the information from vision and proprioception. This often involves desensitizing the balance system to symptom provoking movements.

If VRT is needed, a balance center physical therapist will first perform a thorough evaluation to observe posture, balance, movement, and compensatory strategies.

Using this baseline data, the PT will design an individualized treatment program of exercises and specialized techniques to be performed during your therapy sessions. A home program will also be developed that combines head and body movements with eye exercises. Many times treatment may also include increasing the activities that bring on symptoms in order to strengthen the muscles through exercise and increase the tolerance for certain stimuli.

These exercises can exaggerate the symptoms at first as the body and brain are sorting out the new movement patterns. But evidence shows that with consistent work, these signals from the eyes, proproception and vestibular system will coordinate over time.

In most cases, VRT has been shown to improve overall balance awareness if the exercises are correctly and faithfully performed. The headaches, muscle tension, and fatigue will diminish with the learned postural techniques, and the symptoms of dizziness, vertigo and nausea will decrease or disappear entirely. In many instances, balance medications are no longer required for symptom control. VRT has been so successful that surgical intervention is no longer the only option.

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