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VESTIBULAR REHABILITATION - NEW HOPE FOR DIZZINESS AND
IMBALANCE
Vestibular rehabilitation is a relatively new discipline that
has been designed to help people with dizziness and imbalance. A new application
of old ideas, vestibular rehabilitation (the word "vestibular" refers
to the "vestibule" of the inner ear, an organ which regulates one's
balance.) uses techniques from physical therapy and occupational therapy to
treat patients with vertigo and balance disorders. Assisted by a computerized
balance feedback machine, this type of therapy has been responsible for some
measurable improvement in about 90% of patients.
Dizziness is not only difficult to diagnose, it can be very
difficult to treat. Certain types of vertigo can be managed with diet or
medications. Some may require surgery, others may require the Canalith
Repositioning procedure (a nonsurgical cure for benign positional vertigo).
There are some forms of dizziness that neither surgery nor medications can help.
This may include people who have suffered head injury, spinal cord injury,
stroke, diabetes and other peripheral neuropathy patients, blindness and poor
vision and inner ear disorders such as labyrinthitis, Meniere's disease, and
postoperative brain tumor patients.
These diagnoses are what vestibular rehabilitation was
designed to treat. For example, if a patient suffers a stroke, or some sort of
nerve injury, physical and occupational therapy can train the patient to
compensate for his loss. Likewise, if a patient has lost components of his
balance system, he can be trained to regain balance using the remaining
components.
Once the diagnosis is made, a rehabilitation plan is
developed. Posture strategies and ideal head and body positioning are taught.
Exercises to strengthen each component of balance are performed.
Some of the rehabilitation is done with the aid of the
SwayMeter machine. The SwayMeter gives computerized feedback of a patient's
control of his or her center of gravity. If a patient's weight is centered too
far to the right, the computer can help adjust that center of gravity closer to
the left. The Balance Master can determine which direction a patient may tend to
fall and assign exercises to prevent falls in that direction.
 
One cannot expect bulging muscles after only one trip to the
gym. Likewise, Vestibular rehabilitation takes time. The exact regimen is
tailored individually to the patient, depending on the physical condition,
motivation and diagnosis of the patient. In general, therapy lasts 45 minutes
per session a few times per week and may take 4-8 weeks.
There is, of course, homework to do after each session.
Certain exercises suitable to the home environment are taught. Once patients
motivate themselves to stick to the program, they can experience dramatic
changes in their lifestyles.
Vestibular Rehabilitation may not work for everyone, however
in the 90% that it does affect, it is well worth the effort.
Who needs this treatment?
People who are have problems with vertigo or who have a sense
of imbalance. People who have suffered head injury, spinal cord injury, stroke,
diabetes and other peripheral neuropathy patients, blindness and poor vision and
inner ear disorders such as labyrinthitis, Meniere's disease, and postoperative
brain tumor patients may all be candidates. (People with Benign Positional
Vertigo should undergo the canalith repositioning procedure first since that can
be cured in one treatment.)
What is involved? How is it done?
The treatment procedures may vary depending on the specific
problem and the patient. Therapy is scheduled with our therapist on an
outpatient basis. Sessions last approximately 45 minutes and may be once, twice,
or even three times a week depending on the individual. It may take several
weeks to see any progress.
Is it painful?
No, but there may be a temporary worsening of the symptoms of
dizziness in the beginning. It requires dedication and hard work to overcome
this problem.
What is the success rate?
Success has been excellent. Over 90% of patients show some
level of improvement. Many are able to resume working and recreational
activities.
Have there been any complications?
It is very important to note that vestibular rehabilitation
may actually worsen the symptoms of dizziness and cause nausea before any signs
of improvement are seen. This is similar to the muscle soreness and pain one
experiences when beginning any new physical activity. No patients have reported
permanent worsening of their vertigo or balance.
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