Vestibular Rehabilitation

Dizziness, vertigo, visual disturbance, and/or imbalance are a cluster of impairments known as vestibular disorders; collectively they can diminish quality of life and impact all aspects of daily living. People with vestibular disorders often experience problems such as nausea and/or vomiting, reduced ability to focus or concentrate, and fatigue. This dysfunction can have a major impact on quality of life because the symptoms frequently cause people to adopt a sedentary lifestyle in order to avoid bringing on, or worsening, dizziness and imbalance contributing to emotional problems such as anxiety and depression.

Photo by Wavebreakmedia/iStock / Getty Images
Photo by Wavebreakmedia/iStock / Getty Images

The long-term negative consequence is decreased muscle strength and flexibility, increased joint stiffness, and reduced stamina. Evidence has shown that vestibular rehabilitation can be effective in improving symptoms related to many vestibular (inner ear/balance) disorders.

One form of vestibular dysfunction is BPPV—Benign Paroxysmal Positional Vertigo. BPPV occurs as a result of displaced otoconia, small crystals of calcium carbonate, which are normally attached to the membrane in the inner ear. Trauma, infection, or even simple aging, can cause these crystals to detach from the utricle and collect within the semicircular canals of the ear. Simple head movements cause the misplaced crystals to move and overstimulate sensitive nerve hairs in the canals sending false signals to the brain causing dizziness and nausea.

The goal of vestibular rehabilitation is a repositioning procedure returning these crystals to the correct place stopping these false signals and the debilitating symptoms they can cause.  This repositioning is accomplished through the Epley maneuver, a series of head position changes that moves the crystals from the canal back to the utricle. Once in the utricle, the crystals re-adhere to their sticky matrix on the membrane and can eventually dissolve.