Dizziness, Vertigo & Vestibular Rehabilitation

What is the Vestibular System?

St. Catharines Physiotherapy centre LV P

Your vestibular system is responsible for integrating sensory stimuli and movement and for keeping objects in visual focus as the body moves. When your head moves, signals are transmitted to the labyrinth, which is an apparatus in the inner ear that is made up of three semicircular canals surrounded by fluid. The labyrinth then transmits movement information to the vestibular nerve and the vestibular nerve carries the information to the brainstem and cerebellum which are the areas of the brain that control balance, posture and motor coordination.

The vestibular system is made up of the parts of the inner-ear and brain that control balance. Therefore, damage to this system can lead to dizziness, difficulty balancing, and vision problems. If the damage to the system is permanent, the body can be retrained to compensate for the damage.

What is Vestibular Rehabilitation?

Vestibular Rehabilitation Therapy (VRT) consists of a set of exercises that encourage the brain and spinal cord to make up for balance or equilibrium deficits. These deficits are present due to inner ear or central nervous system disease or abnormality. VRT exercises will be designed specifically for you by your St. Catharines Physiotherapist at LV Physiotherapy who have specialized knowledge in this area. VRT is sometimes referred to as Balance Retraining Therapy.

A wide variety of disorders that cause dizziness or imbalance can be treated with VRT. Effectiveness of VRT depends on a proper diagnosis, the skill/training of the Physiotherapist developing your treatment plan, and how well you adhere to your exercise program.

The goal of VRT exercises is to encourage the brain and spinal cord to make up for any balance or equilibrium deficits that are present due to inner ear or central nervous system disease or abnormality. Essentially, patients teach their vestibular system to do one of the following:

  • Adapt to stimuli that is presented

  • Substitute other sensory pathways

  • Get used to the change in the vestibular signals sent to their brain so that they can manage their vestibular disorder and maintain a normal functioning life despite possible ongoing symptoms

In some cases, VRT can eliminate vestibular symptoms. However, this is unfortunately not always the case. Therefore, minimizing symptoms or frequency of symptom recurrence is considered a successful outcome of VRT.

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What Conditions Does Vestibular Physiotherapy Treat?

  • Benign Paroxysmal Positional Vertigo (BPPV)

  • Post-Concussion Syndrome

  • Persistent Postural Perceptual Dizziness (PPPD)

  • Vestibular Neuritis/ Labyrinthitis

  • Motion Sensitivity/ Sensitivity to Crowds

  • Unilateral/Bilateral Vestibular Hypofunction or Loss

  • Meniere’s Disease (Endolymphatic Hydrops)

  • Mal de Debarquement Syndrome (MdDS)

  • Migraine Associated Vertigo (Vestibular Migraine)

  • Labyrinthine Infarction

  • Cervicogenic Dizziness

  • Acoustic Neuroma

  • Dizziness and Imbalance following a CVA (Stroke) or other Central Nervous System Disorder

  • Poor balance as a result of aging or deconditioning

  • Dehiscence or Perilymphatic fistulas

  • Visual Vertigo

  • Ototoxicity

  • And More

What are Symptoms of a Vestibular Disorder?

Symptoms vary widely but could include:

  • Dizziness (constant or intermittent)

  • Vertigo

  • Light-headedness

  • Motion sensitivity

  • Impaired Balance/ Feeling unstable

  • Feeling of being pulled to or leaning to one side

  • Fear of falling/ increased risk of falls

  • Visual issues (shaky or unstable vision, difficulty looking at screens or focusing, blurred vision)

  • Nausea and/or vomiting

  • Cold sweats

  • Headaches or head pressure

  • Anxiety and/or Depression, difficulty with stress management

  • Mild cognitive issues (memory or concentration)

  • Tinnitus (ringing in the ears, whooshing, buzzing or pain/pressure in ear)

  • Hearing loss

  • Twitching eyes

  • Nystagmus

  • Fatigue

  • Anxiety

  • Depression

  • Panic attacks

***A physiotherapy assessment is recommended to determine the cause of dizziness and whether rehabilitation is appropriate.***

Vertigo vs. Dizziness?

Vertigo or dizziness are symptoms rather than a disease. Vertigo refers to the sensation of spinning or whirling that occurs as a result of a disturbance in your balance (Vestibular) system

Vertigo may be used to describe feelings of dizziness, lightheadedness, faintness and unsteadiness.

Vertigo usually occurs as a result of a disorder in the vestibular system (structures of the inner ear, the vestibular nerve, brainstem and cerebellum).

What Can I Expect at my Physiotherapy Assessment for Dizziness/Vertigo?

A detailed history of your problem is the most crucial information needed by your St. Catharines Physiotherapist to diagnose the cause of your vestibular disorder and to appropriately develop a treatment plan with VRT exercises. After listening to your subjective history of your symptoms your Physiotherapist at LV Physiotherapy will perform a Physical Examination.

The Physical Exam may include:

  • Balance Assessment

  • Gaze Stabilization

  • Eye Tracking

  • Neurological Scan

  • Reflexes

  • Special tests to determine the cause and appropriate treatment for your dizziness.

Depending on what your physiotherapist finds on their initial examination they may send you for a series of other tests to further determine the cause of your vestibular symptoms.

Physiotherapy Treatment for a Vestibular Disease/Condition may include:

  • Balance retraining

  • Positional vertigo manoeuvres

  • Vestibular rehabilitation/retraining

  • Visual tracking

  • Habituation exercises

  • Gaze stabilisation

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What is Benign Paroxysmal Positional Vertigo (BPPV)?

Benign paroxysmal positional vertigo or BPPV is a condition caused by displacement of tiny particles in the inner ear called otoconia. These otoconia are calcium carbonate crystals that are normally present in parts of our inner ear called the utricle and saccule which are responsible for informing our brain about where our head is in space relative to gravity.

The otoconia are normally held in place on top of a jelly like substance that has a large number of other hair-like structures penetrating into it.

A second part of the vestibular system is made up of 3 fluid filled tubes called semicircular canals. As their name indicates they are circular and align in various angles off of the utricle and saccule to sense the direction and speed of our head movements.

BPPV occurs when the otoconia break loose from the jelly material in the utricle and make their way into one or more of the semicircular canals.When this occurs, individuals experience episodes of sudden and severe vertigo (dizziness) when their head moves or is positioned in certain ways.

Common triggers of the vertigo or dizziness episodes including rolling over in bed, getting out of bed and lifting your head to look up.

BPPV tends to come and go for no apparent reason. An affected person may have attacks of vertigo for a few weeks, then a period of time with no dizziness symptoms at all.

Contact Us to Book an Appointment:

If you are searching for Vestibular Therapy in St. Catharines we can help. If your dizziness symptoms are holding you back from living a normal life, schedule an assessment at LV Physiotherapy today with one of our St. Catharines Physiotherapists.

Call: 905-682-5119