The vestibular system is both a sensory and motor system and therefore
plays many roles in postural control. Most importantly it controls your
body’s sense of position and motion, orients your trunk to vertical
and stabilizes your head during movement. Because of its characteristic
responsibilities vestibular system disorders can have a large impact on
balance, headaches, dizziness and visual abnormalities. Vestibular disorders can be
acute, related to mild traumatic brain injuries (concussions), or BPPV,
stable, related to vestibular neuritis and acoustic neuromas,
progressive, including multiple sclerosis, or
fluctuating, including meniere’s disease. The more acute and stable a condition
is the better the prognosis for recovery but that doesn't mean the
other disorders cannot be treated. (5)
Physical Therapy has been shown to be an effective treatment for symptoms
including vertigo, dizziness visual abnormalities, and balance impairments.
Treatment of most Vestibular disorders is performed in 3 ways
· Habituation: if the symptoms increase with motion or visual stimuli
treatment consists of repeated exposure of the provoking movement to decrease
dizziness in a controlled manner.
· Gaze Stabilization: when your symptoms increase due to a visual
change or you have complaints of not seeing clearly or poor tracking of
objects when the head is moving treatment consists of eye fixation with
head movements. It can also include long term management with gaze stabilization
as a compensation for a permanent or extensively damaged vestibular system.
· Balance Training: if there are balance deficits associated with
your vestibular dysfunction we use objective testing to determine the
types of balance loss and treat with visual and somatosensory changes,
dynamic stabilization, movement strategies and dual task performance models.
Benign Paroxysmal Positional Vertigo (BPPV) is the most common vestibular
condition that is triggered by changing of head position. It occurs when
a particle of calcium carbonate crystals dislodges and migrates to one
of the semicircular canals of the ear that it is not supposed to be in.
This leads to excitement of a nerve ending that will give your system
a false sense of movement of the body. The mismatching of information
from one ear compared to the other, what your visual system is seeing
or what your muscular system is feeling leads to a sense of vertigo or
dizziness. After specific manual testing your therapist can determine
what ear and more specifically what canal is being affecting and treat
the condition with a series of head and body movements that repositions
the crystals and usually within 1-7 treatments returns to full functional
With all complaints of dizziness it is important to see your Medical Doctor
and Physical Therapist if appropriate. After a thorough evaluation of
the history of your condition and objective measures, your Doctor of Physical
Therapy at ProFysio Physical Therapy will create a customized plan of
care to improve vestibular function, range of motion, strength, coordination
of musculature, static/dynamic balance limitations, and/or visual coordination
to thereby improve your quality of life, reduce your dizziness, and decrease
your risk of further injury.