What is Vestibular Rehabilitation?
Vestibular Rehabilitation is the use of specific exercises and manual techniques to eliminate or reduce vestibular, balance and equilibrium problems and their secondary effects. During your initial assessment our specially trained Victoria Physiotherapist Jennifer Kolot will identify the exact circumstances that provoke your symptoms, for example rolling over in bed, turning your head to reverse the car, walking on uneven ground or in the dark. If appropriate you will be given an exercise program that has been designed to address your specific problems that were outlined in your initial assessment. There is one condition that does not require ongoing exercises, that is Benign paroxysmal Positional Vertigo or BPPV, which you can be treated by Jennifer.
Exercise programs usually involve repeated exposure to the circumstances which challenge your vestibular system until it’s response becomes more normal. That is, you no longer feel dizzy, nauseous, lose your balance or have blurred vision in those situations. This occurs due to a process called “vestibular compensation”. Our specially trained Kinesiologist Heidi Nottelman will create a custom exercise program for you. As you progress you will be challenged in different ways to continue to get the maximal benefits from your program.
Problems Arising From The Vestibular System
The Vestibular system consists of the semi-circular canals and the Otoliths (utricle and saccule- in the inner ear, on both sides of the head, as well as specific parts of the base of the brain (the brainstem) called the vestibular nuclei. Information from the inner ear travels along the vestibular nerves to the brainstem. This information is analysed and the brain responds by sending messages along nerves to the muscles of the limbs, body and eyes. In this way the vestibular system is involved in the control of balance, and coordination of eye and head movements. This enables us to sit, stand and walk without falling, and to maintain clear vision, no matter the position or speed of movement of the head. Problems in one inner ear can lead to an imbalance in the information coming to the brainstem resulting in one or more of the following:
- Vertigo – the sense that you or the world is rotating
- Dizziness – various sensations including spinning or wooziness in the head
- Light headedness
- Blurred vision – often when moving your head
- Disequilibrium – the sense of being off balance
- Veering to one side when walking
- Falls Problems in the inner ear on both sides of the head are often more severe than those experienced by people with problems on one side only.
When only one side is affected the unaffected side can take over some of the role of the damaged side and compensate for the loss, resulting in minimal reduction in function.
However, when both sides are affected the vestibular system has difficulty functioning normally. As a result you might experience:
- Blurred vision when moving your head, walking or in a moving vehicle, this often results in: – objects in the distance appearing to jump or bounce – difficulty reading street signs – difficulty recognising peoples facial features at a distance this is known as oscillopsia
- Disequilibrium – the sense of being off balance
- Unsteadiness in standing or walking, especially with head movements, on uneven surfaces and in poorly lit or dark environments
In addition, secondary effects can develop, particularly in cases where the vestibular problems have been present for a while. These occur as a result of avoiding movements or activities that provoke your symptoms or make you feel unsafe. They can include:
- Stiffness and/or pain in the neck from restricting head or eye movements
- Headaches or eye aches
- Reduced fitness or stamina
- Inability or reduced ability to participate in recreational and sporting pursuits, or to perform certain work/home duties
Many patients have neck pain and headaches associated with their vertigo, dizziness or imbalance. Musculo-skeletal physiotherapy can provide some relief for these symptoms, however, if the problem is vestibular in origin then the neck pain and headaches are usually secondary problems. In this case treatment of the neck will not have a lasting effect and only resolution of the vertigo, dizziness or imbalance will achieve this.
Vestibular Physiotherapy is a specialized form of Physical Therapy that is focused on rehabilitation for problems with balance, vertigo, disequilibrium and chronic dizziness. Below are just some of the various ways Shelbourne Physiotherapy can help with vestibular conditions.
Vestibular Rehabilitation in Victoria BC
Vestibular rehabilitation is the repeated practice of certain activities or movements that cause mild dizziness symptoms and or unsteadiness. This regular training can allow the brain and body to adapt to a chronic dizziness problem or recover from acute vestibular damage. It utilizes neural plasticity, the ability of the brain to adapt itself, to promote stronger neural connections within the brain to better deal with vestibular information. It can also restore a persons confidence to move without fear of having a severe vertigo episode. It is appropriate for many forms of vestibular dysfunction and many of the exercises can be done safely at home. The most effective form of rehabilitation is an individually tailored program specific to the clients needs and goals. This is best formulated with a well-trained vestibular specialist such as Jennifer Kolot or Nina Bai
Canalith Repositioning Manoeuvres for BPPV in Victoria BC
This form of treatment is specifically for a particular type of dizziness disorder, Benign Paroxysmal Positional Vertigo (BPPV). BPPV is the most common cause of dizziness in isolation and many people who say they have had vertigo before will be talking about this problem. It is characterised by extremely violent sensations of spinning associated with certain head movements. The exact head movement depends on which inner ear canal is affected, and it is believed to be caused by calcium carbonate particles that alter the normal nerve activity within the inner ear. Whilst most BPPV does eventually settle by itself, physiotherapy can drastically speed the process along, with people often reporting an 80-100% improvement within the first one or two sessions. Sometimes BPPV can be a bit stubborn, but the good thing is that there is treatment for stubborn BPPV (cupulolithiasis) too.
Balance, Strength and Functional Training in Victoria BC
Balance and strength are so important for our ability to live the life we want. People can lose confidence in their ability to move and walk safely when they are suffering from a dizziness disorder. Jennifer Kolot is the ideal Physiotherapist to provide specific balance and strength training and address the issues of people suffering vestibular and mobility issues. A daily home strengthening and balance program can be created to help decrease falls, restore leg strength, improve walking safety and endurance, and probably the most important thing of all: Get you back doing the things you love.
Our Vestibular Physiotherapists are passionate about providing appropriate education to clients about their condition. Often they have had dizziness issues for months if not years without a proper diagnosis. Learning about your particular condition can set the mind at ease and restore your confidence in your body, and this is often the beginning of the recovery process.
Falls account for a huge percentage of total disability in older adults. As we age the risk of falling increases, as does the risk of serious complications from falls such as fracture, head trauma or other injury. Our Shelbourne Physiotherapists can give you important advice on how to decrease your risk of falls, minimize your risk of injury, and even teach you how to safely get up off the floor. Sometimes using an appropriate gait aid such as a walking stick or wheelie frame can get people back to their usual activities, our Physiotherapts can recommend appropriate aids and when it is best to use them.