Vestibular rehabilitation involves treatment of symptoms of dizziness, vertigo, motion sensitivity, balance and postural control issues that occur due to vestibular dysfunction.
Common vestibular issues:
- Vertigo, dizziness, head spinning, light-headedness, dysequilibrium and associated diplopia.
- Benign Paroxysmal Positional Vertigo – canalathiasis, or cupulothiasis, posterior, or horizontal
- Vestibular neuritis and hypofunction (uni or bilateral)
- Persistent Perceptual Positional dizziness (PPPD)
- Cerebellar ataxia and dysequilibirum/ balance disorders
- Cervical instability, headaches, and associated vertigo and vestibular migraines
- Maldebarque, Oscillopsia, Labyrinthitis, Photophobia, Meniere’s disease
- Concussion and head trauma
- Acoustic neuroma or Schwanoma
- An ability to differentially diagnose a central vs peripheral cause for client’s vertigo with specialised FRENZEL video goggles and performing the HINTS exam
Vertigo & vestibular assessments incorporate:
1) Outcome measures: Dizziness Handicap Inventory, and ABC balance score
2) Oculomotor, Vestibular, positional, dynamic visual acuity tests, balance, gait testing and proprioceptive testing for the neck +/- auricular pressure testing.
Vestibular rehabilitation includes habituation training, gaze stabilisation for clients with reduced Vestibular Ocular Reflex, brock string training for vergeance insufficiency, balance retraining and core and hip stabilisation training for maldebarque & PPPD as well as canalith repositioning manoeuvres for clients with posterior and horizontal BPPV. For some people with cervicogenic vertigo- deep neck flexor stabilisation and gaze shifting exercises and suboccipital massage may also be needed.