Vestibular disorders can be severe enough to require vestibular rehabilitation. Individuals who suffer from a disorder in their inner ear’s vestibular system may experience symptoms such as dizziness, inadequate balance, blurred vision, and more.
The vestibular system is one of the two parts of the inner ear. The human ear is made up of three sections: outer, middle, and inner. The middle ear consists of two parts: the cochlear and the vestibular sections. The cochlear section is responsible for receiving sound waves and converting them into neural messages. The vestibular section of the ear plays a role in balance and has a direct connection to the cerebellum. The vestibular section is primarily involved in maintaining the balance of the head. When this system is disrupted, an individual cannot maintain proper balance. These disorders are more commonly observed in older adults. Some may assume that the vestibular system isn’t important, but dysfunction in this area can lead to symptoms like dizziness, imbalance, impaired hearing, blurred vision, nausea, and other issues. Therefore, it is crucial to treat any disorders in this part of the body.
Individuals who have a vestibular disorder can benefit from vestibular rehabilitation therapy (VRT) to treat the disorder and restore their health. The foundation of vestibular rehabilitation is exercise. Proper and moderate physical activity can stimulate the vestibular system, and over time, individuals will experience a reduction in symptoms. However, it’s important to note that many individuals may not fully recover, and the vestibular dysfunction may persist. Rehabilitation exercises can make individuals feel better and stimulate the vestibular system to work more actively. In some cases, the vestibular system may not be the issue, and symptoms like dizziness, blurred vision, etc., may actually stem from the cerebellum, eyes, or other systems. The primary goal of vestibular rehabilitation is to reduce the symptoms of vestibular dysfunction and compensate for any deficiencies through other senses.
There are several methods for vestibular rehabilitation, and some individuals may find relief with just one of these methods, while in other cases, all three methods might not improve the individual’s balance. Vestibular issues vary from person to person, and treatment methods will differ accordingly. Below, we will explain three vestibular rehabilitation methods.
The most important sense for humans is vision. The vestibular system plays a role in coordinating eye movements and maintaining correct vision. In some cases, vestibular disorders can interfere with vision as well. In these cases, vision stabilization techniques are used to help individuals improve their vision. Various exercises are performed to stabilize vision. Some movements aim to replace touch and vision in performing vestibular functions. One of the essential exercises in vision stabilization for individuals with vestibular disorders involves staring at an object at a distance, either close or far. This exercise stimulates the vestibular system and encourages it to function over time. In this rehabilitation method, the individual with vestibular dysfunction should look at the object from various angles and focus on it. When the individual stares at an object from different angles and varying distances, the vestibular system is activated, trying to synchronize the eyes and form a clear image. As mentioned earlier, vestibular dysfunction may be so severe in some cases that it is not fully treatable, and only compensations using other senses, such as touch, can be made.
Another common issue for individuals with vestibular dysfunction is balance problems. In some cases, the problem is so severe that the individual cannot even stand on their own. In these situations, vestibular rehabilitation techniques can improve balance or even completely resolve balance issues in some cases. Balance exercises should be performed in a controlled and safe environment, as the patient may lose balance at any moment and fall. Therefore, the exercise environment must be designed to prevent any harm to the individual. Walking is one of the most common balance exercises and can be done on both flat and uneven surfaces. There are various exercises focused on balance and vestibular rehabilitation, which concentrate on activities such as walking, standing, sitting, bending, spinning, holding objects, etc. These exercises can help the individual recover quickly and reduce the symptoms related to vestibular disorders that affect balance. Benign Paroxysmal Positional Vertigo (BPPV) is a serious condition, and individuals who have this disease should avoid balance exercises as they may not be able to participate or perform them safely.
Habituation is another method of vestibular rehabilitation. The main goal of this method is to treat dizziness, particularly in individuals who experience dizziness when making quick movements. In this technique, patients are asked to perform the movements that cause dizziness at a slow pace initially. The patient repeats the exercises until dizziness is no longer triggered, allowing them to perform the movements slowly without issues. Once the patient has mastered the movements at a slow pace, they should gradually increase the speed. Performing the movements at a higher speed can improve concentration and body balance, reducing the intensity of dizziness during these movements.
Vestibular rehabilitation is typically done on an outpatient basis, although in some cases, it may be performed in a hospital. Patients are visited by a licensed physiotherapist or occupational therapist with advanced qualifications. Vestibular rehabilitation begins with a comprehensive clinical examination. This examination includes collecting a detailed history of the patient’s symptoms and how those symptoms affect their daily activities. The specialist records the type and severity of the symptoms and discusses how to expedite recovery. Additionally, information about medications, vision or hearing problems, other medical issues, history of falls, current and previous activity levels, and the patient’s living conditions are gathered. The examination also includes various tests to evaluate the patient’s issues. The specialist tests the vestibular and visual systems to assess how well eye movements are controlled. Tests evaluate sensation (including gathering information about pain), muscle strength, the severity and range of rotational movements, coordination, posture, balance, and walking ability. A personalized exercise program is created based on the findings from the clinical examination, laboratory test results, imaging studies, and information provided by the patient regarding their rehabilitation goals. For example, an individual with benign paroxysmal positional vertigo (BPPV) may benefit from positional exercises, while someone with visual instability and dizziness from inner ear inflammation may be prescribed vision stabilization exercises and habituation techniques. If dizziness affects balance, balance exercises may also be included.
An essential part of vestibular rehabilitation is establishing an exercise program that can be regularly performed at home. Agreeing to the home exercise program is vital to achieving the rehabilitation goals and improving the patient’s condition. Along with the exercises, patient and caregiver education is an integral part of vestibular rehabilitation. Many patients find it helpful to understand the underlying issues related to vestibular dysfunction and how they impact daily life. A specialist can also provide information on how to address these problems and discuss what can be expected from vestibular rehabilitation. Educating patients is important as it helps demystify their experience, which can alleviate the anxiety that may result from their vestibular disorder.
Learning vestibular rehabilitation exercises is not difficult, but to achieve the maximum benefit, patients must be committed to performing them regularly. Sometimes, these exercises may feel exhausting. Therefore, it is important to set up a consistent routine in which the exercises are integrated into the patient’s daily life. Initially, the exercises may seem to worsen the symptoms. However, over time and with consistent effort, the symptoms should gradually decrease. This means that participating in daily life activities will become easier for patients.
Several factors can impact the potential for recovery when patients undergo vestibular rehabilitation. For example, the type of vestibular disorder plays a significant role in recovery. Patients with stable vestibular disorders like inner ear inflammation have the best chance of experiencing significant symptom relief. However, when patients have progressive vestibular disorders, such as multiple sclerosis (MS), or conditions with fluctuating symptoms like migraines or Meniere’s disease, it may be more challenging to achieve full recovery. Thus, success in vestibular rehabilitation will be harder to attain in such cases. To improve the chances of successful vestibular rehabilitation for patients with progressive or fluctuating disorders, medical management of these conditions is crucial. Patients with vestibular migraines may benefit more from vestibular rehabilitation by employing behavioral changes (reducing migraine triggers and participating in cognitive behavioral therapy) or using medication to reduce or eliminate migraine attacks. Although vestibular rehabilitation does not treat the dizziness attacks experienced by migraine patients, if these attacks are reduced through diet and medication, or if a more invasive intervention is identified, vestibular rehabilitation can help reduce symptoms that occur between attacks.
In conclusion, vestibular rehabilitation therapy (VRT) is an effective way to treat or improve the condition of individuals suffering from vestibular dysfunction in the inner ear. It’s important to note that vestibular rehabilitation may not be effective for all patients or may take a long time to show results. I hope you have found this therapeutic exercise content helpful, and feel free to share it with those who may benefit from it. For more valuable content, you can visit the Sports World section of SaadNews. Thank you for your time and support!
