In this blog, I share the Key Points about Vestibular Rehab proven by research and found in the medical literature.
Vocabulary: Vestibular Rehab is short for Vestibular Rehabilitation. It is specialized physical therapy for the inner ear balance system, or the vestibular system. Exercises can include training for the inner ear, the brain, the sense of touch, the balance reflexes and the focus of your attention.
Vestibular Rehab: What You Need to Know
Key Point #1:
Undiagnosed Vestibular Problems (inner ear problems) can cause falls, even if they aren’t bad enough to cause complaints of dizziness or vertigo. One epidemiological study found that:
- One out of three US adults over 40 years old had a Vestibular Deficit upon clinical exam, with or without complaints of dizziness or vertigo.
- Dizziness in US adults over 40 years old had 12 times increased risk of falling within a year.
- Patients with sub-clinical vestibular dysfunction still had 6 times increased risk of falling but did not have complaints of dizziness.
- Sub-clinical means they are not actively complaining of dizziness or vertigo, but show a vestibular deficit when examined.
Most of these things can be improved or resolved with a proper vestibular rehab treatment.
Key Point #2:
All Older Adults should be Screened for BPPV during a Physical Therapy Clinical Exam due to Normal Aging of Vestibular System and high rates of falls in the elderly.
One study recommended: “Even if the older adult physical therapy patient does not present with a vestibular diagnosis or complaints consistent with it, it is recommended that the older adult always be assessed for BPPV during the clinical examination because of its prevalence.” (Oghalai, 2000).
Sadly, this is not happening for all older adults who are seen in physical therapy on a routine basis.
Key Point #3:
Specialized Physical Therapy, called Vestibular Rehab, is Recommended prior to Diagnostic Testing for people with dizziness and vertigo, due to the success rates.
Evidence-based BPPV Clinical Practice Guidelines published by the American Academy of Otolaryngology recommend a referral to a Vestibular Specialist for BPPV evaluation and treatment, prior to diagnostic testing for patients with vertigo and dizziness due to the prevalence of BPPV and the success rate of this conservative approach. (BPPV Guidelines, revised in 2017)
Key Point #4:
Vestibular Rehab improves balance even in people without Vestibular Problems.
Researchers have shown that balance and fall risk will improve with exercises to strengthen the vestibular system EVEN IN THE ABSENCE of a specific vestibular dysfunction. (Research findings by Courtney Hall, et al.)
Key Point #5:
There is a strong body of evidence supporting vestibular rehab physical therapy and its success for people with dizziness, vertigo, imbalance or chronic falls. Therefore, a consultation with a Vestibular Physical Therapist is HIGHLY recommended for anyone with dizziness, vertigo, imbalance or unexplained repeated falls.
You can find a Vestibular Specialist in your geographical area using the Provider Directory at the Vestibular Disorders Association. Be sure to find someone who claims they can perform “particle repositioning maneuvers,” which are required to resolve the most common vestibular disorder, BPPV.
Sometimes, people need 6-8 weeks of Vestibular Rehab Exercises after BPPV symptoms are ruled out or resolved for a full recovery, depending on the root cause of symptoms.
Disclaimer
This blog is provided for informational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.
Thank you for explaining how increasing the strength of one’s vestibular system can help them gain the balance they need to avoid falling. My grandmother has recently been having trouble accessing her bathroom by herself since she tends to lose her balance, and I would like to find a way to help her start walking again so that she can use the restroom while I’m at work. Maybe it would be best for me to find a rehabilitation service that can assist her.
My problem is dizziness but more importantly neck and head pain which is more of a problem as it is constant. The pain around the right side of the head to the temple and forehead. The neck pain is the most severe
Hi Peter,
This article may help you because I write about dizziness from the neck:
Cervicogenic dizziness or cervical vertigo
I am also publishing my first book on vertigo later this year, and I have a whole section on this topic because it is very common.
You say that this medication could also be harmful could specify a little in what ways it can be harmful
Hi Alfredo,
I encourage you to take all medications as prescribed by your doctor and discuss any concerns with your doctor.
I have written at least four blog articles on vertigo medications. I will link them up for you here:
Medications and Dizziness
Medications for dizziness and vertigo
Meclizine for Vertigo
Vertigo Medications
Also, in this video lecture, one of my colleagues discusses medications for vertigo.
I would love information about vertigo
Hi Mary Ann,
Well, you are in the right place for information on vertigo!
I have plenty of blog articles on this website.
I also have well over 100 blog articles on my other website.
You can enter key words or phrases in the search field at the top of the page at your convenience, to find articles I have written related to your area of particular interest.
I am also releasing a book on vertigo later this year.
You can join my mailing list here if you want me to email you occasionally with information about vertigo.
I hope that helps!