Management of Bilateral Vestibular Hypofunction (BVH)

Goals of Interventions:

1. The patient will demonstrate improved stability of gaze during head movement.
2. The patient will demonstrate reduced subjective complaints of gaze instability.
3. The patient will demonstrate improved static and dynamic balance.
4. The patient will be independent in the proper performance of a home exercise program (HEP) that includes walking.
5. The patient will demonstrate enhanced decision-making skills regarding the performance of basic and instrumental activities of daily living.

Management of BVH

1. Gaze stability exercises 

1. Use of exercise 2, is not recommended for a patient with a BVH because this exercise may cause an excessive retinal slip.
2. But in patients with asymmetrical BVH, exercise 2 is useful.

Fig.1: Gaze stability exercises

2. Postural stability exercises.

3. Habituation exercises.

4. Specific Interventions for Abnormal Central Vestibular Function

1. Goals of intervention:
1. The patient will demonstrate enhanced decision-making skill regarding fall preventions and safety precautions to allow safe functioning within the home and community.
2. The patient will demonstrate enhanced decision-making skills regarding the use of compensatory strategies to assist in gaze stability.
2. The patient will be independent in the performance of a HEP that includes walking.
3. The physical therapy intervention for a central vestibular lesion at a level of brainstem likely will be similar to a UVH with the same expectations for recovery.
4. Gait and balance exercises
5. Habituation exercises