Vestibular Rehabilitation

Introduction

• Vestibular rehabilitation (VR), or vestibular rehabilitation therapy (VRT) is a specialized form of therapy intended to alleviate both the primary and secondary problems caused by vestibular disorders. 
• VR is an exercise-based program primarily designed to reduce vertigo and dizziness, gaze instability, and/or imbalance and falls.

Fig.1: Vestibular rehabilitation

Contraindications of Vestibular Rehabilitation

1. Vestibular rehabilitation is not appropriate for the unstable vestibular disorder (e.g., Ménière's disease, uncontrolled migraine, PLF, or unrepaired superior semicircular canal dehiscence).
2. Therapist's alert to:
1. Sudden loss of hearing
2. Increased feeling of pressure or fullness to the point of discomfort in one or both ears
3. Severe ringing in one or both ears.
3. The therapist must be observant for the discharge of fluid from the ears on the nose, which may indicate CSF fluid leak.
4. Patients with acute neck injuries may not be able to tolerate physical examination, CRM, gaze stability exercises.

Topics under Vestibular Rehabilitation

1. Interventions for Benign Paroxysmal Positional Vertigo (BPPV)
2. Interventions of Unilateral Vestibular Hypofunction (UVH)
3. Management of Bilateral Vestibular Hypofunction (BVH)