Vestibular Therapy

VESTIBULAR THERAPY

Feel like your world is off-kilter due to persistent dizziness or the inability to focus on objects? You are not alone. Millions of individuals with balance disorders struggle with daily activities many take for granted, like smoothly walking across a room or operating a vehicle. The specialized vestibular rehabilitation therapists at Neurability Therapy facilitate life-changing transformations for people battling imbalance issues stemming from inner ear disorders through tailored treatment plans fully customizing interventions to meet patients’ unique symptom profiles and activity goals.

WHAT IS THE VESTIBULAR SYSTEM?

The vestibular system is the body’s built-in balance and orientation system. It is located in the inner ear and works closely with the brain, eyes, and muscles to help you:

Maintain balance while standing, walking, or moving.
Stabilize your gaze and vision when your head moves.
Sense motion and spatial orientation (knowing where your body is in space).

Key Components of the Vestibular System

Inner Ear Structures

The semicircular canals detect rotational movements (e.g., turning your head side to side).
The otolith organs (utricle and saccule) detect linear movements (e.g., moving forward in a car) and gravity (tilting your head).

Vestibular Nerve: Sends signals from the inner ear to the brain about movement and position.

Brain Integration: The brain combines vestibular signals with input from your eyes and proprioceptors (sensors in your muscles and joints) to coordinate posture and movement.

VESTIBULAR CONDITIONS

Benign Paroxysmal Positional Vertigo (BPPV) — BPPV is a vestibular disorder caused by tiny calcium crystals (otoconia) becoming dislodged and moving into the semicircular canals of the inner ear. This disrupts normal balance signals when the head changes position. Common symptoms may include sudden, brief episodes of vertigo (spinning sensation) when turning in bed, looking up/down, or rolling over.

Vestibular Neuritis — Vestibular neuritis is inflammation of the vestibular nerve, usually due to a viral infection, which disrupts signals from the inner ear to the brain. Common symptoms may include intense dizziness or vertigo lasting hours to days, nausea, imbalance, and difficulty focusing the eyes during head movement.

Labyrinthitis — Labyrinthitis is an inner ear infection or inflammation that affects both the vestibular and cochlear (hearing) nerves. Common symptoms may include vertigo, hearing loss, ringing in the ears (tinnitus), and difficulty maintaining balance.

Persistent Postural-Perceptual Dizziness (PPPD) — PPPD is a chronic vestibular condition where the brain becomes overly sensitive to motion and visual stimuli, often following an initial vestibular event like BPPV or concussion. Common symptoms may include non-spinning dizziness, unsteadiness, and increased symptoms in busy environments or with movement, lasting over 3 months.

Ménière’s Disease — Meniere’s disease is a chronic inner ear disorder related to fluid buildup and pressure changes in the inner ear. Episodes come and go, often without warning. Common symptoms may include episodes of vertigo lasting 20 minutes to several hours, hearing loss, tinnitus, and ear fullness.

Acoustic Neuroma (Vestibular Schwannoma) — An acoustic neuroma is a slow-growing, noncancerous tumor that develops on the vestibular nerve near the inner ear, affecting balance and hearing. Common symptoms may include imbalance, one-sided hearing loss, tinnitus, and occasionally vertigo or facial numbness as the tumor enlarges.

Vestibular Migraine — This form of migraine affects the brain’s interaction with the vestibular system, even in the absence of head pain. Common symptoms may include episodes of vertigo lasting minutes to hours, motion sensitivity, visual aura, and possible headache.

Superior Canal Dehiscence Syndrome (SCDS) — SCDS occurs when a small hole or thinning develops in the bone overlying one of the semicircular canals in the inner ear, making the inner ear overly sensitive to sound and pressure changes. Common symptoms may include dizziness or vertigo triggered by loud noises or pressure (e.g., sneezing), hearing internal sounds like eye movement (autophony), and imbalance.

Vestibular Hypofunction (Unilateral or Bilateral) — This condition results from reduced function of one or both vestibular systems, leading to imbalance and difficulty with motion, especially in low-light or uneven terrain. Common symptoms may include chronic dizziness, blurred vision during head movement (oscillopsia), imbalance, and difficulty walking in the dark.

Central Vestibular Disorders — These involve the parts of the brain (e.g., brainstem or cerebellum) that process vestibular signals. Causes include stroke, multiple sclerosis, tumors, or traumatic brain injury. Common symptoms may include unsteadiness, visual disturbances, vertigo, and coordination issues—but typically without inner ear involvement.

Our therapists identify the specific underlying cause then customize treatment to target and train compensatory mechanisms for recalibrating spatial orientation perception and skills.

WHAT TO EXPECT FROM VESTIBULAR THERAPY

No singular set of interventions works universally for vestibular disorders since presentation varies widely based on factors like comorbidities and duration since onset.

Our licensed therapists will begin with a comprehensive vestibular and balance assessment, which may include but not limited to:

Eye movement and gaze stability testing
Positional tests and screening for BPPV
Balance and gait analysis

Based on your unique findings, we develop a customized treatment plan that may include:

Canalith repositioning maneuvers
Habituation exercises to reduce sensitivity to motion
Gaze stabilization training (e.g., VOR exercises)
Balance retraining and fall prevention strategies
Education on posture, movement, and symptom triggers
Gradual exposure to symptom-provoking movements
Relaxation techniques

We continually adjust protocols based on symptoms and demonstrated progress working collaboratively towards self-management once acute flare-ups resolve.

BENEFITS OF VESTIBULAR THERAPY

Reduced dizziness and vertigo episodes
Improved balance and confidence walking
Decreased fall risk
Better coordination and spatial awareness
Enhanced focus and head movement control
Return to daily activities without fear or discomfort

VESTIBULAR THERAPY FAQS

What activities occur during vestibular therapy sessions?

Sessions incorporate guided exercises like saccadic eye movement drills, multi-plane balance reactions through perturbed stance, habituation platforms, and progressive gait training to bolster gaze stability and equilibrium reactions. Some exercises may temporarily provoke dizziness as your brain relearns movement, but symptoms typically improve over time.

How many therapy sessions are required?

While programs range in length averaging 6-8 weeks with weekly sessions, each patient is different and may depend on any comorbidities and cause of dizziness or vertigo. BPPV may be treated in a shorter period of time though central dizziness may require much longer treatment.

How frequently should I attend therapy?

Initially 1-2x weekly allows efficient progressions though tapered to monthly or prn maintenance checks once acute symptoms stabilize.

What triggers loss of balance and dizziness?

Inner ear infections, nerve inflammation, crystals displacing or medication side effects tip the delicate vestibular equilibrium swiftly causing sensory mismatch making even routine motions disorienting and provoking sudden falls.

TAKE CONTROL OVER YOUR VESTIBULAR CONDITION

Don’t waste another minute feeling controlled by unpredictable spins, lightheadedness or off-kilter sensations stealing your independence. The experts at Neurability Therapy leverage personalized vestibular therapy protocols proven to resolve the root mechanistic causes of chronic dizziness and imbalance issues. Request an appointment to regain stability or call us to speak with a therapist about evaluating your situation today!

Request An Appointment

Please fill out this form and
we will contact you about scheduling.
______________________

Wendy Brown

Beverly is an incredibly talented and atypical Occupational Therapist that pushes her patients with calculated skill and intent. She and I (a Physical Therapist) share many of the same patients and have collaborated closely with each other to assure the best possible outcomes for our clients. You cannot ask for a better Occupation Therapist than Beverly!

Jessica Tran

Beverly has been working with my father for close to a year now and has been wonderful. He has locked-in syndrome with only slight finger movement in one of his fingers. One of his goals was to be able to use a power wheelchair and Beverly was determined to make that happen. Over the last several months she found a wheelchair vendor and was able to get him a device which allowed him to drive the power wheelchair with his finger. We were amazed!! We are super grateful for her hard work and dedication!