Vestibular Rehabilitation (VR) is form of therapy that is becoming popular for those who are experiencing dizziness symptoms due to an inner ear impairment. The statistics reveal that approximately 35% of individuals over the age of 40 have experienced some form of vestibular dysfunction and a further 4% report a chronic problem with balance. 80% of people over the age of 65 experience dizziness and Benign Paroxysmal Positional Vertigo (BPPV) is the cause of 50% of dizziness in this age group. What is BPPV? It is simply when crystals, also known as “Otiliths” or “Debris” move into the semi circular canals, which are located in the inner ear. These crystals should not be in the semi-circular canals. These canals are responsible for giving your body information about angular movements such as up/down/forward/backwards or side to side movements when your body moves in those directions. The inner ear is known as the “Vestibular System” and it plays an important role with informing your body about movement. What causes BPPV? There is no clear answer for this. However, one strong theory is that it could be due to a vertebrobasilar insufficiency. Simply put it may be due to a blood flow impairment to the vestibular system.

Dizziness and Vertigo are two separate symptoms and should not be used interchangeably. Dizziness is described as light-headed, swaying and disorientation. Some people may even describe it as a sense of spinning inside their head, however, this is still classified as dizziness. Vertigo is a subcategory of dizziness and is described as a sense of spinning that is around them. More specifically it is an illusion of movement occurring in the environment. Both of these symptoms can cause an individual to fall and increase their risk for future falls. A clinician needs to assess whether the symptoms being presented by the client are truly vertigo or dizziness.

What are some of the causes of dizziness? The most common causes are cardiovascular, neurological, visual, or a vestibular disorders.

Research reveals that vestibular impairment is an underlying cause in as many as 45% of people complaining of dizziness.

What are some of the causes of Vestibular disorders?
Head trauma such as Whiplash, Concussions, BPPV, Meniere’s Disease and Vestibular Neuritis/ labyrinthitis (viral).

Signs and Symptoms of Vestibular Disorders
Nystagmus (Shaking of the eyes), Vertigo, Dizziness, Imbalance and gaze instability.

There are many treatment techniques that can help with vestibular disorders. A trained practitioner who has vestibular training such as a physiotherapist can assist by performing a thorough assessment of the vestibular, visual and proprioceptive (balance) system.

For those who are interested in knowing the names of some of the tests used that a practitioner may perform for assessment, they are Dix-Hallpike Test, Sidelying test or a Head Roll Test to name just a few.

There are many treatment options available. If the vestibular disorder is BPPV, head maneuvers such as Epley Maneuver, Gans Maneuver, Barbeque Roll, or Liberatory Maneuver will be used and are all quite effective. In addition, there are exercises that usually are given that work on the “visual” and “balance” systems. Each individual will have a program that is customized to their vestibular problems.

Individuals who are living with vestibular disorders, experience a great deal of anxiety due to the fact that they are unable to be out in the public for fear they will fall and be mislabeled or misjudged if they are seen stumbling around. They will experience dizziness, nausea, vertigo and imbalance. Living life in isolation and not being able to enjoy the physical activities that they used to perform is not an appropriate way to enjoy and live life. I urge you to visit a practitioner who is trained in vestibular rehabilitation to see what could be causing your dizziness.  Don’t fall through the cracks. No Pun intended! Vestibular Rehabilitation will not harm you. It is safe and effective.

Until next time!

REFERENCES
Bernard Tonks. Vestibular Rehabilitation. 2018.