What is Vestibular Physiotherapy
Vestibular physiotherapy is a specialised type of physiotherapy that focuses on treating vertigo, dizziness, and balance problems that arise from issues within the inner ear (vestibular system).
It helps people regain their balance and reduce dizziness by retraining the brain and nervous systems to compensate for dysfunctions in the inner ear.
How the Vestibular system works
The vestibular system is a complex sensory organ within the inner ear. It includes three semicircular canals, which are filled with fluid. This fluid moves in response to our head movements and gravity, sending information back to our brain for interpretation via the vestibular nerve.
The utricle and saccule in the inner ear contain tiny hairs and crystals, which help to detect positioning of the head in relation to gravity. This system is essential for maintaining our balance, coordinating eye movements and sensing spatial orientation. It works together to help us to stay balanced, upright and moving smoothly and allows us to keep our eyes focused on a target as we move.
Dysfunction may occur anywhere along this pathway from inner ear to the brain (such as crystals/debris accumulating in the semicircular canal; or inflammation of the vestibular nerve) which can lead to dizziness/vertigo or unsteadiness.
Additionally, issues may arise when there is a mismatch of information from the vestibular system and information received from other organs in the body, including the eyes, muscles & tendons and joints.
How can Vestibular Physiotherapy help?
Vestibular physiotherapy can help by:
- Ease dizziness and vertigo symptoms caused by BPPV: Canalith repositioning techniques such as the Epley’s manoeuvre can be used to help reposition the inner ear crystals in conditions such as BPPV.
- Improve gaze stability: Exercises to improve the coordination of eye and head movements to reduce mismatch between the vestibular system and ocular system (eyes) to reduce dizziness/unsteadiness.
- Reduce falls risk: Exercises to improve balance and depth perception through incorporating different surfaces, visual backgrounds and challenging other senses. Stability and strengthening exercises can also help to prevent falls by improving reaction time and postural awareness.
- Reduce frequency and severity of migraine/vestibular migraine symptoms: Habituation exercises are prescribed to slowly and gradually challenge stability in various environments. Lifestyle and environmental modifications are also recommended to improve the threshold of migraine triggers and thereby reduce frequency of migraines. Habituation exercises can also be of benefit to people suffering from motion sickness and dizziness.
- Cervical spine assessment and treatment to reduce dizziness: Dizziness symptoms can sometimes originate from the cervical spine. Assessment and treatment through soft tissue management and exercises can improve posture and strength to reduce dizziness.
- Balance and stability exercises to improve function of the vestibular system in vestibular hypofunction: Specific exercises can help retrain the brain, inner ear and eyes to work together more efficiently in situations such as vestibular hypofunction (i.e. in Meniere’s Disease or following vestibular neuritis), thereby improving balance and stability.
- Improving confidence: Reducing severity and frequency of dizziness/unsteadiness episodes can greatly improve confidence to resume daily activities.
Treatment approaches
Gaze stabilisation exercises
These exercises work by maintaining the stability of the head while tracking objects. This can also be reversed by moving the head while staying focused on an object.
Balance training
Improving balance and coordination in a variety of positions and environments. This may include tasks such as stability exercises, balancing on an unstable surfaces or performing tasks requiring coordination.
Cervical spine treatment
Often, the cervical spine can contribute to the dizzy symptoms a patient experiences. Gentle soft tissue release and exercises can help to reduce these symptoms.
Canalith repositioning exercises
Techniques used to help reposition displaced inner ear crystals. The Epley is commonly used to treat BPPV, however other techniques such as the Semont technique can also be used.
Habituation exercises
Through exposing the brain to a careful amount of stimuli that would normally trigger a dizzy spell, the brain is able to adapt and reduce the amount of dizziness felt by the patient. These exercises are progressed slowly to gradually increase a person’s threshold to when they experience dizziness.
Our Wynnum Vestibular Physiotherapists
Amie Rice Mooyman
Qualifications
Amie completed a Bachelor of Human Movement Studies in 2011 before completing a Masters of Physiotherapy at the University of Queensland in 2013.
Why Vestibular Rehabilitation?
Amie is a physiotherapist with a keen interest in vestibular physiotherapy. She finds it incredibly rewarding helping patients regain their balance and confidence after suffering from what can be a very debilitating disorder.
Amie has had advanced training in vestibular rehabilitation techniques including the Epley maneouva, vestibular habituation and gaze stability exercises.
Other Interests
When not working Amie is kept busy running around after her young family.