WHAT IS THE VESTIBULAR SYSTEM?
The vestibular system is a sensory organ located within the inner ear. It comprises of two types of sensors: the 3 Semi-Circular Canals (SCC) and the 2 Otolith organs. These sensory organs detect head motion and in turn generate reflexes that stabilize our gaze and maintain our head and body posture. The SCC detect angular motion such as nodding or shaking your head. The Otolith organs (namely the Saccule and Utricle) detect linear motion such as up/ down like in an elevator, or accelerating/ decelerating like in a car. This information from the vestibular system is relayed to the brain. In turn it controls eye muscles to provide gaze stability, neck muscles to maintain head stability as well as generating compensatory body movement to maintain postural stability and thus prevent falls. As such together with our vision and proprioception (muscles and joints) the vestibular system forms a key element of our balance system.
If the system is damaged by disease, aging or injury it can result in a vestibular disorder.
VESTIBULAR DISORDERS CAN INCLUDE BUT NOT LIMITED TO
Benign Paroxysmal Positional Vertigo (BPPV)
Migraine Associated Dizziness
- Post removal of an Acoustic Neuroma/Vestibular Schwannoma
SYMPTOMS ASSOCIATED WITH A VESTIBULAR DISORDER
Loss of balance
Hearing loss or change
Tinnitus (ringing in the ears)
Vestibular Rehabilitation Therapy (VRT) is a specialised form of physiotherapy designed to address dizziness, imbalance, difficulty maintaining clear vision, and functional decline as a result of a vestibular disorder. Evidence has shown that vestibular rehabilitation is effective in improving symptoms related to many vestibular (inner ear/balance) disorders (1,2). VRT is an exercise-based program that may comprise of:
Habituation Exercises: this involves repeated exposure to specific movements or visual stimuli that provoke dizziness, in a controlled manner.
Gaze Stabilisation Exercises: exercises which help to improve control of eye movements so vision remains clear during head movement.
Balance Training Exercises
Canalith Repositioning Manoeuvres: are a series of coordinated movements/positions performed by the physiotherapist to treat patients with benign paroxysmal positional vertigo (BPPV).
The physiotherapist will design an individualised treatment plan which includes supervised sessions and if applicable an individualised home program to address the problems identified on the initial assessment.
Duration of treatment depends on the diagnosis and clinical symptoms; some patients may only be seen 1-2 visits while others may require 3-4 months.