Vestibular rehabilitation is a field that has grown substantially in recent years, and has become a major component in the management of patients with dizziness/disequilibrium/vertigo, etc. An assessment will determine if you are a candidate for a vestibular rehab program, and if so, an individualized treatment plan can begin immediately.
Signs and symptoms of vestibular disorders primarily include one or more of the following:
• vertigo (a sense of spinning)
• poor gaze stability
Due to the highly variable nature of these symptoms and their causes, it is recommended that you speak to your doctor prior to assessment for vestibular involvement. Should your doctor feel that your condition may involve the vestibular system, a referral for assessment may be made.
There are different types of vestibular disorders, with variable patient presentation. Symptoms may be the result of BPPV, a unilateral vestibular lesion, bilateral vestibular lesion, or other medical condition. An assessment will determine whether your symptoms can be managed with vestibular rehabilitation.
Assessment for BPPV (Benign Paroxysmal Positional Vertigo)
BPPV is a common cause of vertigo, and may occur at any age. It is a biomechanical problem involving displacement of the crystals within the inner ear, resulting in episodic vertigo and nystagmus, and often resulting in nausea and balance difficulties. While the cause of BPPV is often unknown, it may be linked to a specific factor (e.g. trauma).
Assessment for BPPV includes two maneuvers (Dix-Hallpike Test, Head Roll Test), and if positive, treatment will occur immediately with particle re-positioning maneuvers in clinic (i.e. relocating the crystals that have become displaced).
While BPPV can have spontaneous remission, treatments have excellent success rates, often with full resolution of symptoms in 1-3 treatments.
Assessment/Treatment of Vestibular Function
Vestibular symptoms are also commonly the result of unilateral or bilateral vestibular lesions, or various other medical conditions, and assessment will determine whether a rehabilitation program is appropriate. Testing may include: assessing for nystagmus or irregular responses to eye tracking or fixation, assessment of gaze stability during head movements, motion sensitivity testing (a reliable and valid test for monitoring motion provoked dizziness), and/or balance and gait assessments. Each patients rehabilitation program is individualized and built from their specific assessment findings. Patient specific goals are the focus of each plan, along with goals derived from assessment results – these are discussed with the patient following initial assessment.
While clinical progressions and ongoing assessment is often necessary, a home exercise program that is complied to is an essential component of vestibular rehabilitation. Education is a major focus as well, both during patient care and with regard to instruction post discharge. The patient can expect to work in clinic with the therapist during each treatment session, with ongoing assessment and development of a progressive personalized program to manage and improve symptoms.
Booking Your Assessment
Alicia Wilson (MPT, BAHonsKin, Cert. MDT) is a physiotherapist with a special interest and advanced training in vestibular rehabilitation. Patients wishing to book as assessment with Alicia should bring a driver to the assessment with them, as assessment and treatment may bring on symptoms. Assessments will range from 45 -60 minutes in length, and include a detailed subjective history and a physical examination.
If your physician would like to refer you to our Vestibular Rehabiliation Program, you can print out a referral form and have your physician fax it to 519-433-8515. Alternatively, you can call Central Loction: 519-439-6111 or North Location: 519-433-9111 and ask to book an appointment. You may also email us at Central Location: ReceptionCentral@fpclondon.com or North Location: ReceptionNorth@fpclondon.com