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Vestibular Therapy in Edmonton, AB

Vestibular Therapy in Edmonton, AB

For people who experience dizziness or unsteadiness, vestibular therapy is a big part of the road to recovery. Vestibular rehabilitation is used to retrain the vestibular system, which is the main centre for balance in the body.

Without a properly functioning vestibular system, it can lead to symptoms of vertigo and unsteadiness, and may even result in falls or other injuries. Our physiotherapists in Edmonton, AB, are trained in vestibular rehabilitation and the specialised techniques to support recovery from a range of different balance disorders.

What Does “Vestibular System” Mean?

The vestibular system is the term for the connections between the vestibular apparatus, vestibular nerves, and the brain, and is the main system the body uses to maintain balance. These links are very important as they help convey important messages about where the body is in space and how it is moving. In turn, the brain can then tell the muscles what to do to keep the body upright.

There are three main parts of the vestibular system:

  • The vestibular apparatus: The vestibular apparatus is a small grape-sized structure located in the inner ear. It senses head movements, acceleration, and gravity. It works by using small specially designed hairs and crystals to detect these movements.
  • The vestibular nerves: The vestibular nerves then carry this information about movements from the vestibular apparatus to the brain.
  • The brain: The brain is the processor, assessing this information and using it to control the muscles and joints in the body. The brain also relies on feedback from other sensory systems, including the muscles, joints, eyes, ears, skin (and other systems) to help determine how the body is positioned in space. For example, the movement of walking puts varying degrees of pressure on the muscles and joints. These tissues sense this, and relay the information to the brain via nerves to tell the brain where the body is in space. The brain then reacts accordingly with the proportionate activation of the muscles and other systems for balance.

The vestibular system works efficiently and seamlessly, all day and all night long. All these parts of the system work together to enable the two different types of balance: static balance and dynamic balance.

Static Balance

Static balance is about stationary balance. It is critical to be able to maintain an upright position in order to complete everyday activities, like working at a computer or standing to cook dinner.

Dynamic Balance

Dynamic balance is about moving balance. It is critical to be able to use proactive and reactive movements during moving activities, like walking and running, in order to maintain an upright position.

Vestibular physiotherapy uses slightly different approaches to treat static and dynamic balance, depending on which system is affected and the severity of the problem.

Who Could Benefit From Vestibular Rehabilitation In Edmonton?

Vestibular rehabilitation is more common than people may realise. At Revive Spine and Sport Physiotherapy, our physiotherapists use vestibular rehabilitation for a range of conditions, including:

  • Dizziness
  • Unsteadiness
  • Benign positional vertigo (BPPV) (positional vertigo)
  • Meniere’s disease (episodes of vertigo)
  • Vestibular neuritis
  • Migraine or headaches
  • Recovery from stroke
  • Parkinson’s disease
  • Recovery from traumatic brain injury
  • Aging
  • Falls, or a history of near misses

It’s important to note that vestibular rehabilitation is not usually used in isolation. Vestibular therapy is commonly combined with other forms of therapy, such as medications, allied health therapy, resistance strength training, and much more, to get the best outcomes.

Additionally, some forms of dizziness may indicate more serious underlying pathology. All symptoms of dizziness, or anything else unusual (such as vision changes or severe headaches), should be thoroughly assessed by a doctor. For example, vestibular neuritis can cause a severe spinning sensation, and is often linked with nausea, vomiting, unstable walking, and sometimes vision changes. This needs to be treated by a medical professional before vestibular rehabilitation is considered in the recovery process.

Treating Balance Problems At Revive Spine and Sport Physiotherapy

Vestibular therapy is prescribed by trained physiotherapists, like those at our Revive Spine and Sport and Sport Physiotherapy Clinic in Edmonton, to help manage dizziness and the conditions that affect balance. It involves a series of balance and eye movement exercises that target the cause of any symptoms. No singular case of dizziness or unsteadiness is the same, so our physiotherapists at Revive Spine and Sport Physiotherapy Clinic select and tailor every exercise and treatment accordingly. For cases when vision or hearing (or other systems) are affected, we will refer to specialists for further investigation.

Before commencing vestibular therapy, our physiotherapists will complete a thorough assessment to understand the symptoms and create a working diagnosis. This includes a series of questions to understand the type of dizziness, if there are any problems with walking or moving, or anything unusual that might be going on, like vomiting or persistent symptoms. They will also complete a physical examination to test the elements that relate to balance, like standing on one leg, walking up and down stairs, or navigating obstacles. These assessments help determine which vestibular exercises will be most beneficial.

Vestibular rehabilitation is designed to treat dysfunctional systems that affect balance. Depending on the way that balance has been affected, vestibular rehabilitation can be tailored to any type of symptoms and causes. There are three main types of vestibular rehabilitation exercises:

1. Eye Movement Exercises

Eye movement exercises encourage the different parts of the vestibular system to communicate better. The aim is to produce long-term changes by addressing error signals that occur between the eyes, vestibular system, and brain. There are two types of eye movement exercises:

Habituation

Habitation is designed to lessen dizziness symptoms by repeated exposure to the triggering movements. Triggering movements for patients may include standing up from a chair or walking around a supermarket. Habituation exercises mildly provoke the symptoms in a controlled way in order to “habituate” the brain and vestibular system to the movements. Ultimately, this helps the body get used to these movements once again, reducing or alleviating symptoms.

Gaze Stability

These exercises are designed to recalibrate the vestibular system by retraining the signals between the vestibular apparatus and brain. The exercises may be started in a stationary position, and gradually progressed to incorporate head movements and dynamic movements. Gaze stability exercises may include:

  • Slow or quick head motions
  • Fixating on a visual target
  • Tracking exercises
  • Can be combined with different positions, such as a sitting or walking depending on the severity of symptoms (and if targeting static or dynamic balance)

2. Balance Retraining

Balance retraining is a large component of vestibular rehabilitation. Exercises for balance can help retrain the whole balance system so patients feel more confident and stable throughout activities of daily living, like work, home duties, and hobbies. This may include exercises like standing on one leg, walking outside, on uneven surfaces, or up and down stairs. These functional exercises mimic the requirements of daily movements, thereby training the body to maintain balance throughout daily life.

Balance exercises should be customised to each patient to address their underlying balance problem. The exercises should be moderately challenging to promote changes in balance, but also adequately supervised to ensure safety throughout the movements.

3. Strength And Flexibility 

Muscle and joint health can also affect balance. Weak or inflexible areas of the body may make it more difficult to respond to sudden balance reactions, or it may reduce how balance signals are sent from different parts of the body to the brain. Strength and flexibility exercises complement the other forms of treatment by improving muscle conditioning. This can play a role in ease of balance during static and dynamic positions.

At Revive Spine and Sport Physiotherapy Clinic, our physiotherapists always take time to explain the exercises and show our patients how to complete them. This way, they can be easily practised at home for the best results. Vestibular rehabilitation is usually about consistency and frequency of practice, so repetition is important for efficacy.

Unlike other types of exercises that are completed for a longer period once per day, vestibular exercises are usually completed for short periods multiple times per day for the best effect. Even just 12 minutes of vestibular exercises across three sessions throughout the day can improve vestibular symptoms. Our physiotherapists will guide the prescription, including the best dosage, intensity, and frequency. With time and effort, symptoms can decrease to more manageable levels, and eventually resolve.

The Benefits Of Vestibular Rehabilitation For Patients In Edmonton

There are many benefits of vestibular rehabilitation:

  • Reduced risk of falling
  • Improving balance
  • Reduce symptoms of dizziness or unsteadiness
  • Improving ability to stabilise in static and dynamic positions
  • Increased body strength

How Long Is Vestibular Rehabilitation Needed For?

The length and number of vestibular rehabilitation sessions depends on the cause and severity of the symptoms. Some types of dizziness, like BPPV can be treated with one session. BPPV is a disorder that affects the vestibular apparatus as the small crystals that detect movement become displaced. Sometimes, only one treatment is required to reposition the crystals and resolve any symptoms.

However, for other conditions, vestibular rehabilitation may be needed for much longer. For example, after a stroke, it may require weeks or months of therapy to retrain balance and teach new balance strategies.

Start On The Road To Better Balance At Revive Spine and Sport Physiotherapy Clinic

The therapists at Revive Spine and Sport Physiotherapy Clinic are experienced and trained in vestibular rehabilitation. We assess, manage, and treat a range of vestibular disorders with the most up-to-date treatment approaches, working one-on-one with patients to get the best outcomes.

Find out what our vestibular physiotherapists in Edmonton can do for dizziness and unsteadiness. Get in touch with our experienced team!

References

Better Health. Dizziness and vertigo. Available from: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/dizziness-and-vertigo 

Cleveland Clinic. Vestibular Rehabilitation Therapy. Available from: https://my.clevelandclinic.org/health/treatments/15298-vestibular-rehabilitation#:~:text=Vestibular%20rehabilitation%20therapy%20involves%20exercises,such%20as%20vertigo%20and%20labyrinthitis.

Epworth. Vestibular Rehabilitation. Available from: https://www.epworth.org.au/who-we-are/our-services/rehabilitation/falls-and-balance/vestibular-rehabilitation

Han B. et al. (2011). Vestibular Rehabilitation Therapy: Review of Indications, Mechanisms, and Key Exercises. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3259492/

Physiopedia. Vestibular Rehabilitation. Available from: https://www.physio-pedia.com/Vestibular_Treatment

Physiopedia. Vestibular Treatment. Available from: https://www.physio-pedia.com/Vestibular_Treatment

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