VESTIBULAR REHABILITATION THERAPY

 

VESTIBULAR REHABILITATION THERAPY

An overviews of Rehabilitation Therapy of Vestibular System-

Riyanka choudhury, Msc.aud.

SHROBONEE- Your Hearing Aid Specialist

9B, Mohan Lal Street, Kolkata - 700004, India

www.shrobonee.com ,  +919830074043

Vestibular Rehabilitation Therapy (VRT) can best be described as systematic repetitive exercises and protocols which extinguish or ameliorate patients motion provoked symptoms as well as enhancing postural stability and equilibrium. 

Rehabilitation Options for Patients With Dizziness and Imbalance

Patients with peripheral vestibular dysfunction often present with more than simply symptoms of dizziness. Patients may have an array of physical and functional limitations that affect their everyday activities. For instance, persons with a unilateral vestibular hypofunction (unilateral weakness) may have difficulty driving because of an inability to quickly check their blind spot, and persons with benign paroxysmal positional vertigo (BPPV) may subconsciously avoid fully checking their review mirror for fear of provoking an episode of vertigo.(Deanna Dye, PT, PhD,2008)

Audiologists conduct vestibular evaluations in patients with balance and dizziness disorders. Audiologists may also provide rehabilitation of patients with BPPV and serve as members of multidisciplinary teams that manage patients with balance disorders. A key ingredient to successful rehabilitation is proper identification of the problem and a systematic and progressive program of exercises.

Exercises prescribed depend directly on the underlying pathology and symptom presentation.

ENG AND VNG and other vestibular test help to diagnosis in which area and in which vestibular organ pathology exists, correlating with symptoms and results,  different maneuvers and exercises are recommended


Who needs to have this treatment?

Dizziness may be a symptom of certain medical conditions that also affect your sense of balance. Dizziness and balance issues may also cause muscle fatigue and headache. Vestibular rehabilitation therapy may help people with conditions including:

 

Repositioning Maneuvers

REPOSITIONING MANUEVERS:

Maneuvers are only done by experts in clinic according to pathology , its not recommended to do at home by patients. Different maneuvers are used for different canal pathology lesion. The various rehabilitation interventions, the most noteworthy is the effectiveness of canalith repositioning treatment (CRT) for canalithiasis BPPV or liberatory maneuvers for cupulolithiasis BPPV. The recovery of BPPV with correct application of CRT results in a resolution of symptoms with a success rate of 65%-95% within one or two treatments (Asawavichianginda, Isipradit, Snidvongs, & Supiyaphun, 2000). 

BPPV with the most common variant (crystals in the posterior SCC) can be treated successfully — with no tests, pills, surgery or special equipment — by using the maneuver.

Different maneuvers  are:

BBQ MANUEVERS

SEMONT MANEUVERS

EPLEY’S MANUEVER

The Brandt-Daroff exercises are a series of movements that can help with certain types of vertigo.

Adaptation exercises and habituation exercises are there to diminish or reduce the vertigo or dizziness.

Cawthorne- Cooksey Exercises for balance disorder, Cawthorne-Cooksey exercises are special exercises that can, in many cases, overcome the difficulties experienced with the disequilibrium. The purpose of these exercises is to build up a tolerance mechanism and the more diligently and regularly they are carried out, the sooner the symptoms will disappear.

Aims of exercises:

  1. To train movement of the eyes, independent of the head.
  2. To practice balancing in everyday situations with special attention to developing the use of the eyes and the muscle sense awareness.
  3. To practice head movements that cause dizziness.
  4. To become accustomed to moving about naturally in daylight and in the dark.
  5. Generally, to encourage the re-building of confidence in making easy, relaxed, spontaneous movements.

When you begin:

During the first few times the exercise is performed, you should have another person present in case the dizziness becomes very severe.

BENEFITS OF VRT

  • May be the best or only management.
  • Cost effective.
  • Non-invasive.
  • Short course of therapy.
  • User friendly.
  • Returns or restores everyday function.

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