Understanding the biologic weakness causing a vestibular disorder is critical in designing correct therapeutic interventions and having successful outcomes. Through accurate assessment and diagnosis, the therapist saves time and ultimately money in being able to begin the proper therapy specific to cause. It is critical to make an appropriate diagnosis because the therapist will use a different treatment strategy based on the nature of the otoliths dysfunction and the canals involved. Without this diagnosis, weeks of unnecessary and costly therapy regimens can be wasted.

Why is VRT needed?

If the brain cannot rely on the information it receives from the vestibular system, a person's ability to maintain posture and coordinate balance can become overly dependent on vision or on the information received from the muscles and joints (proprioception).

This can lead to developing new patterns of movement to compensate for the change and to avoid head movements that are apt to create symptoms of dizziness and nausea. For example, a person might adopt an exaggerated hip sway as a method of balancing, swivel the entire body rather than just the head when turning to look at something, or always look down at the floor to avoid what appears as a confusing swirl of activity.

Unfortunately, these types of adaptation can result in headache, neckache, muscle stiffness, general fatigue, and a decrease in the ability to retrain the brain to adjust to the vestibular problem, hence making the symptoms much worse.

The goal of VRT is to retrain the brain to recognize and process signals from the vestibular system in coordination with information from vision and proprioception. This often involves desensitizing the balance system to movements that provoke symptoms.

What happens during VRT?

Our therapist will first perform a thorough evaluation. This includes observing posture, balance, movement, and compensatory strategies.

Using the result of this evaluation and the diagnostic results from Dr. Fodero, the therapist will develop an individualized treatment plan that includes specific head, body, and eye exercises to be performed both in the therapy setting and at home. Many times, treatment may also include increasing activities and exercise in order to strengthen muscles and increase tolerance for symptom-provoking stimuli.

Some of the exercise and activities may at first cause an increase in symptoms as the body and brain attempt to sort out the new pattern of movements. But with time and consistent practice, coordination of signals from the eyes, proprioception, and vestibular system can occur.

How does VRT help?

In most cases, balance improves if the exercises are correctly and faithfully performed. Muscle tension, headaches, and fatigue will diminish, and symptoms of dizziness, vertigo, and nausea will decrease or disappear. Many times, VRT is so successful that no other treatment is required.

If surgery is required to correct an inner ear problem, VRT will also be an important part of treatment. A therapist may perform a presurgery vestibular evaluation, make daily visits during the hospital stay to help with the temporary increase in balance problems that often accompanies surgery, and may provide a series of simple exercises to do for home care after discharge from the hospital. Often, therapists provide further therapy after a person has recovered from the surgery.