Our Treatments

Vestibular Rehabilitation Therapy

Vestibular Rehabilitation Therapy (VRT) is a conservative approach for treating dizziness and balance difficulties. Vestibular Therapy refers to treatments carried out by a specially-trained physical or occupational therapist to improve the function of the inner ear following injury or illness. Our team is composed of Competency-Certified Vestibular Rehabilitation Specialists who have received specialized training and certifications in the field of Vestibular Rehabilitation. Our Director of Vestibular Rehabilitation, Larry Grine, spent two years as an understudy and Research Assistant for Dr. Susan Herdman and Dr. Ronald Tusa at the Bascom Palmer Eye Institute in Miami, FL. Dr. Herdman is a leading Physical Therapist and researcher in the field of Vestibular Rehabilitation. Dr. Tusa is a Neuro Ophthalmologist and is also a leading figure in the vestibular research and Vestibular Rehabilitation.

After injury or illness, such as Vestibular Neuritis or infection, the signals our inner ears send to our brain are not always complete and accurate. This incomplete information causes difficulty in how our brain processes information; thereby, causing a discrepancy between what our eyes see, what our inner ear feels, and our muscles communicate to our brain. This discrepancy or “imbalance” of information is called a sensory conflict and this conflict causes our bodies to respond with dizziness, vertigo, and loss of balance.

Our specially trained Physical Therapists will develop an individualized treatment plan that includes exercises to “rebalance” the inner ear system, strengthen posture, gait and components of the balance system (eyes, ears and legs). A home exercise program may be designed specifically to the patient’s tolerance, physical condition and diagnosis. Individuals who have not had success with long-term unresolved inner ear disorders, who have undergone a period of medical management with little or no success, may still benefit from VRT.

At VTFC our clinical focus is to diagnose and treat the challenging and frustrating problems of patients with dizziness, vertigo, imbalance and falls. Vertigo is a false sense of spinning. These symptoms, while not often life threatening, are often profoundly life altering, leading to extreme disability and impaired quality of life.

Vestibular Rehabilitation is an exercise-based program designed to promote central nervous system compensation for inner ear deficits. VRT can help a variety of vestibular conditions to help “rebalance” the inner ear system.

Vestibular Conditions Commonly Treated with VRT Include:
  • Benign Paroxysmal Positional Vertigo (BPPV)
  • Acute / Chronic Unilateral Vestibular Hypofunction
  • Bilateral Vestibular Hypofunction
  • Meniere’s Disease
  • Labyrinthitis
  • Vestibular Neuritis
  • Acoustic Neuroma Surgery

Benign Paroxysmal Positional Vertigo (BPPV) is the Most Common Cause of Vertigo

Benign: It is not life-threatening
Paroxysmal: It comes on in sudden, brief spells
Positional: It is triggered by certain head positions or movements
Vertigo: A false sense of spinning or rotational movement

Associated dizziness and imbalance from BPPV can occur spontaneously, occur following an ear infection, or after head trauma. The estimate incidence of BPPV is 107 per 100,000 per year and a lifetime prevalence of 2.4 percent. It is thought to be extremely rare in children, but can affect adults of any age, and is most common with seniors. BPPV is caused by tiny calcium carbonate crystals, called otoconia, that are displaced from their normal location in the Utricle of the inner ear. These displaced crystals float in the enclosed semicircular canals causing a disturbance in the vestibular system and triggers symptoms of vertigo and imbalance. Vertigo from BPPV can range from mild to extreme and typically last 60 seconds or less. Treatment of BPPV includes a sequence of specific movements, called a Canalith Repositioning Maneuver or Epley Maneuver. BPPV research points to a 92% effective treatment rate in one visit. Reoccurrence of BPPV is possible and is treated when present.

Vestibular Hypofunction:

Infection, injury, surgery, and disease can cause long-term damage to the structures of the inner ear, which can lead to an imbalance between the left and right vestibular system. Insult to one side (unilaterally) or both (bilateral) sides of the vestibular system will cause an over-dependence on the visual system (eyes) and the proprioceptive (muscles and joints) for information on the body’s equilibrium. Such long-term symptoms can lead to behaviors or postures that limit functional activity and head movements and usually detracts from the patient’s quality of life. Treatment for Vestibular Hypofunction is a progression of exercises designed to “rebalance” the peripheral vestibular systems through eye, movement, and balance exercises. A vestibular system which is unbalanced and causing symptoms to the patient is considered an uncompensated vestibular system and VRT is needed to assist in the rebalancing.

Common Diagnoses with Vestibular Hypofunction:
  • Acute / Chronic Vestibular Neuritis
  • Vestibular Infection
  • Unilateral Vestibular Hypofunction
  • Bilateral Vestibular Hypofunction
  • Labyrinthitis
  • Acoustic Neuroma Resection Rehabilitation

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