In order to maintain good balance, information is required from your vestibular system, your eyes, your muscle and joints. All of these systems need to be giving correct information to your brain in order to provide normal balance function. Many balance disorders result in either no information or incorrect information being given to the brain. Vestibular Rehabilitation (VR) helps reorganise this information so that the brain receives the current information.
VR is a form of exercise therapy that is tailored to each individual patient. The exercises aim to improve your balance and reduce the effect of the dizziness/imbalance on your daily activities. The treatment may take several months as it involves re-tuning the brain. The success of the treatment relies on regular practice, sometimes it can be hindered by other existing health conditions or medication's, for example: anxiety of
Why do I need Vestibular Rehabilitation?
Many people who have experienced a balance problem are left with some symptoms, even after their initual episodes have been resolved.
The balance system normally retunes itself after any upset, however, if it doesn’t, it creates a range of vague sounding symptoms. These can range from feeling uncomfortable in busy environments such as supermarkets, veering off to one side or even feeling dizzy with sudden head movements. Your GP or ENT consultant would have recommended this treatment for you
Who will I see?
During the appointment either a senior audiologist with special interest in balance disorders or vestibular physiotherapist will assess your symptoms and create a care plan with you to minimise your symptoms.
How long does the appointment last?
The first appointment will last 30 minutes and a follow up appointment will last approximately 15 minutes. Depending on your care plan and goal, you may be given multiple follow up appointments. As the balance system takes time to re-tune the exercises are altered according to the symptoms and the circumstances, there may be multiple follow up appointments.
Do I need to bring anything with me?
No, but it may be best to bring a relative/ friend just in case we have to do treatment on the same day because this may cause dizziness.
We also suggest you avoid driving and ask a family member or friend to do so.
What will happen at my first appointment?
The clinician will take a detailed history of your symptoms and agree on a plan. Depending on your symptoms the following may occur:
- Dix-Hallpike manoeuvre; this is a diagnosis test to check if you have a false sense of motion. Your head will be turned into different position while watching your eye movement
- You may also have an Epley Manoeuvre; this is a canalith repositioning manoeuvre which is aimed to move calcium particles which have become dislodged in the inner ear, back to where they belong. The procedure involves moving your head into different positions
- You maybe given exercises to do at home, then a follow up appointment.
- You may be given dietary information and life style changes
What do I need to do before my appointment?
It is best to wear trousers just in case you need to have treatment. If possible, keep a diary of when the dizziness occurs. Your consultant may have already given you some recommendations when you saw them if appropriate to you, for example dietary modification or regarding medication. It is helpful if these recommendations have been started if they were provided. Please do no make changes to medications unless you are advised to do so by your consultant.
It can be helpful for you to make a note of any particular triggers you may have noticed for your symptoms or examples of things that you have been doing when your symptoms seem to have been worse as this can be very helpful in designing an effective exercise programme.
Will the exercises make my imbalance/dizziness worse?
Yes, only for a short period. This is because this is about retraining the brain to use your eyes, balance organs and ankle support, therefore, you are likely to feel worse before you start to feel better. If you do, this is usually a good sign as it means that the exercises are starting to re-tune your balance system. Gradually you should be able to start doing some of the things that initially made you feel dizzy or uncomfortable, as these things will often be incorporated into your exercise programme.
It is important to note that your balance system may not recover fully using this process. However, overtime with regular practice you should see a great improvement in your symptoms.
The exercises are designed to stimulate the balance system in a very controlled way allowing the brain to begin to recognise exactly what is not quite right, try to find the right response and adjust as required. You may therefore feel a little off balance or dizzy to start with but this improves with continued practise. As your symptoms improve the exercises will be altered accordingly
Very gradually things will improve. It is worth bearing in mind that even with ‘normal' balance systems everyone feels a little off balance sometimes, particularly when stressed, anxious, tired or unwell. Vestibular rehabilitation will not mean that you will not experience any imbalance feelings ever again, but it will help your inner ear balance system to work as well as it can enabling you to resume normality.
How does Vestibular Rehabilitation work?
Like any other form of rehabilitation, VR requires regular repeatable exercises. These can range from simple head and eye movements to any physical activity that currently causes you a problem.
You will be given a very simple set of exercises to begin with, which will eventually progress as you improve. With each visit your progress will be monitored and the exercise program will be modified for your individual needs.
How will I know if Vestibular Rehabilitation is working?
Firstly, you are likely to feel worse before you start to feel better. If you do, this is usually a good sign as it means that the exercises are starting to re-tune your balance system. Gradually you should be able to start doing some of the things that initially made you feel dizzy or uncomfortable, as these things will often be incorporated into your exercise programme.
The balance system may not recover fully using this process, however overtime you should see a marked improvement in your symptoms.
How long does Vestibular Rehabilitation take?
VR program can take many months, as you are trying to re-tune one of the body’s reflexes. The success of the program relies on regular practice of the exercises.
Contact us
To cancel or change your vestibular rehabilitation appointment, please contact:
Rachel White - Balance test appointment co-ordinator
