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Vestibular Rehabilitation Therapy (VRT)


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Vestibular Rehabilitation Therapy (VRT)

Vestibular rehabilitation therapy (VRT) is an exercise-based program designed to promote central nervous system compensation for inner ear deficits. VRT can help with a variety of vestibular problems, including benign paroxysmal positional vertigo (BPPV) and the unilateral or bilateral vestibular hypofunction (reduced inner ear function on one or both sides) associated with Ménière’s disease, labyrinthitis, and vestibular neuritis. Even individuals with long-term unresolved inner ear disorders who have undergone a period of medical management with little or no success may benefit. VRT can also help people with an acute or abrupt loss of vestibular function following surgery for vestibular problems.


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What Controls Balance?

  • The eyes (vestibular-ocular reflexes).
  • The inner ear (vestibular disorders; from disease or ototoxicity).
  • The joints (somatosensory impairment from severe joint trauma or surgery).

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

The exercises at EAR CARE MEDICAL CENTER include the following:

  1. In bed or sitting
  2. Eye movements
  • Up and down
  • From side to side
  • Focusing on finger moving from three feet to one foot away from face
  1. Head movements
  • Bending forwards and backwards
  • Turning from side to side
  • Turning head up & down.
  • Turning head full circle (clock wise & anti clockwise) 
  1. Sitting
  • Eye and head movements, as 1
  • Shrug and circle shoulders
  • Bend forward and pick up objects from the ground
  • Bend side to side and pick up objects from the ground
  1. Standing
  • Eye, head and shoulder movements, as 1 and 2
  • Change from a sitting to a standing position with eyes open, then closed (please note this is not advised for the elderly with postural hypertension)
  • Throw a ball from hand to hand above eye level
  • Throw a ball from hand to hand under the knee
  • Change from a sitting to a standing position, turning around in between
  1. Moving about
  • Walk up and down a slope
  • Walk up and down steps
  • Throw and catch a ball
  • Any game involving stooping, stretching and aiming (for example, bowling)

Gaze Stabilization Exercises

The aim of gaze stabilization exercises is to improve vision and the ability to focus on a stationary object while the head is moving.

We at EAR CARE MEDICAL CENTER assess you and say which exercises are suitable for you.

  1. Look straight ahead and focus on a letter (for example, an ‘E’) held at eye level in front of you.
  2. Turn your head from side to side, keeping your eyes focused on the target letter. Build up the speed of your head movement. It is crucial that the letter stays in focus. If you get too dizzy, slow down.
  3. Start doing the exercise for a length of time that brings on mild to moderate symptoms (you could use the number rating scale). This might only be for 10 seconds. Over time, you can build up to one minute (the brain needs this time in order to adapt). Build up gradually to repeat three to five times a day.

You can also do this exercise with an up and down (nodding) movement.

Progressions with this exercise can include placing the target letter on a busy background. You should start the exercise whilst seated and then move on to standing.