Managing Balance Problems: Vestibular Rehabilitation Therapy

An inner ear problem can affect your balance system. Vestibular rehabilitation therapy is a specialized form of therapy that helps with symptoms such as dizziness and imbalance.

Checking eye movement

The therapist will check for nystagmus. This is an uncontrolled repetitive jumpy eye movement. Nystagmus in certain positions may indicate there isan inner ear problem. It can even show which semicircular canal is affected. The therapist will watch your eyes while you move into different positions.

Treating your condition

Healthcare provider holding woman’s head as she lies on exam table, ready for canalith repositioning procedure.

Treatment can include:

  • Canalith repositioning. This is a series of guided head and body movements. It helps move crystals, easing symptoms of benign positional vertigo (BPV).

  • Habituation exercises to retrain your balance system. The therapist will teach you how to do these exercises at home.

  • Gaze stabilization exercises. These are to retrain the eyes to stay in focus while your head moves. This helps ease the feeling of being unsteady (disequilibrium).

  • Gait and balance training. This includes standing and walking on different surfaces. The therapist can teach you how to keep your balance and prevent falls.

Doing habituation exercises

The therapist will teach exercises suited to your condition. Habituation exercises will make you dizzy at first. Just remind yourself that symptoms likely will last for only a minute. If you keep doing the exercises, they will help lessen your dizziness. Then when you do a movement like that in daily life, it is less likely to bring on symptoms.

Getting back into action

Dizziness doesn't have to keep you from exercising. Start with activities that don't make you dizzy. Then ease into more challenging activities. Try these tips:

  • Always exercise with a partner.

  • Stop if you have nausea or feel that you may faint.

  • Walk on a treadmill, holding on to the handles for support. Be sure you are connected to the treadmill's emergency stop.

  • Use a ball machine for sports such as tennis until you're ready for a live game. This way, you know where to expect the ball.

  • Don't give up. With time and consistent therapy, symptoms generally improve, and most people can return to activities and sports.

Online Medical Reviewer: Ashutosh Kacker MD
Online Medical Reviewer: Rita Sather RN
Online Medical Reviewer: Tara Novick BSN MSN
Date Last Reviewed: 3/1/2022
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