Physical Therapy for Vestibular Disorders

Vestibular disorders may occur when a disease or injury affects your vestibular system -- the parts of your inner ear and brain that control balance and eye movements. Symptoms, including dizziness and feeling off-balance, may be mild and only last for seconds or may be severe and interfere with your daily life. You may be referred for vestibular rehabilitation if you are experiencing these symptoms. 

Before treatment can begin, you will undergo a thorough evaluation with a physical therapist specifically trained in vestibular disorders. This includes a detailed medical history and an assessment of your eye movements, balance, strength, and walking gait. They may also conduct testing to determine if certain body positions, movements, or environments cause or worsen your symptoms.

Vestibular rehabilitation therapy is a type of physical therapy that helps your brain and inner ear work together. The goal is to make you feel steadier on your feet and to relieve or reduce your symptoms. Your physical therapist will teach you the best exercises to treat your specific condition and will ask you to perform these exercises at home between appointments. Depending on your condition, you may have one or more of the following treatments.

Habituation
Habituation exercises may be appropriate for people who feel dizzy when they move around, make quick head movements, or change positions. They also address symptoms that occur in visually stimulating environments like grocery stores or when watching fast-paced video. Repeated, safe exposure to the movements and situations that cause dizziness helps to reduce the response to that activity so that symptoms are minimized or alleviated.

Gaze Stabilization
These eye and head movement exercises help you if you have unsteady vision, especially during movement. 

Balance Training
Balance training exercises can improve steadiness and help reduce the risk of falls.  

Stress Management
Vestibular disorders can cause anxiety, especially when faced with triggering stimuli or environments. We teach cognitive behavioral techniques such as replacing negative thoughts with productive ones, progressive muscle relaxation, and breathing exercises to help you manage the stress that can occur with vestibular disorders.

A Team of Experts in Balance Problems
As a Duke patient, you have access to a range of specialists including neurotologists who specialize in complex problems of the inner ear, auditory nerve, and base of the skull. Our specialized audiologists can conduct vestibular function tests.

Research on Balance Problems
Duke specialists focus their research on balance problems, including migraine-associated vertigo; Meniere’s disease; chronic, disabling disequilibrium; and viral inner-ear diseases. We conduct studies aimed at improving treatments for these often-disabling conditions.