At K.M. Woods Physiotherapy, Glasgow, our vestibular specialist physiotherapist sees many patients presenting with issues relatively easily corrected with Vestibular Rehabilitation Therapy (VRT).
Vestibular Rehabilitation Therapy (VRT) is a specialist area of physiotherapy which focuses on the treatment of dizziness and issues of poor balance. Problems with the vestibular system typically manifest as dizziness in younger to middle-aged individuals, whereas they tend to manifest as poor balance in more elderly individuals. Treatment of these issues will typically reduce predisposition to falls and episodes of nausea, which can be consequences of dizziness and poor balance.
When Is My Vestibular System Challenged?
Simply, this system is challenge all day, every day. Any movement of the body, head, or neck, or stimulation of the eyes, ears, or neck muscles, will challenge the vestibular system.
For example, when sat on a stationary train in the station, we get a momentary “head rush” upon seeing a nearby train pulling out, perhaps giving the impression that we the train we ourselves are sat on is moving. The immediate computing of signals from the ears, eyes, & neck muscles allows the brain to over-ride this impression, thereby preventing us from getting dizzy or feeling nauseous.
What Structures Are Encompassed Within The Vestibular System?
A complex entity, the vestibular system functions with input and signals into the brain from three sources – the inner ear crystals, the eyes, and the proprioceptive (position sensing) nerve endings in the neck muscles. Once received, these signals are processed vestibular system in the brain, and then used to maintain balance, posture, and multi-task functioning.
How Do Problems Occur In The Vestibular System?
Problems occur in two ways.
Firstly is the problem of mixed signals to the brain. Issues present when mixed signals are transmitted to the brain from the eyes, ears, or neck muscles. This can be due to trauma to the head or neck, infection, or simply disuse (in patients following post-operative bed rest, where a lack of movement causes the sharpness of the vestibular system to be compromised due to lack of stimulation).
The second problem is one of mal-positioning of the inner ear crystals, which can get dislodged from their normal location in the utricle, and then migrate into the semi-circular canals. This mal-positioning then causes balance disturbances and dizziness.
Signs & Symptoms of Vestibular Dysfunction
- Poor spatial awareness, exacerbated with neck movement
- Poor balance
- Struggling to walk in a balanced manner when vision is restricted (when in darkness etc.)
- Poor awareness of symmetrical posture
- Sensations of nausea and dizziness
- Prone to falls, slips, trips
- Difficulty functioning in environments busy with people, sounds, colors etc.
How Does Physiotherapy Help?
In terms of crystal mal-positioning, specific treatment maneuvers are performed by the physiotherapist to simply move these troublesome crystals back to their correct position, immediately leading to an improvement in, or cessation, of symptoms.
With regard to the issue of mixed-signals, whichever of the three signalling sources is impaired can be rehabilitated with specific exercises. These exercises are designed to improve the functionality of the impaired system, and to subsequently reduce the compensatory over-activity of the other two systems. These exercises are patient specific (in response to the findings at initial assessment), and gradually progressive to ensure the patient feels confident and in control at all times when performing their home exercises.
Who Can Benefit From Vestibular Rehabilitation?
Simply, people of all ages and demographics can benefit from vestibular physiotherapy.
It seems a commonly held perception that impaired balance is to be accepted as a natural consequence of ageing. This is often not the case – poor balance in the elderly has been shown to often be due to vestibular dysfunction, essentially meaning that vestibular rehabilitation physiotherapy can improve and possibly resolve symptoms.
At K.M. Woods Physiotherapy, Glasgow, we also see many patients attending for vestibular rehabilitation following trauma to the head or neck. This trauma can occur during a road traffic accident, sporting tackle or collision, fall, or prolonged issues of poor postural positioning. This trauma can lead to either displacement of the inner ear crystals, or a disconnect in the signalling pathways between the eyes, ears, and or ears, and the brain. Again, specific treatment and rehabilitation has been shown to gain full recovery from these issues.
VRT consultations and assessments/treatments are available at each of our 4 clinical physiotherapy sites – Glasgow Wet End, Clarkston, Newton Mearns, & Kirkintilloch.
Do you wish to speak to our specialist vestibular physiotherapist to see if you or a loved one may benefit from vestibular rehabilitation, and gain an immediate improvement in your quality of life or safety while walking? Please call 0141 353 0906 today.