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Balance & Vestibular Treatment

Balance & Vestibular

Symptoms of dizziness, vertigo (spinning) and imbalance are not uncommon complaints in the general population, although they most frequently present in older persons.   The reasons for these symptoms can vary greatly.  Head injuries, vestibular neuritis, stroke, and neck degeneration are just a few examples of sources for these symptoms.  Physical therapists are an excellent resource to assist in the diagnosis and treatment of this expansive category of disorders.  

Multiple systems in our body must work together to maintain our upright posture and stability.  Our brain works closely with and processes information from the inner ear (which gives feedback about our head position in space), our eyes, and proprioceptive system (which provides feedback about our body’s position in space).  Furthermore, we must be flexible and strong to allow our bodies to maintain our stability.  Deficits with ANY of these areas can result in “conflict” resulting in dizziness, vertigo or loss of balance and stability.

Just as the problems of dizziness, vertigo and imbalance can be multi-factorial, the physical therapy examination for these problems must be comprehensive.  The physical therapist will complete a medical review followed by assessment of your posture, visual tracking and gaze stability, neck motion, reactions to head motions, reactions to positional changes, static and dynamic balance abilities and overall flexibility and strength.  The results of these examination findings guide the physical therapist in determining the source of the problems and an appropriate plan of care to address them.  

Balance & Vestibular treatment at CPT

In some cases, the sensation of “vertigo” is caused by the dislodging of little stones in the inner ear called “otoconia”.  This results in an intense sensation of vertigo with head motion, usually in a specific direction, that stops quickly – usually within 30 seconds, after it is provoked. The condition can be very debilitating as the person afflicted with it begins to restrict movement and limit activities.  Our vestibular certified therapists can perform simple tests to identify the inner ear canal that is affected.  Then, a gentle repositioning maneuver is performed to restore the otoconia to its proper position.  Symptom relief can be immediate and the maneuvers are > 90% effective with just one treatment.

Many cases, however, are the result of conflict between the systems discussed earlier and result in dizziness and imbalance.  In these instances, the therapist must take a more dynamic approach and incorporate activities that will expose the body to the stimulus that cause the problems.  Through the processes of habituation, accommodation, and substitution, the brain works to retrain itself.  The premise of a vestibular rehabilitation program is to present to the brain the conflict that exists.  Over time, the brain will adjust, and symptoms diminish.  This treatment is very effective but requires cooperation and compliance by the patient to perform home exercises, sometimes several times per day.

American Institute of Balance Certified Therapists

With the complexity of vestibular disorders, it is important to find a therapist that has a solid understanding of differential diagnosis and variations in treatment approaches.  CPT is proud to employ therapists who have received advanced certifications in vestibular rehabilitation and concussion through the American Institute of Balance.  You can reach out to any CPT location and find a therapist who has this specialized training. 

Our training and ongoing collaboration with the American Institute of Balance ensures that we maintain a standard of excellence in our assessment and treatment approaches. Our Honesdale office is a designated “Center of Specialty Care” in collaboration with AIB.  The facility offers state-of-the-art equipment for assessment and treatment of vestibular disorders, balance issues and concussion.  All offices can collaborate with the center to support your recovery. Or, you can choose to receive your full course of care at the Honesdale location.