What Is Vestibular Physiotherapy ?
Vestibular disorders are conditions which affect the vestibular system; part of the inner ear and brain that help control balance and eye movement.
Common symptoms of vestibular conditions can include:
Vertigo (room spinning)
Dizziness
Light headedness
Imbalance
Trouble concentrating
Motion sickness
Increased anxiety
Disequilibrium/disorientation/giddiness/unsteadiness on your feet
Differentiating between conditions which cause these symptoms and providing specific treatment strategies is incredibly important and something Keilor Road Physiotherapists are experts in.
You can find the most common vestibular disorders we treat on our Vestibular Physiotherapy page.
In this blog, we’ll look at some of the less common vestibular complaints, that your Keilor Road Physiotherapy physiotherapist will rule out at your initial consultation.
Meniere’s Disease
A disorder of the inner ear that relates to a build-up of fluid in the inner ear canals that can lead to swelling and pressure with dizziness, fluctuating hearing loss and tinnitus (ringing in the ears or hearing of non-present sound).
Management: Balance retraining is important to assist with the imbalance that can plague people between attacks. Its goal is to help retrain the ability of the body and brain to process balance information. Compensation strategies can also be implemented for acute episodes.
Age related balance loss (Presbystasis)
As we age, our balance system degenerates through the three balance pathways: vestibular, visual, and somatosensory (proprioception). A reduction in lower limb muscle strength and mobility, and increase in joint pain, along with reduced brain central processing speed lead to reduced balance and unsteadiness during walking. An increase in anxiety as a result of this can reduce confidence and lead to social isolation.
Impaired Inner Ear Function
Cardiovascular Health
Neurological Disease
Arthritis
Mental Status
Nutrition
Impaired Vision
Lifestyle and Environmental Factors
Management: Medical investigations are conducted to rule out differential diagnoses and an individual’s static and dynamic balance, lower limb strength and gait are assessed by one of our expert Physiotherapists. The next step is then to explore walking (gait) and balance retraining, lower limb strengthening and advice regarding activities of daily living adjustments to reduce falls risk. Use of the LLLS is also utilised here at KRP.
The aim of an active rehabilitation program here at KRP is to improve quality of life and independence.
Vestibular Neuritis
Vestibular neuritis and labyrinthitis are disorders resulting from an infection that inflames the inner ear or the nerves connecting the inner ear to the brain. This inflammation disrupts the transmission of sensory information from the ear to the brain. Vertigo, dizziness, and difficulties with balance, vision, or hearing may result.
Management: When other illnesses have been ruled out and the symptoms have been attributed to vestibular neuritis or labyrinthitis, medications are often prescribed to control nausea and to suppress dizziness during the acute phase. Once the acute phase subsides, expert physiotherapy here at Keilor Road Physiotherapy helps via vestibular rehabilitation, which includes supervised and personalised balance retraining to assist with unsteadiness. Time frames for resolution vary based on a person by person basis, with most individuals achieving a complete resolution of symptoms.
Vestibular migraine physiotherapy Melbourne.
Vestibular Hypofunction
Loss of vestibular function bilaterally results in difficulty maintaining balance, especially when walking in the dark or on uneven surfaces and in a decrease in the patient’s ability to see clearly during head movements. In addition, patients with bilateral vestibular hypofunction or loss (BVH or BVL) also complain of intense feelings of being off-balance and of strange but disturbing sensations in their heads with head movement. Because of these problems, patients with BVH may restrict their activities and can become socially isolated.
Primary Complaints include:
Balance and Risk for Falling
Oscillopsia (visual blurring that occurs during head movements)
Sense of Disequilibrium, Imbalance, and Dizziness
Physical Deconditioning
Management: Vestibular rehabilitation can improve postural stability, decrease the sense of disequilibrium and improve visual acuity during head movements enabling people with BVH to resume a more normal life. Unfortunately, most patients have residual functional problems and subjective complaints. The exercises used for patients with BVL are aimed at fostering the substitution of alternative strategies to compensate for the lost vestibular function and at improving any remaining vestibular function.
Superior Semicircular Canal Dehiscence
Vertigo and auditory symptoms and signs can result from a dehiscence (opening) in the bone overlying the superior semicircular canal of the inner ear. It is normally evoked by loud noises and/or by manoeuvres that change middle-ear or intracranial pressure (such as coughing, sneezing, or straining) and can manifest itself as a chronic loss of balance, dizziness and/or oscillopsia, which is the apparent motion of objects that are known to be stationary.
Management: Balance retraining can assist with reducing falls risk and to enhance quality of life.
Post-operative dizziness due to ear surgery or head injury.
Due to change in pressure and inflammation within the inner ear, a loss of balance can occur following surgery or trauma to the head and ear, including concussion.
Management: Balance retraining can assist to reduce falls risk in these acute populations. Balance retraining is supervised by one of our expert physiotherapists and implemented initially within our onsite Clinical Pilates and Exercise Studio, where the progression from static, stable surface training is built towards dynamic, unstable surface exercises allowing for simulation of more functional environments.
What does vestibular therapy involve?
Your unique set of symptoms will be assessed, with detail, education and clear, concise explanation fundamental in making sure you understand exactly what is happening, 100% of the time. This is provided in the form of a take home Tailored Health Plan.
Vestibular physiotherapy involves a comprehensive rehabilitation plan that may include hands on physiotherapy, customised exercises to address the problems found on evaluation and can centre around progressive eye exercises, balance exercises, walking, or graded exposure to neck movements or environments that produce your symptoms.
Do I need a referral?
You don’t need a referral to see any of the experienced physiotherapists here at KRP. Being primary care health providers, all of physiotherapists are equipped with the skills to be able to offer an accurate diagnosis and tailored health plan on day one of your treatment journey.
We also have access to the best Doctors and Specialists in Melbourne, who are only a phone call or email away for us.
Can the appointment take place over video / phone?
We also offer Telehealth appointments, including initial assessment, for those that are isolating, working from home, or may be too symptomatic to leave the house. Conversations via video call or over the phone remove travel time and lower the cost of an appointment, not to mention how easy and convenient it is. Use this link for more information. (Link to telehealth).
Is the appointment covered by medicare?
If you have been dealing with your condition for longer than 6 months, or if your condition is likely to last longer than 6 months, you can arrange a Chronic Disease Management Plan or CDM (formerly Enhanced Primary Care plan or EPC) through your GP for a maximum of 5 physiotherapy visits covered by Medicare. You can read more about Medicare Physiotherapy in our blog here.
Need help from a vestibular physio?
KRP can help you reduce symptoms of dizziness or vertigo through improved function, increased balance and reduced risk of falling following vestibular physiotherapy.
Servicing Niddrie, Essendon, Airport West, Keilor & Melbourne’s Northern suburbs for over 40 years, you can book with one of our trained vestibular experts below or call 93794557 to speak to one of our admin superstars.
Related links
Article by
John Keller | Clinical Director
Sports & Musculoskeletal Physiotherapist
John graduated as a Physiotherapist from the Auckland University of Technology with the John Morris memorial prize for outstanding clinical practise in 2003. John has since completed Post Graduate Diplomas in both Sports Medicine and Musculoskeletal Physiotherapy with distinction, also collecting the Searle Shield for excellence in Musculoskeletal Physiotherapy.