Vestibular Rehabilitation
and Balance Re-training Programs

The balance system is controlled by an organ in the inner ear called the labyrinth. It has three main structures that let us know when we are in motion and whether the motion is up and down or from side to side. These structures can also tell us when we are being still, or, if we are moving, what parts of the body are moving. Disease, exposure to unusual motion or altered gravitational environments, and aging can impair balance. Many Americans have at some time experienced vertigo, dizziness or balance problems. It is estimated that two million adults in the United States, particularly the elderly, have chronic impairment from dizziness or difficulty with balance. In a study of people age 65 to 75, one third experienced dizziness and imbalance. Furthermore, balance-related falls account for more than half of accidental deaths in the elderly. (Information from the National Institutes of Health.)

Typical symptoms are light-headedness, room spinning, ears ringing, loss of balance and/or falling. These happen because the brain or central nervous system receives conflicting messages from three primary pathways (vestibular mechanisms): inner-ear, visual-oculomotor, and musculo-skeletal pathways. Approximately 85% of all dizziness and vertigo cases can be attributed to inner ear disorders.

Conservative management using Vestibular Rehabilitation Therapy (VRT) protocols and procedures has proven to be very effective to compensate for these conflicting messages. VRT uses a series of exercises performed repeatedly to eliminate or lessen a person’s motion-provoked dizziness symptoms, and to increase postural stability and equilibrium. VRT works by re-training the central nervous system to adapt and re-organize input from the vestibular mechanisms and eliminate conflicting signals between these mechanisms.

Balance requires an intact musculo-skeletal system, peripheral sensory feed back, correct processing and integration of movement, and sensory stimuli from the cerebellum, the brain’s center for balance and coordination. Therefore, some patients may need both vestibular rehabilitation and balance retraining or just one of the forms of therapy. The treatment of balance dysfunction is based on the appropriate determination of the origin of the dysfunction. Exercises to manage the dysfunction(s) are typically done in half-hour sessions, focusing on home exercise carry-over.

If you suffer from dizziness or balance problems, talk to your doctor. When appropriate, your doctor may prescribe Vestibular Rehabilitation Therapy at one of The Minneapolis Clinic of Neurology’s four physical therapy clinics: Burnsville, Coon Rapids, Edina and Golden Valley.

For more information about balance disorders, please visit the National Institute on Deafness and Other Communication Disorders web page.