BALANCE AND VESTIBULAR DEFICITS
Dizziness and disequilibrium are second only to low back pain in frequency of occurrence in the adult population. Balance and Vestibular deficits are a major medical concern, and the resulting effects of an untreated balance disorder can be devastating. The good news is that in many cases a physical therapy implemented treatment plan can successfully treat the problem, preventing subsequent injury.
WHAT IS VERTIGO?
Many people who suffer from acute dizzy spells can be helped by physical therapy. Benign Paroxysmal Positional Vertigo (BPPV) is characterized by a brief episode of vertigo (spinning) every time your head moves into
a specific position. Common causes for this disorder are trauma to the head (concussion, motor vehicle accident, etc.) and acute infection, but frequently the cause is unknown. Patients usually complain of a spinning sensation being provoked by lying down, rolling over in bed, bending over or looking up. Common activitiesthat can provoke this sensation include getting out of bed, gardening, washing hair in the shower, and going to the dentist or beauty parlor. The main symptom that people with BPPV complain of is having a feeling of spinning related to a certain position of the head.
Other symptoms may include nausea, occasional dizziness, occasional light-headedness, and an overall sense of not feeling quite right. The symptom of spinning may come on immediately when you get into the provoking position or it
may be delayed from 0 to 40 seconds
WHAT CAUSES VERTIGO?
Why do people get BPPV? The vestibular system inside the inner ear has three semicircular canals. Small hairs are located within these canals, and these hairs sense the speed and direction of head movements. An area adjacent to these canals uses small stones to sense equilibrium; essentially, these stones roll around in your inner ear, giving feedback to your brain about which way your head is leaning. Occasionally one of these stones may inadvertently end up in the canals, disrupting the hair cells. When this occurs a signal is sent to the eyes making them twitch (a phenomenon called nystagmus). It is this twitching that causes the spinning sensation and resultant decreased balance. Certain areas of the semicircular canals are more sensitive than others, which can account for the variance in the intensity and/or frequency of symptoms. The stone can also be free floating or adhered to the side
of the canal, explaining the variance of symptoms occurring immediately or up to 40 seconds after the head is put into the provoking position.
Balance can be affected by many primary or secondary diagnoses. We can provide a comprehensive evaluation to determine the areas of deficit and treat accordingly. Procedures may include use of one or more of the following:
- Canal Repositioning Treatment
- Proprioceptive Training
- Vestibular Training
- VOR Training
- Oculomotor Exercises
Balance Maintained by 3 Systems:
Diagnoses Effecting Balance:
- Peripheral Neuropathy
- Vestibular Hypofunction
- Visual Deficits
- Strength Deficits
CORNERSTONE PHYSICAL THERAPY’S BALANCE AND VESTIBULAR PROGRAM
Cornerstone Physical Therapy provides comprehensive Balance and Vestibular Rehabilitation. We perform specific treatment
protocols for specific diagnoses, with a focus on alleviation of symptoms and return of function. Please contact our experts with any questions you may have about balance or any rehabilitation related concerns.
WHAT CAN PHYSICAL THERAPY DO?
Upon evaluation by a physical therapist, the nystagmus (“eye twitch”) will determine which of the three semicircular canals is affected, thus guiding treatment. The most common treatment involves putting the head in a series of different positions in order to move the misplaced stone back to its original place. The benefit of this method is rapid relief of vertigo. However, if a patient has extreme spinning, nausea or extreme fear when getting into the provoking position, habituation exercises can be performed. This
technique requires repetitive provocation of the vertigo and nausea, which takes longer to relieve symptoms. These repeated positional changes may cause prolonged and generalized disequilibrium with persistent nausea, but generally symptoms will improve over time.
If you are currently having brief episodes of spinning directly related to position changes, physical therapy may help you with your symptoms.