Vestibular Rehabilitation Therapy (VRT) - Resource Guide

Vestibular Rehabilitation Therapy (VRT) is a specialized treatment designed to help individuals recover from balance disorders, dizziness, and vertigo caused by vestibular or inner ear injuries that may occur from a traumatic brain injury (TBI). This therapy focuses on retraining the brain to process balance and spatial orientation correctly by using targeted exercises that improve stability, coordination, and eye movement control. VRT can significantly reduce symptoms like vertigo, dizziness, motion sensitivity, and unsteadiness, helping patients regain confidence in their daily activities.

Our customized vestibular rehabilitation programs are tailored to each patient’s needs, supporting a structured approach to restoring balance and enhancing overall quality of life.

What the Patient Should Expect in Their Appointment:

Initial assessment includes a thorough review of symptoms, medical history, and functional limitations.

A series of diagnostic tests to assess balance, neck function, eye movement control, and positional vertigo.

Hands-on techniques such as canalith repositioning maneuvers (for BPPV) and gaze stabilization exercises.

Education on home exercises and strategies to manage symptoms during symptom flares.

Follow-up appointments to track progress and adjust the treatment plan as needed.

Diagnostic, Treatment, or Both?

Vestibular therapy is primarily a treatment but may include diagnostic elements during the initial assessment to determine the nature of the balance dysfunction.

Average Recommended Testing Plan:

1

Typically, 6-12 sessions over 6-12 weeks, depending on the severity of symptoms and the patient’s response to therapy.

2

Sessions are usually scheduled 1 time per week.

3

Home exercise program adherence is crucial for optimal recovery and is assigned from the first session.

Who Makes the Perfect Referral for This Service?

Patients with a history of traumatic brain injury (TBI) or concussion experiencing dizziness, balance issues, or vertigo.

Individuals diagnosed with vestibular disorders such as Benign Paroxysmal Positional Vertigo (BPPV), vestibular neuritis, or Ménière’s disease.

Patients with unexplained dizziness or motion sensitivity.

Those experiencing imbalance or frequent falls related to inner ear dysfunction.

Patients struggling with visual disturbances related to head movement (e.g., difficulty focusing, blurred vision with motion).

Additional Important Notes:

Patients with BPPV typically see improvement in just 1-3 visits with repositioning maneuvers.

Patients with TBI-related vestibular dysfunction may require a more prolonged course of therapy.

Collaboration with other providers (neurologists, ear/nose/throat doctors (ENTs), audiologists, physiatrists, primary care) is essential for comprehensive care.

If a patient does not improve within the expected timeframe, further diagnostics (MRI, ENT referral) may be considered.

Clinicians should be aware of contraindications, such as unstable cardiovascular conditions or acute neurological symptoms requiring urgent attention.

Key Vestibular Therapy Techniques:

Benign Paroxysmal Positional Vertigo (BPPV):

BPPV is a common cause of vertigo that occurs when tiny calcium carbonate crystals (otoconia) in the inner ear become dislodged and move into the semicircular canals, disrupting normal balance signals. This leads to brief but intense dizziness triggered by specific head movements such as rolling over in bed or looking up.

Canalith Repositioning Maneuvers:

These are specific head and body movements designed to guide the dislodged crystals back to their proper place in the inner ear, alleviating symptoms. The most common technique is the Epley maneuver, but other approaches include the Semont exercise. Most patients experience relief within 1-3 sessions of repositioning therapy.

Gaze Stabilization Exercises:

These exercises help retrain the brain and eyes to work together when vestibular function is impaired. They are designed to:

Improve visual focus during head movements (important for reading, walking, and daily tasks).
Reduce dizziness caused by eye movement and head motion.
Strengthen the connection between the eyes and the vestibular system (inner ear).

Common Gaze Stabilization Exercises Include:

VOR (Vestibulo-Ocular Reflex) exercises – The patient focuses on a target while moving their head side to side or up and down.
Target tracking – Following a moving object with the eyes while keeping the head still.

Balance Exercises:

Combining head movement with standing or walking tasks to improve stability.
Includes exercises with head movement, eyes closed, and on uneven surfaces. These exercises train the brain to adapt or compensate for inner ear damage. They also work on stimulating other sense such as touch and joint movement (proprioception).

These exercises are particularly beneficial for patients with TBIs, vestibular neuritis, and dizziness triggered by head motion.

Contact Us

We’re here to support your recovery journey. Reach out to schedule an appointment, ask questions, or learn more about our services. Our team is dedicated to providing compassionate care and guiding you through each step of your healing process.

Phone Number

P: (206) 861-8200

care@bimseattle.com

Fax

F: (206) 324-1178

Location

3213 Eastlake Ave E, Suite A, Seattle, WA 98102

Hours of Service

Monday - Friday

8:00 AM-5:00 PM