Treating Dizziness and Imbalance with Physical Therapy

Posted by: seattledizzygroup | October 31, 2017

Treating Dizziness and Imbalance with Physical Therapy

October is National Physical Therapy Month!

Every October, the American Physical Therapy Association (APTA) celebrates National Physical Therapy Month (NPTM) which is a great opportunity to learn about the many benefits of physical therapy and recognize the impact of physical therapists.

Maximize your movement. Participate in your recovery. Choose physical therapy!

Find out more: www.apta.org/NPTM

How Can Physical Therapy Help with Dizziness and Imbalance?

Dizziness is a common problem, especially among older adults. In fact, for people over the age of 65, dizziness is one of the most common reasons for physician visits and hospitalizations. Regardless of the cause of dizziness, the sooner you get help, the better.

The good news: most dizziness and balance disorders can be successfully treated—and they are not an “inevitable” part of aging.

Your physical therapist can perform tests to determine the causes and also to assess your risk of falling. Often, there is more than one reason for dizziness and falls in the same person. Based on your physical therapist’s evaluation and your goals for recovery, the therapist will customize a treatment plan for you. Your therapist’s main focus is to help you get moving again and manage the dizziness at the same time. Exercise and new ways to perform daily activities are the primary treatments.

During your recovery, your physical therapist will teach you strategies to help you cope with your symptoms:

Do certain activities or chores around the house cause you to become dizzy? Your therapist will show you how to do those activities in a different way to help reduce the dizziness.
Have simple activities become difficult and cause fatigue and more dizziness? Your therapist will help you work through these symptoms right away so you can get moving again and return to your roles at home and at work more quickly.

Physical therapy treatments for dizziness can take many forms. The type of exercise that your therapist designs for you will depend on your unique problems and might include exercises to improve your balance, to improve your ability to focus your eyes and vision, and to “correct” differences between your brain and your inner ears. The inner ears tell the brain how the body is moving in relation to gravity. They also communicate information about head motion, which is used to coordinate eye motion.

In addition to those exercises, your physical therapist might prescribe exercises to improve your strength, your flexibility, and your heart health—with the goal of improving your overall physical health and well-being.

(Information from Move Forward PT)

Evidence has shown that vestibular rehabilitation (a specific type of physical therapy) can be effective in improving symptoms related to many vestibular (inner ear/balance) disorders. People with vestibular disorders often experience problems with vertigo, dizziness, visual disturbance, and/or imbalance. These are the problems that rehabilitation aims to address. Other problems can also arise that are secondary to vestibular disorders, such as nausea and/or vomiting, reduced ability to focus or concentrate, and fatigue.

Symptoms due to vestibular disorders can diminish quality of life and impact all aspects of daily living. They also contribute to emotional problems such as anxiety and depression. Additionally, one of the consequences of having a vestibular disorder is that symptoms frequently cause people to adopt a sedentary lifestyle in order to avoid bringing on, or worsening, dizziness and imbalance. As a result, decreased muscle strength and flexibility, increased joint stiffness, and reduced stamina can occur.

Treatment strategies used in rehabilitation can also be beneficial for these secondary problems.

(Information from Vestibular Disorders Association)

Vestibular Rehabilitation Therapy Promotes Compensation

Vestibular rehabilitation (VR), or vestibular rehabilitation therapy (VRT) is a specialized form of therapy intended to alleviate both the primary and secondary problems caused by vestibular disorders. It is an exercise-based program primarily designed to reduce vertigo and dizziness, gaze instability, and/or imbalance and falls.

For most people with a vestibular disorder the deficit is permanent because the amount of restoration of vestibular function is very small. However, after vestibular system damage, people can feel better and function can return through compensation. This occurs because the brain learns to use other senses (vision and somatosensory, i.e. body sense) to substitute for the deficient vestibular system. The health of particular parts of the nervous system (brainstem and cerebellum, visual, and somatosensory sensations) is important in determining the extent of recovery that can be gained through compensation.

For many, compensation occurs naturally over time, but for people whose symptoms do not reduce and who continue to have difficulty returning to daily activities, VRT can help with recovery by promoting compensation.

The goal of VRT is to use a problem-oriented approach to promote compensation. This is achieved by customizing exercises to address each person’s specific problem(s). Therefore, before an exercise program can be designed, a comprehensive clinical examination is needed to identify problems related to the vestibular disorder.

Depending on the vestibular-related problem(s) identified, three principal methods of exercise can be prescribed: 1) Habituation, 2) Gaze Stabilization, and/or 3) Balance Training.

For patients with Benign Paroxysmal Positional Vertigo (BPPV) the exercise methods described above are not appropriate. First a clinician needs to identify the type of BPPV the patient is suffering from, and then different repositioning exercises can be performed. After BPPV has been successfully treated and spinning symptoms resolved, some patients will continue to report non-specific dizziness (symptoms other than spinning) and/or imbalance. In these cases, treatment using habituation exercise and/or balance training may be indicated.

(Information from Vestibular Disorders Association)