Vertigo rehabilitation
VESTIBULAR REHABILITATION
Vestibular rehabilitation uses the plasticity of the central nervous system, i.e. its ability to develop new balancing strategies in light of an impairment in the peripheral vestibular system. Sometimes there is no peripheral vestibular deficit but a deterioration in the central use of inputs from the inner ear. Two types of mechanism are involved: habituation, which reduces the intensity of the response by repeating the stimulation, and adaptation, which leads to a reorganization of the neural circuits, a recalibration in vestibulo-ocular and vestibulo-spinal reflexes, and better use of visual and proprioceptive resources. To do this, vestibular rehabilitation uses various methods of sensory habituation, substitution or illusion through a combination of physical exercises and/or instrumental manoeuvres using a rotational chair, oculo-motor ramps, optokinetic target generators, posture platforms, etc. According to the literature, the mean duration for a VR programme is 4 to 10 weeks.
Designed for an inner ear condition called benign paroxysmal Positional Vertigo (BPPV). This condition occurs when the salt-like crystals in the inner ear called otoconia, become dislodged and float within the canals of the vestibular system. Treatment includes one or two sessions of 20 Minutes. In clinical setup as the crystals are gently repositioned.
For individuals who have a loss of balance, unsteadiness of loss of sure footedness. Most of these patients do not report dizziness or motion intolerance. We emphasize practical solutions to the common problems of difficulty getting around in the dark, walking on uneven surfaces and moving unencumbered on ramps or stairs. Fall prevention, movement coordination and improved participation in everyday activates are all high priorities of the program.
Designed for the patient whose symptoms may be severe and who requires supervision during exercise. Therapy sessions include the use of vestibular equipment which most people enjoy. For older patients, there is an emphasis on fall prevention. Typically the patient participates in two or three sessions of 60 minutes each. As the patient progresses, home exercises are added to accelerate the results.
Home based therapy which the patient based on test result and the situations which bring on symptoms. This approach is most commonly used with patients that do not require supervision during exercise. Best results occur when the patient spends 20-30 minutes per session two to three times a day. Most patients report a significant reduction in their symptoms within a two to four week time spent.
ROTATIONAL CHAIR
The patient is placed on a chair rotating at high speed to the right or left and stopped abruptly. The patient is then asked to fix their gaze on a target in front of them and to say when the target stops moving. These accelerated rotations make the vestibular inputs symmetrical.
OPTOKINETIC STIMULATION
Spots of light are shone in front of the patient, who is standing and must maintain balance either on a hard surface or on a foam mat. These procedures are designed to encourage the use of vestibular inputs and adjust the patient’s faith in them and the resulting stabilisation strategies based on the use of visual information.
FIRST THINGS FIRST
The first step to getting better is the proper diagnosis. According to the National institute of health, 85% of all equilibrium or Balance problems can be directly related to an inner ear disorder. Changes in the inner ear may occur for many reasons, including illnesses, infections, trauma, or simply the natural aging process, For some individuals who have experienced Meniere’s disease, labyrinthitis (inner ear infections) or vestibular neurinitis (inflammation of the balance nerve), the sense of “not feeling quite right” or dizziness may linger for year after the original occurrence. For others, the loss of sure footedness causes a constant fear of falling and possibly a more serious injury.
HOW DOES VR THERAPY WORK?
Think of each inner ear as a propeller on an airplane. In order for the airplane to fly in a straight line ,each propeller must propeller an equal number of revolutions per second. If one of the propellers stops or slows, the airplane will veer off course, or fly in circles. Likewise, when there is a change in one of the human vestibular system’s outputs we experience the feeling of turning or motion, which we call dizziness or vertigo. Now imagine that the airplane has a very sophisticated on-board computer that could be programmed to adjust and correct for the difference.
between the two propellers to keep the airplane flying a straight course. In the case of a human balance disorder, the brain acts as the body’s on-board computer. Vestibular Rehabilitation and Balance Retraining actually re-programs the vestibular system’s connections within the brain to adjust to the imbalance.