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  • Writer's pictureAriela Liberman

Dizziness & Disequilibrium Exercises Used in Vestibular Rehabilitation Therapy

Updated: Dec 18, 2023

Dizziness and disequilibrium can be unnerving, especially if they happen frequently and at inconvenient times. Dizziness can get in the way of living your life, but much of the time it is left untreated. 15-20% of adults every year experience dizziness, including vertigo, but that doesn't mean you have to live with it!


The most common symptom people report when they have an underlying vestibular disorder is dizziness. The good news is that it can be treated with physical therapy! Vestibular Rehabilitation Therapy (VRT) is a form of physical therapy that utilizes various exercise techniques to improve gaze stability, postural awareness, and balance. The goal is to reduce dizziness and get you back to the things you love.


vestibular rehabilitative therapy exercises

What Is the Vestibular System?


The vestibular system is located in the inner ear and is essential for sensing movement of the head and body, which in turn sends information to the brain about spatial awareness and head position in relation to gravity. There are various parts that make up the vestibular system, which helps to acknowledge rotational and linear acceleration of the head and body, ensuring that the body maintains equilibrium or a sense of balance.


Common Vestibular Disorders


The causes behind dizziness are plentiful and varied; breaking down the reason behind your ailment can be complicated, however, here are the most common vestibular disorders that might explain your dizziness.



1. Vestibular Hypofunction

Vestibular hypofunction occurs when there is a disruption in the pathway or nerve response between your vestibular system and brain. This in turn creates a weakness in your balance system. This can be due to damage to the inner ear, medications, or aging. This condition can impair your balance, vision, and posture, especially when in busy places or dark rooms.


2. Ménière’s Disease

Ménière’s disease is an inner ear disorder that causes dizziness, ringing in the ears, and hearing loss. Although there is more research being performed in this area, it is thought that it is caused by a buildup of fluid in the inner ear, which interferes with balance and hearing. It is more likely to happen between the ages of 40-60 but can develop at any age.


3. Persistent Postural Perceptual Dizziness (PPPD)

PPPD or 3PD, is due to a triggering event that causes our brain to get stuck into visual reliance to determine where our body is at in space and against gravity. Having those visual cues without the proper information from the vestibular system creates an inaccurate sense of balance and stability. People with PPPD tend to feel like they're floating, swaying, or rocking, and it can get worse in stimulating environments, such as being in a crowd.

 


What Is Vestibular Rehabilitation Therapy (VRT)?


VRT is a specialized form of therapy intended to alleviate symptoms of vestibular disorders. This form of treatment uses three methods of exercise to reduce vestibular disorder symptoms: habituation, gaze stabilization, and balance training. Your physical therapist will create an exercise program custom to your specific problems and needs.


Habituation

Habituation exercises are used for patients who experience dizziness when they move around, change positions, or feel dizzy in stimulating environments like grocery stores. Habituation exercises repeatedly expose patients to movements or visuals that induce dizziness in order to eventually decrease those symptoms. Over time, the symptoms will decrease as the brain gets used to those environments.


Gaze Stabilization

Gaze stabilization exercises are used for patients who struggle to maintain a fixed gaze while their head moves; the world seems to be bouncing or moving when looking at objects. These eye and head exercises improve control of eye movements to steady vision.


Balance Training

Balance training exercises are used for patients who have difficulties with balance or unsteadiness. These exercises improve steadiness so that daily activities can be accomplished without fear or risk of falling, especially in the dark.



 


Examples of Exercises in Vestibular Therapy


Everyone's body is different, and will therefore have different experiences regarding symptoms and conditions. However, here are a few examples of exercises that will help with feelings of dizziness when done correctly and consistently.


We strongly recommend getting evaluated by a physical therapist if you are experiencing lasting symptoms of dizziness, imbalance, lightheadedness, gaze instability, ringing in the ears, or unexplained falls. A physical therapist will be able to guide you in performing exercises for your specific condition.


X-Chops With Head Following



Vestibular-Ocular Reflex (VOR) - Level 1



Standing Balance - Feet Together - Eyes Open



See more examples of balance exercises here.


 

Interested in VRT?


Rehab United offers a comprehensive approach to vestibular and balance therapy that utilizes the most effective and efficient techniques to achieve the best results. Each patient will receive a thorough one-on-one evaluation to determine the underlying cause of the above-mentioned symptoms. In addition, your balance and fall risk will be assessed to formulate a plan of care to maintain your safety and improve your quality of life. Request an appointment today!




 

Ariela Liberman is a Marketing Associate and a staff writer for Rehab United, with a Bachelor of Arts in Media Studies. Born and raised in San Diego, she is a Southern California native with a passion for writing, digital marketing, health, and wellness.


Medically Reviewed By: Brittany Hollenbeck, PT, DPT, FAFS, CERP, BFRC, a physical therapist, certified vestibular physical therapist, and Clinic Director of Rehab United in La Mesa. She received her Doctorate in Physical Therapy in 2015 from San Diego State University and has stayed at the forefront of evidence-based treatment techniques through various continuing education courses. She has treated numerous injuries and disorders involving musculoskeletal, nervous system, and vestibular pathologies with great success.


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