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Patients with poor balance disorder is increasing. In fact, vestibular disorder is now common among people of all ages affecting their ability to carry out daily activities and elders with increasing falls.

What is a Vestibular Disorder?


Our balance relies heavily from the signals received from our eyes, inner ear, muscles and joints known as the visual, vestibular and proprioceptive input. When any of these system malfunction, you can become dizzy and develop symptoms such as feeling lightheaded, spinning or fainting as the messages received to and from our brain are not consistent with what our eyes and body are seeing and feeling.

 

Common Vestibular Disorders are:

  • Inner Ear Infection such as Vestibular Neuritis, Labyrinthitis
  • Benign Paroxysmal Positional Vertigo (BPPV)
  • Meniere’s Disease
  • Vestibular Migraine
  • Vestibular Occular Reflex (VOR) Dysfunction

 

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Treatment for Vestibular Disorder

Depending on the cause, physiotherapy treatment begins with the collection of patient’s detailed medical history and physical examination to evaluate dysfunctions within the visual, vestibular, musculoskeletal and proprioceptive system that is conducted in the rehabilitation centre.

1. Musculoskeletal Rehabilitation (MR)

Abnormalities in the nerves, muscles and joints from the neck and head region, may send symptoms from the neck to the head and vice versa. If you experience increased symptoms when pressure is applied to your neck, neck stiffness, blurred vision or have pain that travels behind your eyes, MR can improve your joint movements, reduce nerve impingement and muscle spasm over the upper cervical spine. This promotes normal neck movement without obstructing the blood flow and nerve pathway.

2.Vestibular Rehabilitation Therapy (VRT)


Upon solving the head and neck symptoms, VRT is applied to guide the brain to regain balance and postural control using compensation methods. When there is an imbalance or damage to our vestibular system, our body must learn coping strategy by relying on other alternative signals to regain postural stability.

Types of VRT treatment includes :

  • Canalith Repositioning : Returning free floating calcium particles from the inner ear to the utricle.
  • Gaze Stabilisation : Correcting unsteady eyes to reduce retinal slip and improving visual acuity by producing eye movements opposite to the direction of head rotation.
  • Balance Training : Muscle strengthening to improve stability and confidence
  • Habituation : Putting patients through repetitive and demanding visual, head and body movement to overcome dizziness

 

 

Vestibular recovery can be as immediate as 1 to 2 session in addressing the issue of balance and dizziness while returning patients to normal activities and reducing risk of falls in elderly.

References:

  1. Dougherty JM, Carney M, Hohman MH, et al. Vestibular Dysfunction. [Updated 2022 Aug 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558926/

Prepared by:

Zoe Lim

Your Physio Subang Jaya

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