Vestibular Therapy

Services

BPPV – Canalith Repositioning Maneuvers & Liberatory Maneuver

BPPV stands for Benign Paroxysmal Positional Vertigo, which is the most common type of vertigo and is caused by a problem with the inner ear. BPPV is characterized by brief episodes of spinning or dizziness that last for seconds to minutes and is triggered by changes in head position, such as rolling over in bed, sitting up or getting out of bed, tilting the head back or quick head movements. Medication is currently 0% effective at curing the cause of this type of Vertigo.

Canalith Repositioning Maneuvers and Liberatory Maneuvers are a series of movements used to reposition small calcium carbonate crystals called otoconia that have become dislodged from their normal position within the inner ear. These crystals can migrate into one of the three semicircular canals, causing the inner ear to send incorrect signals to the brain about the body’s position, leading to vertigo and other symptoms.

A Certified Vestibular Therapist can perform a series of test that can determine which semicircular canal is affect to determine which inner ear is affected and which Canalith Reposition Maneuver needs to be complete. These test are known as the gold standard for diagnosing this very common type of vertigo/dizziness. It is always best to consult with a Certified Vestibular Therapist prior to trying any maneuvers yourself as an incorrect Canalith Reposition Maneuver or a Maneuver done incorrectly will not fix this pathology and can sometimes make your symptoms worse.

During a Canalith Repositioning Maneuvers or Liberatory Maneuver, a therapist will guide the patient through a series of specific head and body movements to allow gravity to move the displaced crystals back into their proper location within the inner ear. These Maneuvers can completely eliminate the symptoms of BPPV by restoring normal function to the inner ear and usually occurs in one to three physical therapy sessions. These Maneuvers have been studied and proven in systematic reviews which is the highest level of evidence/research for proving if treatment is successful or not and has been shown to be safe and effective with a success rate of 95% (see systematic review below). This pathology has been by far the quickest pathology I have ever been able to make symptom free out of any pathology I have treated in my career. Patients may require several sessions to achieve optimal results, but many report significant improvement or complete elimination of symptom after just one session – 92.5% success rate in just one week (see randomized control trial below). It’s not very often you are able to walk into a doctors appointment symptomatic and most likely walk out symptoms free.

Other Vestibular Services/Treatment Options

Habituation Exercises

Habituation exercises are a type of vestibular rehabilitation therapy that is used to treat vertigo and dizziness. Habituation exercises involve repeated exposure to movements or stimuli that provoke vertigo with frequent rest breaks for symptoms to return to your baseline, with the goal of reducing the brain’s sensitivity to these triggers over time. The theory behind habituation exercises is that repeated exposure to the movements or stimuli that provoke vertigo can help the brain adapt and become less sensitive to them. This can ultimately eliminate or reduce the frequency and severity of vertigo episodes and improve overall balance and function.

Habituation exercises can be an effective way to treat vertigo and dizziness associated with vestibular disorders. However, it’s important to work with a qualified vestibular therapist to determine the appropriate exercises for your specific condition and to ensure that they are performed correctly and safely without over stimulating the vestibular system.

Substitution Exercises

Substitution exercises are another type of vestibular rehabilitation therapy that is used to treat vertigo, a common symptom of vestibular disorders. These exercises involve training the patient to rely on other sensory inputs, such as vision and touch/proprioception (awareness of the position and movement of the body.), to compensate for the abnormal signals coming from the vestibular system.

During substitution exercises, the patient is typically asked to perform tasks that challenge their balance and coordination while focusing on visual cues or other sensory inputs. These exercises are designed to help the brain learn to rely on other sensory inputs to maintain balance and spatial orientation, which can reduce the symptoms of vertigo over time.

Substitution exercises can be an effective way to treat vertigo and other symptoms of vestibular disorders. However, it’s important to work with a qualified vestibular therapist to determine the appropriate exercises for your specific condition and to ensure that they are performed correctly and safely.

Adaptation Exercises

Adaptation exercises are a type of vestibular rehabilitation therapy that is used to treat vertigo, a common symptom of vestibular disorders. These exercises involve exposing the patient to controlled, repetitive movements that may cause mild dizziness, with the goal of helping the brain adapt to the abnormal sensory signals that are causing the vertigo.

During adaptation exercises, the patient is typically asked to perform head and body movements while focusing on a stationary target. The movements are designed to stimulate the inner ear, which is responsible for balance and spatial orientation. By exposing the patient to controlled movements that cause dizziness, the brain is able to adapt to the abnormal sensory signals and reduce the symptoms of vertigo over time.

Adaptation exercises aim to improve the function of the vestibulo-ocular reflex (VOR), which is responsible for stabilizing the visual field during head movements. These exercises involve moving the head and eyes together in a controlled manner to stimulate the VOR and help it adapt to changes in head position. This can improve visual stability and reduce symptoms of dizziness.