Vestibular Rehabilitation therapy (VRT) is a form of physical therapy that uses specialized exercises that result in gaze and gait stabilization. Most VRT exercises involve head movement, and head movements are essential in stimulating and retraining the vestibular system.

Vestibular rehabilitation therapy has been a highly effective modality for most adults and children with disorders of the vestibular or central balance system. In a number of studies, customized VRT programs were significantly more effective than generic exercises in resolving symptoms.

The basis for the success of Vestibular rehabilitation Therapy is:

Vestibular Rehabilitation.ent

Vestibular Rehabilitation

Τhe use of existing neural mechanisms in the human brain for adaptation, plasticity, and compensation. The extent of vestibular compensation and adaptation is closely related to the direction, duration, frequency, magnitude, and nature of the retraining stimulus. Specifically designed VRT exercise protocols take advantage of this plasticity of the brain to increase sensitivity and restore symmetry.

This results in an improvement in:

  • vestibulo-ocular control,
  • an increase in the gain of the vestibulo-ocular reflex (VOR),
  • better postural strategies, and
  • increased levels of motor control for movement.

Other factors that affect the degree of individual compensation include:

  • overall physical status,
  • the functional status of remaining sensory systems,
  • integrity of central brain mechanisms,
  • age, and
  • higher sensory functions such as memory, motor coordination, and cognitive ability. 
The process of compensation depends on various mechanisms, including substitution strategies, prediction strategies, and cognitive strategies.
Components of VRT may involve learning how to trigger the symptoms in order to ”desensitize” the vestibular system (habituation):
  • for positional or motion-provoked symptoms,
  • adapting to improve the gain of the vestibulo-ocular or the vestibulospinal reflexes, and
  • substituting alternative senses to replace lost vestibular function by biasing use away from the dysfunctional vestibular input.

When combined, this results in a progressive waning of symptoms of imbalance, disequilibrium, and motion-induced unsteadiness.

As compensation occurs for a vestibular deficit, the remaining CNS processes allow sufficient control of eye, head, and body movements to maintain stable gaze, posture, and position.