Vestibular Rehabilitation consists of a program of multisensory stimulation, based on exercises and habit modification, to improve the symptoms of patients with vestibular disorders and their functional recovery, in addition to minimizing the risk of falls and enhancing quality of life. It is based on the concept of vestibular compensation, expressed through the neuroplasticity of the Central Nervous System, and defined as the set of physiological processes that seek anatomical and functional reorganization of both the vestibular system and the brain areas connected to it.
In simpler terms, vestibular rehabilitation is a therapeutic approach using physical, cognitive, and sensory exercises to improve vestibular symptoms (dizziness, vertigo, and instability). These exercises can be performed with or without instruments. It is an individualized process, with goals set according to the patient’s specific deficits. In addition to these exercises, it is crucial for patients to understand their condition, as this reduces uncertainty and fears that may arise during the recovery process.
Indications for vestibular rehabilitation include:
– Peripheral vestibular pathologies (Unilateral: neuritis, BPPV, surgeries, Ménière’s disease, acoustic neuroma; and bilateral: idiopathic, polyneuropathy, ototoxicity, trauma, autoimmune, CANVAS)
– Central pathologies (stroke, vascular pathology of the posterior fossa, MS, Parkinson’s, TBI, vestibular migraine, ataxias)
– Presbyvestibulopathy
– PPPD (Persistent Postural-Perceptual Dizziness)
– Motion sickness
– Motion intolerance
– Visual dependency
It is important to begin treatment early, although improvements are seen regardless of the timing. The presence of other conditions such as anxiety, depression, peripheral neuropathy, migraine, abnormal binocular vision, and cognitive impairment can negatively impact therapy outcomes. Lastly, the prolonged use of vestibular suppressants adversely affects recovery.
