J Clin Neurol.  2011 Dec;7(4):184-196. 10.3988/jcn.2011.7.4.184.

Vestibular Rehabilitation Therapy: Review of Indications, Mechanisms, and Key Exercises

• Han BI
• Song HS
• Kim JS

• KMID: 2179003
• DOI: http://doi.org/10.3988/jcn.2011.7.4.184

Abstract

Vestibular rehabilitation therapy (VRT) is an exercise-based treatment program designed to promote vestibular adaptation and substitution. The goals of VRT are 1) to enhance gaze stability, 2) to enhance postural stability, 3) to improve vertigo, and 4) to improve activities of daily living. VRT facilitates vestibular recovery mechanisms: vestibular adaptation, substitution by the other eye-movement systems, substitution by vision, somatosensory cues, other postural strategies, and habituation. The key exercises for VRT are head-eye movements with various body postures and activities, and maintaining balance with a reduced support base with various orientations of the head and trunk, while performing various upper-extremity tasks, repeating the movements provoking vertigo, and exposing patients gradually to various sensory and motor environments. VRT is indicated for any stable but poorly compensated vestibular lesion, regardless of the patient's age, the cause, and symptom duration and intensity. Vestibular suppressants, visual and somatosensory deprivation, immobilization, old age, concurrent central lesions, and long recovery from symptoms, but there is no difference in the final outcome. As long as exercises are performed several times every day, even brief periods of exercise are sufficient to facilitate vestibular recovery. Here the authors review the mechanisms and the key exercises for each of the VRT goals.

Keyword

vestibular rehabilitation therapy; balance rehabilitation therapy; balance retraining therapy; gaze stability; postural stability; habituation

MeSH Terms

Activities of Daily Living
Cues
Exercise
Head
Humans
Immobilization
Orientation
Posture
Vertigo
Vision, Ocular