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What is the frequency of inner ear disorders?
The problem of dizziness and disequilibrium is significant, second only to low-back complaints in frequency of occurrence in adult populations.
Vertigo / Dizziness itself is not a disease but rather a symptom of a problem within the peripheral or central nervous system.
There are many causes of dizziness; however, a large percentage result from pathology within the peripheral vestibular system.
Vestibular rehabilitation is an exercise approach to the remediation of disequilibrium and dizziness symptoms associated with peripheral vestibular pathology. A common neuro-otological approach to managing the dizzy patient with balance problems is to administer medication designed to suppress vestibular function. However, many of the medications used for inner ear disorders have the disadvantage of potential habituation and sedating side effects that frequently limit the patient's ability to perform useful activities.
Vestibular rehabilitation is an alternative form of treatment involving specific exercises designed to (1) decrease dizziness; (2) increase balance function; (3) increase general activity levels. The exercise program is designed to promote central nervous system compensation for the inner ear deficits. Patients are asked to exercise daily at home and to visit the physical therapist or occupational therapist during an initial period of four to six weeks.
Not all patients who have an inner ear disorder need vestibular rehabilitation. Patients who do not demonstrate a spontaneous resolution of symptoms such as dizziness and disequilibrium within six months of their onset may benefit from therapy. In these patients, the central nervous system seems unable to adequately compensate for the inner ear deficit.
Many patients have undergone a period of medical management using medications to suppress vestibular function and reduce symptoms, with little or no success. Symptoms become chronic, often lasting for periods of months or years. These patients with unresolved inner ear disorders may significantly improve their symptoms following vestibular rehabilitation.
Another type of patient who may benefit from vestibular rehabilitation is the one with acute or abrupt loss of vestibular function. Patients who have surgery for unresolved vestibular problems will benefit from a vestibular rehabilitation program designed to help the patient effectively compensate for his or her inner ear disorder.
Physical therapy benefits patients with dizziness and/or imbalance resulting from disorders including:
• BPPV
• Otolith Dysfunction
• Vestibular Labyrinthitis
• Acoustic Neuroma
• Ototoxicity
• Meniere's Syndrome
Several patient studies have been done to examine the effect of vestibular habituation therapy on dizziness symptoms. These studies are unanimous in demonstrating a decrease in symptoms of dizziness and disequilibrium after exercise therapy. One study compared the effectiveness of specific habituation therapy to a general exercise program in decreasing vertigo complaints in patients with a variety of vestibular pathologies. Results supported vestibular habituation therapy over a general exercise program for the remediation of positional vertigo.
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