Vestibular Rehab Therapy (VTR) is defined as the systematic progression of exercise protocols which reduce or extinguish:

  • Hallucination of motion
  • Exaggeration of motion or after-motion

And improves or restores:

  • Coordination of head and eye movement
  • Balance and equilibrium function

Three primary treatment techniques of VRT:

Adaptation-gaze stabilization

A patient may c/o words jumping while reading, difficulty walking down aisle at grocery store, likely has a (+) head thrust test (corrective saccade). Adaptation exercises enhance the recovery of the VestibuloOcular Reflex (VOR). VOR is a compensatory movement of the eyes in the opposite direction of head movement to stabilize gaze. Adaptation occurs due to plasticity of the CNS.

Habituation

Based on the idea that repeated exposure to a provocative stimulus will lead to a reduction of the motion-provoked symptoms. May or may not mean the eyes are focusing on a target. Usually involved head and body movements, such as gait with head turns. Relationship with adaptation mechanism.

Substitution

Strengthens weakened system to return to function by challenging remaining ones (vision, somatosensation, vestibular). Force remaining systems to become more trustworthy when others are lost.

View poster: Vestibular Rehab Therapy (PDF format)

By Jen Wintle, Therapy Resource/DOR, PT, DPT, Sloan’s Lake Rehabilitation Center, Denver, CO