Vestibular Rehabilitation​

Almost 1 in 4 adults under 65 years report dizziness or vertigo, often causing occupational di­fficulties or preventing employment but less than 25 per cent had received treatment.

What is the Vestibular system?


Our sense of balance depends on input from our eyes, inner ear, body and brain working together in harmony. The vestibular system involves signals passed from the inner ear to the brain and provides information that allows us to see clearly and have good balance.




















What causes vestibular problems? 


When there is a problem, the brain can no longer rely on the organs for accurate information. This can give a false sensation of movement and imbalance. The vestibular system can be affected by illness, infections, head injury, a period of immobility, medication and increasing age it and may lead to any of the following symptoms: 


  • A sense of disorientation (or need to hold on to an object when walking) 

  • Vertigo/room spinning

  • Dizziness 

  • Visual disturbances such as trouble focusing or tracking objects with the eyes 

  • Disequilibrium – a sense of being off balance without dizziness or vertigo, especially when walking and a feeling of tilting, veering or floating. 

  • Headaches or migraine 

  • Problems with balance and unsteadiness especially on turning corners and in the dark 

  • Hearing changes 

  • An increased risk of falling 

  • Discomfort caused by busy visual environments, crowds or large open spaces 

  • Loss of confidence or independence 

  • Anxiety 

  • Reduction of hobbies, work, sport or leisure activities 

Who could benefit from Vestibular Rehabilitation? 


Conditions that are known to respond well to Vestibular Rehabilitation include:


  • Labyrinthitis - Viral or Bacterial Infection - Labyrinthitis is inflammation of the part of your inner ear known as the labyrinth which controls your balance and hearing. When you move your head, the fluid in the canals moves and this tells your brain which direction you are moving in and how far and how fast you are going. This information helps your body to balance. Antibiotics may be required or symptomatic relief if viral.   

  • Vestibular Neuronitis - Inflammation of the vestibular nerve. A single severe episode of vertigo lasting at least 48hrs. Symptomatic relief is offered by the GP initially and if it does not fully resolve specific physiotherapy led exercises can help. BPPV may develop following the virus.  

  • BPPV (Benign Paroxysmal Positional Vertigo) - a disorder of the inner ear resulting in episodes of intense dizziness on certain head movements. Small particles are dislodged and sit in the semi-circular canal and disrupt the feedback system. The definition of BPPV can be broken down as follows: 

Benign – means not due to serious disease, although it can still be quite disabling. 

Paroxysmal – because it occurs in short, intense bursts lasting seconds 

Positional – because it is provoked by certain head movement  

Vertigo – is a condition with a sensation of whirling and a tendency to lose balance. It is often referred to as dizziness or giddiness. Vertigo is often incorrectly used to describe a fear of heights. The symptom of vertigo often implies a disorder of the inner ear or vestibular system. 

  • Ménière’s disease is a condition of the inner ear but the cause in as yet unknown. The symptoms of Ménière’s disease are vertigo, tinnitus and hearing loss.  

  • Vestibular Migraine – A type of migraine headache in which the balance system is also affected. As well as symptoms of migraine, vertigo/dizziness may also be experienced. The migraine and vertigo symptoms do not always occur simultaneously for sufferers 

  • Acoustic Neuroma (pre and post surgery) 

  • Dizziness in the Elderly 

What is Vestibular Rehabilitation? 


Vestibular Rehabilitation is a specialised program of treatment to enable normal responses of the eyes, ears and brain to positional changes so that normal balance can be restored. 


What are the benefits of Vestibular Rehabilitation training? 


Some people recover very quickly after a dizzy spell but as it is often unpleasant to move your head as it brings on the dizziness and people begin to keep their head very still.  However, avoiding movement delays recovery and so treatment is essential.


The benefits of physiotherapy treatment to someone with a vestibular

condition can be dramatic with some patients achieving immediate

and lasting relief and may include: 


  • Helping you get back to activities you were enjoying before 

  • Ease symptoms of dizziness and unsteadiness 

  • Reduction of falls 

  • Decrease motion sensitivity and nausea 

  • Improved balance and motion control 

  • Reduced headaches or migraines 

  • Decrease sensitivity to bright lights and noises  

  • Increase the ability to read and concentrate 

  • Increased confidence, particularly in physical ability. 

What to expect from a Vestibular Rehabilitation assessment 


At Physiofit, our assessment and treatment protocols are based on sound evidence-based research and clinically proven techniques and are customised for each patient. Our specially trained Physiotherapist, Jean Thistleton has over 10 years of experience in vestibular rehabilitation.  


A thorough, initial assessment is required to identify the type of dizziness you’re experiencing and to rule out non-vestibular causes first. The assessment will include: 


  • Taking your medical history 

  • Understanding how your symptoms affect your everyday life 

  • Eye coordination tests 

  • Balance tests 

  • Posture 

  • Positional tests 

  • Gait analysis 


If the results are inconclusive or the symptoms are more complex you may be referred for further medical tests to confirm the cause of your vestibular issues. We work closely with a team of specialists whom we can recommend. 


We will then discuss with you your treatment options and the recommended frequency of treatment sessions and how long it will take to regain normal function as well as the likely outcomes. 


Vestibular Rehabilitation treatment  


The treatment plan may include: 


  • Explanation regarding the condition to improve understanding 

  • Specific techniques to treat symptoms for BPPV such as the Epley manoeuvre (Benign Paroxysmal Positional Vertigo) 

  • Eye and head movement exercises 

  • Exercises to improve standing balance and posture 

  • Education and advice on activities of daily living to improve confidence and function 

  • Advice on falls prevention 


Exercise programmes are individually designed appropriate to the diagnosis. The more bespoke this balance training is to the individual, the better the results. The exercises will help to make the balance system less sensitive to any movements that make your symptoms worse and make you feels more stable. 


How can I arrange a vestibular physiotherapy assessment? 


If you have been diagnosed by your doctor as having a vestibular condition or are experiencing any of the symptoms listed above, you may benefit from an assessment with our experienced physiotherapist. For more information or to book yourself an appointment, please contact us via email us at or call us on 01625 590444 

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Need to talk to a Physio? 


Feel free to give us a call on 

01625 590444

Registered address:


4 Trafford Road,

Alderley Edge,