Vestibular & Balance Dysfunction Program

Dizziness and balance problems come in many forms and degrees of client suffering or loss of ability to continue normal daily activities. They are sometimes difficult to sort out, since there may be an overlap of symptoms and signs in individuals, especially the elderly. But, in general, the major categories of dizziness and balance problems addressed by physical therapy fall into the two areas described in this brochure: Vestibular Dysfunction and Balance Dysfunction.

Treatment requires a physician script and treatment diagnosis. The therapist will develop a plan of care after an initial evaluation. In most cases of vestibular or balance dysfunction, coverage under an insurance plan can be expected for short term medical necessity. Depending on the diagnosis and severity of symptoms, treatment can range from 2-3 sessions to several weeks. Each session is approximately 45 minutes in lenght.

Signs and Symptoms of Vestibular Problems-

• Vertigo
• Motion intolerance
• Nausea
• Dizziness with position change
• Room spinning
• Nystagmus (rapid involuntary eye movements)

Possible Treatment Diagnosis

• Benign Paroxysmal Positional Vertigo (BPPV)
• Vestibular neuronitis
• Labyrinthitis
• Head trauma (labyrinthine concussion)
• Meniere's disease
• Central vertigo

Vestibular Program

The primary intervention in this client will be to reduce the acute severity of symptoms of the vestibular system. Treatment may include:

Vestibular

• Canalithic repositioning (Liberatory Maneuver)
• Vestibular-ocular reflex training (inner ear & eye)
• Equilibrium training
• Motion tolerance training
• Habituation training
• Gait training
• Postural control
• Education

Balance

While physical therapy may address impairments in musculoskeletal, neuromuscular, cardio vascular, or pulmonary systems, this type of client will also have a primary need for risk and prevention of falling problems which benefit from:

• Systems evaluation
• Therapeutic exercise
• Postural control training
• Manual therapy (for tissue & joint repositioning)
• Gait training
• Prevention and self management techniques
• Patient education

• History of falls
• Staggering gait
• Lightheadedness
• Postural changes
• Loss of balance when rising
• Holding onto furniture for steadiness

• Gait abnormality
• Postural or skeletal disorder
• Musculoskeletal disorder
• Neurological disorder
• Cardiovascular/pulmonary disorder
• Pain in back or legs
• Decreased position sense

Balance Program Developer

Maredith Spector, PT, MS has over 20 years experience in effective management of postural and functional balance problems. She has authored articles and chapters.

Inquiries: (203) 431-7632