Balance and Vestibular Rehabilitation
A healthy vestibular system is essential for a full active life. When your balance (your 6th sense) is working then you are simply not aware of it and maybe take it for granted. I know I certainly did. Unfortunately due to a number of vestibular disorders your balance system can unexpectedly take a turn for the worse and suddenly make it's presence (or lack of) known. You soon understand just how important it is and how awful it feels when it no longer functions correctly.
Balance is a very complex system vital for perfect functioning. People assume that we people with vestibular problems are a little lightheaded from time to time but the truth is there are moments maybe weeks and months were we simply cannot function. Our vestibular system no longer works correctly thus causing our vision, cognitive abilities and spatial awareness to to be seriously impacted. We are not simply a "little dizzy".
There are three sources that need to work together to send signals to your brain so that perfect balance is achieved. They are:
The eyes provide visual cues identifying his/her surroundings and tells the brain how a person is oriented relative to other objects. For example, when a person walks down a busy street, the eyes inform the brain about how far or near another person is in relation to him/her, the person can then judge when he/she should move or not to stop bumping into other pedestrians. When the eyes and brain are not in sync, all manner of problems arise. The amount of noise, movement and visual stimuli in a busy street causes real problems for someone with vestibular dysfunction.The eyes are telling the brain one thing whilst the brain is thinking something else. Accidents can therefore occur. It's common for vestibular patients to become visually dependent in order to maintain balance since other vital mechanisms (inner ear) do not work efficiently. They depend on visual clues to basically feel where they are in space and maintain balance. That is why many find it more difficult in dark environment,the visual clues are not there. I personally know this to be true as I often have to fix my eye on an object just to get from A to B.
Muscles and joints
Important information from the muscles, joints and skin need to send clear and efficient signals to the brain. However a vestibular problem can upset this important sensory information.
Vestibular system (inner rear)
Sensory information about motion, equilibrium, and spatial orientation is provided by the vestibular system. A fully functioning vestibular system is capable of feeding the brain all of the important motion information as well as gravity information.Unfortunately with a vestibular problem the information being sent to the brain is corrupt. Your eyes are telling the brain you are 10 degrees right whilst the ears are telling the brain you are 30 degrees left and your muscles are saying something completely different so the brain doesn't know what to do and comes to it's own conclusion and the world becomes a disorientated hell hole.
The Vestibular System
A video describing the vestibular system. Shared here with the kind permission from the doctorbhanuprakash Youtube channel.
Vestibular Rehabilitation is usually offered to patients who have been suffering vertigo or dizziness for more than the normal length of time (8 weeks). For some reason these people have not recovered naturally and are therefore given various body and head exercises which are supposed to be repeated daily for up to a year or more.The exercises specifically target the vestibular system thus speeding up compensation. Patients are typically seen on an outpatient basis once every 2-4 weeks and provided a specific daily home program that is upgraded as appropriate.
Many patients will be given Cawthorne cooksey exercises to perform. I had 5 different exercises to complete 3 times a day. These are simple head and posture exercises to aid vestibular compensation. The exercises appear simple but can be very exhausting to a dizzy person. Being dizzy and then purposely making yourself dizzier seems ridiculous and they can make you feel awful but through the discomfort there is light at the end of the tunnel as VRT has been a very successful treatment option for many people giving them back normality.
If these simple exercises are unsuccessful then I suggest that you seek a second opinion. Vestibular rehabilitation can help the recovery process enormously and should seriously be considered if you have had an ongoing dizziness or vertigo. Vestibular rehabilitation when used in conjunction with appropriate medication can help treat dizzy conditions such as Migraine associated vertigo.
Vestibular Rehabilitation helps to :
I have done my fair share of VRT over the years. Performing the exercises I was given 3 times a day. The first attempt was for 9 months and the second attempt lasted 6 months. From the very beginning I made sure I was active and have tried my best to push myself but unfortunately VRT did not help me. Looking back i think it was because i never had a solid diagnoses for nearly 5 years and no medication to help me. So doing VRT was just further irritating my already irritated brain.
However, last year I met with a wonderful Neuro - otologist who told me I am suffering from Migraine associated vertigo and that with the correct medication treating the underlying problem, VRT will help. I have yet to begin my third attempt of VRT for a number of reasons but thanks to my consultant I am now back to exercising 45min a day and feeling an improvement in symptoms some of the time.
Persons with the following unstable vestibular conditions may not find VRT helpful.
It is very important that you get professional medical advice before starting any such exercises. If vestibular therapy is something that your GP or consultant approves of then stay committed to performing the vestibular exercises you are given. Results will not appear over night. Follow your physiotherapists advice and do not give up. The exercises are made to make you dizzier short term thus desensitizing you to future movements.
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