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Vestibular physiotherapy

What is vestibular rehabilitation therapy?
Vestibular rehabilitation therapy is a proven and effective exercise based program. It improves the symptoms of dizziness, vertigo and unsteadiness resulting from inner ear conditions such as:

  •     Benign paroxysmal positional vertigo (BPPV)
  •     Vestibular neuronitis or labyrinthitis
  •     Post acoustic neuroma removal
  •     Vestibular migraine
  •     Ototoxicity
  •     Trauma.

If your symptoms are provoked or aggravated by movement or positional changes, or you have problems with balance or unsteadiness while walking, a doctor or Audiologist can refer you for an initial assessment with a physiotherapist.

What happens in a session?
The initial assessment will take about one hour. If it is appropriate you will be given an exercise program that you can do at home. These exercises are individually tailored to your balance symptoms. Generally the program takes between 10-15 minutes to do and consists of balance and walking exercises as well as desensitizing exercises to reduce the dizzy feelings you may get with particular movements. The daily program can be done up to three times per day for maximum benefit.

Follow up appointments are half an hour long and will be organised as required. The first follow up will usually be scheduled within one to two weeks and any further reviews (up to a maximum of 6) are usually spaced about one month apart. These sessions are used to monitor your progress and carefully grade the exercise program.

What are the likely outcomes?
Vestibular rehabilitation has been shown to be effective in reducing dizzy symptoms with movement, improving balance, walking more steadily, reducing the risk of falls and improving confidence and endurance. It can help you get back to normal everyday activities like maintaining balance in the shower, walking, sport, or housework. It can also help to reduce fatigue and increase independence.

Where can I attend vestibular physiotherapy?
This service is provided by specialist physiotherapists at The Royal Victorian Eye and Ear Hospital. To access the service, you will need a named referral from your GP, addressed to Vestibular Physiotherapy at the Eye and Ear under the Chronic Disease Management Plan.

Your referral can either be faxed or mailed to The Royal Victorian Eye and Ear Hospital:

Address: The Royal Victorian Eye and Ear Hospital
Audiology Department
32 Gisborne St,
East Melbourne
VIC 3002

Fax: (03) 9929 8272

Vestibular rehabilitation is also provided in various community and hospital settings, as well as in private clinics. If you would like to see a physiotherapist closer to your home, a list of providers can be found here.

References:
Hillier SL, McDonald MN (2015) Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database of Systematic Reviews, Issue 1.
Vitkovic J, Winoto A, Rance G, Dowell R, Paine M (2013) Vestibular Rehabilitation Outcomes in Patients with and without Vestibular Migraine. Journal of Neurology, 260: 3039-3048.
Porciuncula F, Johnson CC, Glickman LB (2012) The Effect of Vestibular Rehabilitation on Adults with Bilateral Vestibular Hypofunction: A Systematic Review. Journal of Vestibular Research, 22: 283-298.