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Vestibular Rehabilitation Therapy

Vestibular Therapy is a service we provide that incorporates exercise-based intervention to train and induce central nervous system compensation for inner ear disorders contributing to vestibular dysfunction.

Conditions we treat through Vestibular Therapy in Harrisonburg, VA:                                           

  • Benign Paroxysmal Positional Vertigo (BPPV)
  • Unilateral hypofunction and bilateral hypofunction
  • Labyrinthitis
  • Chronic Meniere’s Disease
  • Balance issues/falls
  • Dizziness associated with post-concussion syndrome
  • Vertigo and dizziness issues (peripheral)
  • S/p surgical procedures for vestibular problems

Our Vestibular Therapy Treatment approaches include:

  • Adaptation approach: typically used with hypofunction unilateral patients
  • Bilateral hypofunction with some remaining function
  • Habituation approach: for motion sensitivity
  • Substitution approach: for those with total bilateral loss and central
  • Peripheral issues
  • Repositioning maneuvers: for those with distorted function

Some patients will receive multiple types of treatment depending on the diagnosis. Positional, balance and oculomotor examinations are performed as a part of the comprehensive vestibular evaluation. Due to the training involved the specific semicircular canal involved is able to be determined with BPPV as well as ways to clear otoconia.          

Why is Vestibular Rehab Therapy (VRT) valuable and what you can expect?

When the organs of the inner ear are damaged by disease or injury, the brain no longer can receive accurate information about motion and balance or equilibrium which can result in dizziness, vertigo, balance problems and other symptoms. Many people are able to recover from these symptoms without intervention in a few weeks allowing for the brain to adapt through normal activity, also known as vestibular compensation.

However, if the vestibular compensation does not take place, a person may rely too heavily on input from vision and proprioception from muscle and joints, which further inhibits vestibular compensation and also creates other symptoms from over-compensating movements throughout the body, such as headache or musculoskeletal issues. VRT enables retraining the brain in coordination with visual and proprioceptive input to achieve the relief the patient is ultimately looking for. This is done through desensitizing the balance system to the very movement that provokes symptoms. Symptoms may at first appear to worsen in response to exercises which is normal. If faithful and consistent performance of prescribed exercises occurs, dizziness, vertigo and nausea will diminish and quite possibly disappear without any other intervention required.



Vestibular Therapy Treatment Approaches at The Center for Hand & Physical Therapy:


Habituation treats motion sensitivity and visual vertigo by enabling the body to accommodate and overcome. 

Checkered Grid for Vestibular Therapy

Cervical Proprioception

Cervical Proprioception is the process of helping one’s neck to know where it is in space, causing an increase in control with two benefits: First, this exercise is meant to relieve vertigo provoked from neck dysfunction, also known as cervicogenic vertigo. Second, Cervical Proprioception helps to improve communication between the visual and cervical proprioceptive system, or communication between the nervous system driven structures of the eyes and the neck. 

Vestibular Therapy - Patient with Laser

VORx1 Viewing

VORx1 Viewing is a gaze stability exercise that improves vestibular system function and the ability to keep eyes on target while the head is moving on the spine.

Vestibular Therapy - Therapist steadying patient's head


Convergence improves a patient’s ability to see near and far targets without double vision.

Vestibular Therapy patient focusing on object

Dynamic Visual Acuity Testing

Dynamic Visual Acuity Testing assists to determine a portion of vestibular function clinically including the ability to keep one’s eye on a target while the head is moving.

Vestibular Therapy patient viewing eye chart