physiotherapy treatment for BPPV vertigo

Vertigo, Vestibular Rehabilitation Therapy

Vestibular Rehabilitation Therapy (VRT) is an exercise-based program for reducing the symptoms of disequilibrium and dizziness associated with vestibular problems like vertigo. ReLiva Physiotherapy provides vestibular rehabilitation with a neuro-otological approach for managing such symptoms at its clinics in Navi Mumbai and Thane.

VRT is an alternative treatment involving specific exercises that can eliminate or significantly reduce symptoms of vertigo by promoting central nervous system compensation for inner-ear deficits. The program is designed to achieve these goals:

  • 1. Decrease dizziness and visual symptoms.
  • 2. Increase balance and walking functions.
  • 3. Increase general activity levels.

Typically the VRT would include:

1. Canalith repositioning maneuver/ Epley maneuver:

Designed for inner ear condition known as Benign Paroxysmal Positioning Vertigo (BPPV). This condition occurs when crystals in inner ear gets dislodged and float in the ear canal. Canalith repositioning maneuvers are very effective in case of BPPV and may require only couple of sessions.

2. Vestibular retraining:

This program would typically include exercises for improving coordination of eye and head movements, balance retraining and desensitization of the vestibular system. This part of the therapy would typically require 8 – 12 sessions. In some cases where significant balance and walking training is required it may require many more sessions.

3. Self Exercise Program:

We educate our clients on the exercises they need to continue to manage their symptoms by themselves at home and continued improvement in fitness and endurance. Person entering a vestibular rehabilitation program needs to undergo a detailed assessment prior to starting the program because not all dizziness is caused by vestibular deficits.

Many times, vertigo is felt due to cervical spondylosis for which a different treatment program is prescribed

What is Vertigo ?

Vertigo is a more like a symptom, rather than a condition itself. It is the sensation that you, or the environment around you, is moving or spinning.

Typically you would feel a loss of balance (which can make it difficult to stand or walk), nauseous and dizzy. Basically the feelings of unsteadiness; wooziness (swimming feeling in head); lightheadedness; feelings of passing out; and sensations of moving, spinning, floating, swaying, tilting, or whirling. These sensations can occur when standing still, lying down or when changing positions.

Feeling of vertigo at times can develop suddenly and may last for a few seconds, or it may last longer. Severe vertigo can lead to constant symptoms which could make normal life very difficult.

What causes Vertigo ?

Vertigo is commonly caused by a problem with the way balance works in the inner ear, although it can also be caused by problems in certain parts of the brain.

Vertigo, dizziness and imbalance are the frequent symptoms in patients who suffer trauma to the head, neck or craniovertebral junction and can result in peripheral or central vestibular dysfunction.

Once trauma, infection, injury or other underlying causes are ruled out, doctors typically zero in on a diagnosis of either Meniere’s disease or Benign Paroxysmal Positional Vertigo (BPPV). These two otherwise benign conditions are the leading causes of vertigo, with a fifth of all cases attributed to BPPV.

Both Meniere’s and BPPV result from disorders of the inner ear, which contains the body’s balance mechanism. Their causes are not known (they are not caused by injury or infection), but the disturbances affect the sense of equilibrium

What is the recovery Vertigo patient can expect with Vestibular Rehabilitation ?

As per Cleveland Clinic, in most cases, if patients continue to perform the exercises they have learned, balance and dizziness problems decrease significantly or completely disappear.  Read More

Vestibular Disorder Association, USA, says that vestibular rehabilitation can be effective in improving symptoms related to many vestibular (inner ear/balance) disorders.  Read More

Expected vestibular rehabilitation outcomes include:

  • Decreased fall risk
  • Decreased dizziness symptoms
  • Improved balance
  • Improved ability to stabilize vision/gaze
  • Increased body strength
  • Return to prior level of movement/function
  • Increase in confidence in ability to maintain balance
  • Improved neck motion, reduced symptoms

How Common is Vertigo ?

As per Medscape, the overall incidence of dizziness, vertigo, and imbalance is 5-10%, and it reaches 40% in patients older than 40 years. The incidence of falling is 25% in subjects older than 65 years. A report reviewing presentation to US emergency departments (EDs) from 1995 through 2004 indicated that vertigo and dizziness accounted for 2.5% of presentations. The estimated number of 2011 US ED visits for dizziness or vertigo was 3.9 million.

fall prevention balance training

Falls of Seniors: What to do

More than one third of person 65 years of age or older fall each year and in half of such cases the falls are recurrent.

If you are a senior, ie 60 year or older that means you need to take more care and precautions for yourself. Other than medical conditions or diseases which you take care by doing routine blood tests and investigations, you should not forget to keep yourself free from falls.

What are falls?

Falls include dropping from a standing or sitting position or from ladder or stepladder.

Falls are common in elderly. It has been proven scientifically that with aging, a lot of brain structures, muscles strength, vision, hearing and sensations show a gradual decline.

Causes of fall

Many things can put you at higher (double or triple) risk for a fall.

Medical Risk Factors

·         Impaired musculoskeletal function, gait (read walking style) abnormality and osteoporosis                 falls

·         Cardiac arrhythmias (irregular heartbeat), blood pressure fluctuation

·         Depression, Alzheimer’s disease and senility

·         Arthritis, hip weakness and imbalance

·         Neurologic conditions including stroke, Parkinson’s disease, multiple sclerosis etc.

·         Urinary and bladder dysfunction

·         Vision or hearing loss

·         Cancer that affects the bones

·         Side effects of medications

Personal Risk Factors

·         Age. The risk for a fall increases with age. Normal aging affects our eyesight, balance, strength, and ability to quickly react to our environments.

·         Activity. Lack of exercise leads to decreased balance, coordination, and bone and muscle strength.

·         Habits. Excessive alcohol intake and smoking decrease bone strength. Alcohol use can also cause unsteadiness and slow reaction times.

·         Diet. A poor diet and not getting enough water will deplete strength and energy, and can make it hard to move and do everyday activities.

 

Falls and accidents seldom “just happen”      People should not fall

Why should you NOT fall?

As a result of fall, you may get a small injury like a bruise or mild bleeding or a muscle pull to some serious injuries like fracture (break in bone) or brain injury and deaths too.

If you are osteoporotic (a condition in which bones are already weak) chances of fracture increases.

Fall risk increases with age. Henceforth, falls are common and serious health problem with devastating consequences in elderly

Prevention of fall is possible by early diagnosis and awareness about intervention. Fall should not be perceived as inevitable part of aging. All elderly, be sure to discuss the fall with doctor, even if you are not hurt. It can also be a sign of new medical condition like diabetes or change in blood pressure.

Physiotherapists play a vital role in prevention of falls.

 

Physiotherapy and rehabilitation at ReLivaTM for fall prevention

Reliva therapists conduct a detail check of elderly muscles strength and sensations of body more specifically for legs. Reliva therapists also conduct scientifically proven validated scales (Fall risk assessment scale and Berg Balance scale) to know if there is any risk of fall and to know balance problems in elderly.

Based on which, Reliva therapists design an exercise protocol to improve strength and balance in sitting, standing as well as walking. Physiotherapists are specially trained for balance specific exercises.  If required, they will prescribe an assistive device (walker or stick which can later be gradually discontinued ) with regular supervised exercise sessions.

Call Reliva if:

You are an elderly

You want to get fall risk check

You want to get balance check

You want strengthening and balance exercises

You want home modification tips.

For simple Tips to Prevent Falls, click here and see the infographic.

What to do if you had a Fall

  • Do not panic. Assess the situation and determine if you are hurt.
  • Slide or crawl along the floor to the nearest couch or chair and try to get up.
  • If you cannot get up, call for help.
  • If you are alone, slowly crawl to the telephone and call nearest hospital or relatives.
  • Once you are ok, do see a doctor or a Physiotherapist even if you haven’t hurt yourself, to ascertain the reason for the fall.

Related articles: Falls Prevention Tips

This article is purely for general information. Please contact your healthcare expert for specialised medical care. Please go through our Disclaimer and Privacy policy.

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