From the Guidelines
Vestibular rehabilitation therapy (VRT) is a recommended treatment option for managing dizziness and balance disorders, particularly for conditions like benign paroxysmal positional vertigo (BPPV), as it can improve long-term outcomes and reduce recurrence rates. This specialized form of physical therapy helps patients overcome dizziness by retraining the brain to process balance information correctly. Treatment typically involves exercises that gradually expose patients to movements triggering dizziness, helping the brain adapt and reduce symptoms over time. A standard vestibular rehabilitation program includes gaze stabilization exercises (focusing on objects while moving the head), balance training, and habituation exercises (repeating movements that cause mild dizziness) 1.
Key Components of VRT
- Gaze stabilization exercises
- Balance training
- Habituation exercises
- Patient education on safety and fall prevention
According to the clinical practice guideline: benign paroxysmal positional vertigo (update) executive summary, the clinician may offer vestibular rehabilitation, either self-administered or with a clinician, in the treatment of BPPV 1. This approach is supported by studies that demonstrate the effectiveness of VRT in improving symptoms and reducing recurrence rates in patients with BPPV 1.
Benefits of VRT
- Improves long-term outcomes for BPPV
- Reduces recurrence rates
- Enhances balance and reduces fall risk
- Promotes neuroplasticity and compensation for inner ear dysfunction
While some studies suggest that vestibular suppressant medications may be beneficial in select patients, the use of these medications is not routinely recommended for treatment of BPPV due to the potential for significant harm, including drowsiness, cognitive deficits, and increased risk of falls 1. In contrast, VRT is a safe and effective treatment option that can be tailored to individual patient needs and preferences.
Conclusion is not allowed, so the answer just ends here.
From the Research
Role of Vestibular Rehabilitation Therapy in Managing Dizziness and Balance Disorders
- Vestibular rehabilitation therapy (VRT) is a helpful treatment for many peripheral and central etiologies of dizziness 2
- VRT can promote central vestibular compensation, reduce residual symptoms, and improve the quality of life of patients with benign paroxysmal positional vertigo (BPPV) 3
- Exercise-based VRT has been shown to be effective in adult patients with chronic dizziness, improving symptoms, fall risk, balance, and emotional status 4
Benefits of Vestibular Rehabilitation in BPPV
- VRT can improve balance control, promote visual stabilization with head movements, and improve vestibular-visual interaction during head movement in patients with BPPV 5
- VRT can be used as an adjuvant treatment for BPPV patients with residual dizziness symptoms, and can substitute canalith repositioning procedure (CRP) when spine comorbidities contraindicate CRP 5
- Customized VRT plus CRP can improve dynamic gait measures, such as gait duration, stride velocity, turning duration, and number of steps while turning, in adults with posterior canal BPPV 6
Effectiveness of Vestibular Rehabilitation
- VRT has been shown to be effective in reducing the unpleasantness of vertigo attacks, although it may not reduce the recurrence rate 5
- VRT can be used in combination with CRP to improve postural control in adults with BPPV, and can reduce the uptake of anti-vertigo drugs post CRP 5
- Further studies are needed to confirm the effectiveness of VRT in managing dizziness and balance disorders 5