Vestibular /Balance Therapy

Balance truly is the key to independence! Our sense of balance is like a 3 legged table with the eyes (vision), ears (vestibular system) and legs ( sensation in our feet, muscles and joints in legs) holding us up. A deficiency in any one of these areas can cause a balance problem and lead to falls. The balance system needs to be strenghtened to stay strong. This in normally done by being active, but when there is a significant balance problem, a skilled vestibular therapist knows how to critically evaluate the balance system to find areas of deficiencies and set up a specific treatment plan to address these deficits.  Balance can improve no matter how old you may be, but it takes work. Falls are not a normal part of aging, but they are a leading cause of death among seniors and this is why regular balance screenings are critical. We have helped thousands of patients improve their balance. We boast the most certified vestibular therapists with the most experience in our area. We know dizziness and balance!

One recent epidemiological study (Agrawal et al, 2009)  estimates that as many as 35% adults aged 40 years or older in the United States—approximately 69 million Americans—have experienced some form of vestibular dysfunction.

Vestibular rehabilitation is an effective treatment for vertigo/dizziness, motion sensitivity, and balance disorders. Studies have shown vestibular rehabilitation to be 90% effective in many patients. It is a conservative, non-invasive, drug free option for patients.Otolaryngologists /ENT, neurologists, cardiologists and family doctors are often consulted to treat the millions of Americans who have complaints of dizziness, lightheadedness and unsteady gait. Since dizziness and imbalance can come from many sources it is important that an accurate diagnosis is made.

Some common causes for dizziness and imbalance may stem from inner ear disorders such as:

Benign Paroxysmal Positional Vertigo (BPPV)

Vestibular Hypofunction: labyrinthitis and Neuritis

Bilateral vestibular loss


Meniere’s disease

Acoustic neuroma

 A vestibular therapist will evaluate patients with dizziness and imbalance to assess their vision and visual motor skills, balance, gait, motion sensitivity, strength, sensation, flexibility and coordination. A fall risk assessment is performed on every patient and exercises are administered to reduce falls risk. A hallpike test and canalith repositioning techniques will be performed on patients who are suspected to have benign positional vertigo. A custom home exercise program will be given on the first visit and upgraded frequently. Therapy sessions are typically two to three times per week. Patients diagnosed with benign positional vertigo usually improve in one to three sessions, in 90% of cases. Treatment for other diagnoses may take from four to eight weeks.In some cases patients may experience an increase in their dizziness and imbalance. It is not uncommon to see an exacerbation of symptoms before improvement. Patients who are compliant and persistent with their vestibular rehabilitation program see results of decreased dizziness, improved balance and overall improved quality of life. We believe in returning our patients back to normal functional ability and help train both the eye and inner ear using many techniques including balance training, ambulation training, and eye coordination. We use Wii-Hab to incorporate balance and eye training together.

Most medical insurance plans will cover this program. Patients should bring their diagnostic test results to their first appointment.For more information regarding vestibular disorders, please visit http://www.vestibular.org/

During your initial evaluation and throughout your physical therapy treatment, we use balance norms for your specific age to see if vestibular balance training is appropriate. These balance tests include balancing with your feet together called Rhomberg Stance, balancing with one foot in front of the other called Sharpened Rhomberg Stance, and Single Leg Stance. All balance exercises are performed with eyes open and eyes closed.