Balance/vestibular Rehabilitation

The brain has the amazing ability to learn and relearn tasks. The only way to improve one’s balance and prevent falling is to challenge it. What to expect with physical therapy is a controlled environment designed to encourage yet challenge the patient while reproducing activities of daily living. The patient is guarded by the therapist 100% of the time to prevent any loss of balance. The therapist will review the patient’s medical history and evaluate the current situation and balance using specific tests and measurements. The therapist may also rule out other contributing factors of poor balance such as home set-up, vision changes, blood pressure or heart rate issues, and shoe wear assessment. ​ Physical therapy can help reduce the risk of falling by: Balance retraining, assessing mobility and walking, strength retraining, aerobic training, education, rebuilding confidence with fear management, fall-prevention techniques, and set-up community programs in the local area that help with balance. It is important to be evaluated by a medical professional prior to attempting any balance exercises independently.

Post-concussion syndrome usually follows a concussion or mild traumatic brain injury (TBI) that involves impact to the head typically in young adults. Signs and symptoms of post-concussion syndrome can sometimes occur up to 2 weeks after the initial injury and can increase if the individual was in a coma, has traumatic memories of the injury, or expects to be disabled from the injury. The prognosis is excellent with symptoms resolving after a few days to several weeks after onset. ​ The signs and symptoms associated with post-concussion syndrome can involve memory loss, dizziness, headaches, and sleeping problems. Doctors do not know why some people have post-concussion syndrome and some do not, therefore a clear way to diagnosis post-concussion syndrome is still controversial and being researched. Physical therapy can help with reducing some of the complications such as dizziness, headaches, and balance problems. However there is a cognitive component to recovery from PCS that should be evaluated by a medical doctor prior to beginning any therapy.

Vertigo is used to describe the sensation of spinning, dizziness, lack of coordination, and control of upright posture even when the body is perfectly still. There are many different types of vertigo all stemming from one of two places either the central or peripheral nervous systems. Central vertigo indicates the brain and spinal cord are involved. Peripheral vertigo involves the inner ear and the crystals in the canals being dislodged. This can happen from an illness, aging, or from environmental factors, such as flying on a plane or quick, jarring motions to the head. ​ There are other causes that contribute to the vertigo sensation such as Meniere’s disease (vertigo associated with hearing loss, ringing in the ears and fluid accumulation), traumatic brain injuries, strokes, multiple sclerosis, tumors, or poor circulation in the arteries of the neck and skull. ​ Testing can be performed by a physical therapist, primary care doctor, or a neurologist specializing in vestibular disorders using an MRI or CT scan. Peripheral and central vertigo can be treated by a physical therapist to help correct and remove all signs and symptoms. However, it is very important to be properly examined by a specialist to focus on the proper treatment with physical therapy. Treatment will focus on maneuvers to remove the dislodged crystals from the inner ear and to re-train the brain to perceive movements without causing the patient dizziness.