Vestibular rehabilitation therapy (VRT) can involve both a therapist-assisted
maneuver and an exercise-based program designed to provide therapy for
inner ear deficits. Vestibular rehabilitation therapy can help with a variety
of vestibular problems, including benign paroxysmal positional vertigo
(BPPV), labyrinthitis, and vestibular neuritis. Even individuals with long-
term unresolved inner ear disorders who have undergone a period of medical
management with little or no success may benefit.
A trained Physiotherapist will first perform a thorough
evaluation that begins with a medical history and includes observing and
measuring posture, balance and gait. The assessment may also include
eye-head coordination tests that measure how well a person’s eyes track
a moving object with or without head movement. Other assessments may
be used, such as a questionnaire measuring the frequency and severity of
symptoms and associated lifestyle changes.
Using the evaluation results, the therapist will develop an individualized
treatment plan that includes specific head, body, and eye exercises to be
performed both in the therapy setting and at home. These exercises are
designed to retrain the brain to recognize and process signals from the
vestibular system and coordinate them with information from vision and
Depending on the diagnosis, the in-office treatment with the therapist may
also involve a specialized form of VRT called a canalith repositioning
procedure, which is often referred to as the Epley maneuver.