Vestibular Rehabilitation Physiotherapy
Vestibular Rehabilitation Physiotherapy provides specialist assessment and evidence-based treatment of vertigo, dizziness, and balance disorders -- using specific manoeuvres, gaze stabilisation exercises, and balance retraining to eliminate dizziness symptoms and restore safe confidence and mobility.
Overview
Vestibular physiotherapy is a highly specialised area delivering dramatic results for common debilitating conditions that are frequently undertreated. Benign Paroxysmal Positional Vertigo (BPPV) -- the most common cause of vertigo -- is treated with specific canalith repositioning manoeuvres (Epley, Semont) that resolve symptoms in 80 to 90% of patients in a single appointment. Vestibular neuritis and labyrinthitis causing unilateral vestibular hypofunction are treated with progressive vestibular exercises promoting central compensation and reducing chronic dizziness.
Vestibular Conditions Treated
- Benign Paroxysmal Positional Vertigo (BPPV -- posterior, horizontal, and anterior canal)
- Vestibular Neuritis and Labyrinthitis (unilateral vestibular hypofunction)
- Chronic Unilateral Vestibular Hypofunction
- Bilateral Vestibular Hypofunction (oscillopsia and imbalance)
- Cervicogenic Dizziness (neck-related balance dysfunction)
- Persistent Postural-Perceptual Dizziness (PPPD)
- Post-Acoustic Neuroma Resection Rehabilitation
- Concussion-Related Vestibular Dysfunction
Vestibular Physiotherapy Techniques
- Epley Manoeuvre (posterior canal BPPV)
- Semont Manoeuvre (posterior canal BPPV alternative)
- Barbecue Roll (horizontal canal BPPV)
- Gaze Stabilisation Exercises (VOR x1 and x2 exercises)
- Static and Dynamic Balance Training (single leg stance, foam, tandem)
- Optokinetic Stimulation (habituating to visual motion sensitivity)
- Cawthorne-Cooksey Exercises (progressive home exercise programme)
- Sensory Reweighting Exercises (proprioceptive, visual, and vestibular integration)
Vestibular Physiotherapy Indications
- Vertigo triggered by head position change (BPPV symptoms)
- Unsteadiness and dizziness after vestibular neuritis
- Chronic dizziness and imbalance without a central cause
- Concussion with persistent vestibular symptoms beyond 2 weeks
- Post-acoustic neuroma surgery causing vestibular dysfunction
- Falls in older adults with vestibular contribution
- Cervicogenic dizziness from neck movement
- PPPD requiring vestibular and cognitive-behavioural rehabilitation
Key Benefits
Discover the advantages of choosing our vestibular rehabilitation physiotherapy services.
Epley repositioning manoeuvre cures BPPV in over 90% of patients in 1 to 2 treatment sessions
Vestibular rehabilitation reduces chronic dizziness disability by 50 to 70% in peripheral vestibular disorders
Gaze stabilisation exercises restore clear vision during head movement within 6 to 8 weeks
Balance rehabilitation significantly reduces fall risk in chronic vestibular hypofunction
Return to driving and work criteria guidance enables confident safe return to normal activities
Clinical Features
The technology, techniques and clinical approach behind our vestibular rehabilitation physiotherapy.
Comprehensive vestibular assessment characterises the specific deficit driving treatment selection
Epley manoeuvre resolves posterior canal BPPV in over 90% of cases in a single session
Gaze stabilisation exercises drive vestibulo-ocular reflex adaptation through controlled challenge
Habituation exercises progressively reduce central vestibular hypersensitivity
Activity avoidance behaviour specifically addressed -- avoidance worsens vestibular compensation
Preparation Instructions
Consistently perform your home exercise programme between appointments -- physiotherapy works best when combined with regular independent practice. Report any significant worsening of pain or new symptoms to your physiotherapist promptly. Attend all scheduled sessions without missing appointments as momentum and progressive loading are central to physiotherapy outcomes. Communicate openly if any exercise is causing increased pain as the programme must be adjusted to remain within therapeutic parameters.
The Procedure
Step-by-step guide to what you can expect during your vestibular rehabilitation physiotherapy procedure.
Vestibular Assessment and Diagnosis
A comprehensive vestibular assessment examines nystagmus (spontaneous gaze-evoked and post head-shake) subjective visual vertical ocular motor function head impulse test and postural stability -- characterising the specific type and location of vestibular dysfunction.
Dix-Hallpike Test and BPPV Repositioning
Dix-Hallpike testing positions the head in the plane of each semicircular canal to provoke the characteristic nystagmus of BPPV. The Epley repositioning manoeuvre moves loose otoliths through the semicircular canal -- resolving BPPV in over 90% of cases in a single treatment session.
Gaze Stabilisation Exercises
Gaze stabilisation exercises (head movement while maintaining visual fixation) use the vestibular-ocular reflex to drive adaptive plasticity in the cerebellum -- progressively improving the ability to maintain clear vision during head movement which is the most disabling symptom of peripheral vestibular loss.
Habituation Exercises
Habituation exercises involve controlled repeated exposure to the specific head movements or visual environments that provoke dizziness -- progressively reducing the central sensitivity to vestibular stimuli through the habituation mechanism.
Balance and Gait Rehabilitation
Progressive balance training from stable to unstable surfaces with and without visual input retrains the balance system to weight sensory inputs appropriately. Gait training in complex environments (narrow walkways and uneven ground) restores community mobility.
Activity Limitation and Lifestyle Guidance
Specific guidance on safe return to driving (DVLA guidance), work, sport and demanding activities. Visual dependency and dizziness-related avoidance behaviours are specifically addressed -- avoidance worsens vestibular compensation and prolongs recovery.
What to Expect
Your physiotherapist performs a detailed assessment of your movement, strength, posture, balance, and functional performance. The findings are explained clearly and a personalised physiotherapy programme is developed collaboratively. Each session includes hands-on treatment and supervised exercise. A home programme between sessions is provided as consistent practice between appointments is essential for progress.
Frequently Asked Questions
Common questions about vestibular rehabilitation physiotherapy.
Related Services
Explore other services in our Physiotherapy department.
Musculoskeletal Physiotherapy
Neurological Rehabilitation
Post-Surgical Rehabilitation
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