Balance therapy, vestibular rehabilitation therapy
Vestibular Rehabilitation
A structured, individually prescribed exercise programme that retrains the brain to compensate for inner ear balance problems and restores confident movement.
What this assessment is
Vestibular rehabilitation is treatment rather than testing, and it is one of the most rewarding parts of our work. When one balance organ is damaged, the brain can learn to recalibrate using the remaining vestibular input together with vision and sensation from the feet and joints. That recalibration does not happen well through rest and avoidance. It happens through carefully graded, repeated exposure to the movements that provoke symptoms. Programmes are built from the assessment findings, taught in the clinic and then practised daily at home, with review appointments to progress the difficulty.
Why it matters
- It reduces dizziness and the fear of falling, which is a major cause of loss of independence in older adults.
- Repositioning manoeuvres can resolve benign paroxysmal positional vertigo in one or two sessions.
- It reduces reliance on vestibular sedative medication, which delays recovery when taken long term.
- It restores confidence for driving, work, prayer, stairs and busy environments such as markets.
Step by step
How the assessment is performed
Each stage follows established audiological protocol, and you are told what is happening before it happens.
- 1
Assessment
Balance function, gaze stability, positional testing and walking are assessed, alongside your hearing. We identify the specific movements and environments that trigger symptoms.
- 2
Repositioning where indicated
If positional vertigo from displaced otoconia is found, a repositioning manoeuvre such as Epley is performed in the clinic, often with immediate relief.
- 3
Gaze stabilisation exercises
Simple exercises in which you fix your eyes on a target while turning your head retrain the vestibulo ocular reflex so vision stays steady during movement.
- 4
Habituation and balance training
Movements that provoke mild symptoms are repeated in short controlled doses so the brain learns to ignore the faulty signal. Standing and walking tasks progress from firm ground and open eyes to softer surfaces and head movement.
- 5
Home programme and review
You leave with a written daily plan, usually a few minutes several times a day, and a symptom diary. Progress is reviewed and the programme is made harder as you improve.
How to prepare
- Wear flat comfortable shoes and clothing you can move in.
- Bring a list of all medications, especially anything taken for dizziness.
- Bring a family member if you are unsteady, both for support and to learn the exercises with you.
- Expect to be moved and to feel briefly dizzy. That is therapeutic, not harmful.
Understanding your results
- Rapid resolution
- Positional vertigo often settles within one to three sessions after successful repositioning.
- Progressive improvement
- After vestibular neuritis, most patients improve substantially over six to twelve weeks of consistent daily exercises.
- Ongoing management
- Where the loss is permanent or bilateral, the programme shifts to long term strategies, fall prevention and environmental adaptation.
FAQ
Common questions
Why do the exercises make me dizzy?
Because they are meant to, mildly and briefly. Controlled provocation is the stimulus the brain uses to recalibrate. Avoiding movement prolongs the problem.
How long before I feel better?
Some patients improve within days, most notice real change within four to six weeks. Consistency matters far more than intensity.
Can medication replace the exercises?
No. Sedatives may help in the acute phase but slow compensation if continued. Rehabilitation is the treatment that produces lasting recovery.
Explore
Other tests we perform
Pure Tone Audiometry
The reference test for hearing. It maps the quietest sounds you can detect across the speech frequencies and shows whether a loss sits in the outer, middle or inner ear.
Paediatric Hearing Assessment
Age appropriate testing for babies and children, using play, toys and visual rewards to obtain reliable thresholds long before a child can describe what they hear.
Tympanometry and Impedance Audiometry
A rapid objective measure of how the eardrum and middle ear move, detecting fluid, negative pressure, perforation and ossicular problems within seconds per ear.