Introduction to Vestibular Rehabilitation

Introduction[edit | edit source]

Vestibular rehabilitation is an evidence-based approach to managing dizziness, vertigo, motion sensitivity, balance and postural control issues that occur due to vestibular dysfunction.[1]

Patients with vestibular impairment typically experience issues with gaze stability, motion stability, and balance and postural control. Vestibular rehabilitation, therefore, includes exercises that are focused towards these areas of pathology or dysfunction. However, the specific treatment approach will depend on the patient’s presentation.[1]

This page introduces vestibular dysfunction in general in order to provide background information and specific context for vestibular rehabilitation.

Epidemiology[edit | edit source]

Vestibular disturbance is a significant issue globally. It is estimated that 35.4 percent of North Americans aged over 40 have experienced some form of vestibular dysfunction. The likelihood of experiencing vestibular dysfunction increases with age.[2]

  • 80 percent of people aged over 65 years experience dizziness - in 50 percent of cases this dizziness is caused by benign paroxysmal positional vertigo (BPPV)[2]
  • 75 percent of adults aged over 70 years have a balance impairment (often associated with vestibular dysfunction and sensory loss in the feet)[3]
  • Nearly 85 percent of adults aged over 80 years have vestibular dysfunction[3]

These numbers are significant as having vestibular dysfunction makes an individual eight times more likely to experience a fall[3] and falls are associated with significant morbidity, mortality[3] and economic cost.[4]

Moreover, the number of people experiencing vestibular dysfunction is expected to grow due to our ageing populations.[1]

  1. 1.0 1.1 1.2 Tonks B. Introduction to Vestibular Rehabilitation Course. Physioplus. 2021.
  2. 2.0 2.1 Agrawal Y, Carey JP, Della Santina CC, Schubert MC, Minor LB. Disorders of balance and vestibular function in US adults: data from the National Health and Nutrition Examination Survey, 2001-2004. Arch Intern Med. 2009;169(10):938-44.
  3. 3.0 3.1 3.2 3.3 Hall CD, Herdman SJ, Whitney SL, Cass SP, Clendaniel RA, Fife TD et al. Vestibular rehabilitation for peripheral vestibular hypofunction: An evidence-based clinical practice guideline: FROM THE AMERICAN PHYSICAL THERAPY ASSOCIATION NEUROLOGY SECTION. J Neurol Phys Ther. 2016;40(2):124-55.
  4. Haddad YK, Bergen G, Florence CS. Estimating the economic burden related to older adult falls by state. J Public Health Manag Pract. 2019;25(2):E17-E24.