Balance & Exercise

Are you feeling unsteady on your feet? Do you struggle with maintaining balance and coordination? If so, vestibular rehabilitation exercises may be just what you need to get back on track! These simple yet effective exercises can help improve the function of your inner ear and brain, ultimately leading to better balance and coordination. In this blog post, we’ll explore some of the best vestibular rehabilitation exercises to help you feel more stable, confident, and in control. So, let’s dive in and discover how these exercises can transform your life!

What is Vestibular Rehabilitation?

Vestibular rehabilitation (VR) is a treatment for conditions that affect the balance and coordination of the inner ear. VR can help people with conditions like vertigo, dizziness, and tinnitus regain their ability to stay upright and move around safely.

The most common VR exercises focus on restoring lost balance by training the body to cues from the inner ear. These exercises often involve standing or sitting in various positions, working on coordination, and timing, and practicing movement habits like slow turning and walking along a straight line.

There is no single approach to VR therapy; each person’s condition will vary significantly in terms of what works best. However, many patients find that regular VR exercises help improve their symptoms over time.

Types of Vestibular Rehabilitation

There are a variety of exercises that can be done to improve balance and coordination in people with vestibular issues. These exercises are done in a standing or seated position and can be done individually or as part of a group exercise routine. Some common exercises include:

1. Activities of Daily Living (ADL)

In order to improve balance and coordination, it is important to begin with activities of daily living (ADL). This includes things like walking, climbing stairs, and getting up from a seated or lying position. By practicing these activities frequently, you will improve your overall equilibrium and coordination.

2. Balance Boards

It can help improve balance and coordination by challenging the brain to use alternative methods of sensing movement. Balance boards come in a variety of shapes and sizes, so it is important to find one that is suitable for your level of difficulty. It is also important to keep track of your progress while using a balance board so that you can continue to challenge yourself as you progress through rehabilitation.

3. Eye-Hand Coordination Exercises

Eye-hand coordination exercises involve working together to move an object from one side of the room to the other. These exercises are beneficial for people who have difficulty coordinating their vision with their hand movements. Examples of eye-hand coordination exercises include: reaching for an object across the room, moving an object from one location on a table to another, and threading a bead onto a

Benefits of Vestibular Rehabilitation

Vestibular Rehabilitation

There are many benefits of vestibular rehabilitation for individuals with balance and coordination challenges. Vestibular rehabilitation can improve overall mobility, reduce falls, and improve daily life activities such as climbing stairs.

Vestibular rehab can help with:
1. Mobility: Vestibular rehab can help improve mobility by improving balance and coordination.
2. Falls prevention: Vestibular rehab can help prevent falls by improving balance and coordination.
3. Daily life activities: Vestibular rehab can help improve daily life activities such as climbing stairs by improving balance and coordination.

To Perform Vestibular Rehabilitation Exercises

There are many different exercises that can perform to improve balance and coordination in the vestibular system. These exercises do in a variety of ways, including seated, standing, and moving around in a circle or pool.

Some of the most common exercises used for vestibular rehabilitation include:
-Balance boards: Balance boards are often used as an introductory exercise for patients because they require little movement and can be easily adapted to different levels of difficulty. Patients should start with easy challenges, such as standing on one end while keeping their eyes closed, before gradually progressing to more challenging tasks.
-Walker shuffles: Walker shuffles are another easy exercise that can help patients build balance and coordination. Patients should stand with their feet hip-width apart and shuffle their feet side to side for 30 seconds.
-Rotational chair: Rotational chairs are a great way for patients to challenge their balance and coordination. Patients should sit in the chair with their back straight and head up, then slowly tilt their chair to the left or the right for 30 seconds.
-Swimming: Swimming is a great exercise for rehabilitating balance because it improves proprioception (the ability to sense your body’s position and movements). Patients should swim in a semicircle for 12 lengths before repeating on the other side.

Q1. What are vestibular disorders?

They are due to a malfunction of the vestibular system, a sensory organ located in the inner ear. Usually, this organ governs our balance through the coordinated perception of visual and proprioceptive information, which integrates the position of the different parts of the body in space and of objects in our environment.

In concrete terms, the vestibular system of the inner ear is made up of channels in which a liquid circulates in which “crystals” are immersed, connected to small eyelashes. When you move your head, the liquid begins to move and the crystals are carried by their weight, which causes the eyelashes to move. This activates receptors connected to the brain by nerves which are responsible for continuously transmitting information about changes in the position of the head to our brain.

An abnormality of the vestibular system is usually manifested by loss of balancevertigo, feelings of lightheadedness (“spinning head”), nausea, or vomiting. Less frequently, patients suffer from concentration and memory problems, disorientation, anxiety, and even depression, which are long-term consequences of chronic pathology. “ Episodes of loss of balance can last less than a minute but repeat themselves several times during a day, which sometimes becomes very debilitating.», explains Loïc Vest. If you suffer from it, it is essential to talk to your doctor and/or an ENT specialist who will be able to identify the cause of the problem and possibly advise you on vestibular rehabilitation.

Q2. What is vestibular rehabilitation?

Vestibular physiotherapy (which has its own learned society, the SFKV) will use the interaction between vision and the organ of balance to correct a deficiency in the perception of sensory information by our brain.

This discipline is one of the specialties of physiotherapy. While some balance disorders resolve on their own, their cause may be pathological if they persist. In this case, a doctor can further test your sense of balance, sight, hearing, and coordination. Once the cause has been identified, the physiotherapist intervenes to “re-educate” the deficient function (difficulty walking, instability of gaze, etc.).

It is important to note that the treatment of a vestibular disorder is based on close coordination between doctors, who will act on the cause, and a physiotherapist who will act on the restoration of functions. “ For this, the physio will use a number of tests to highlight functional disorders. “Says Loïc Vest.

Q3. Are physiotherapists the only ones who can exercise it?

According to the National Health Insurance Fund, only physiotherapists are authorized to provide vestibular rehabilitation, and therefore reimbursed by social security. Osteopaths and chiropractors are not supposed to practice this practice. For good reason, vestibular physiotherapy can be dangerous if it has not been prescribed in advance by a trained specialist. “Indeed, certain vascular and neurological disorders and even certain tumors are capable of mimicking positional or functional vertigo. However, these serious pathologies require treatment by doctors. The vestibular physiotherapist is trained in “red flags” which allow him, thanks to specific equipment, “, emphasizes the physiotherapist.

Q4. In what situations do we need vestibular physio?

Multiple pathologies (traumatic, viral, autoimmune, hormonal) can affect either the vestibular system or the transmission of information to the nervous system which includes the brain and the spinal cord. However, the most common vestibular disorders are:

  • The functional disorder, including motion sickness, corresponds to a sensory illusion or “visual dependence”. ” It concerns 60 to 70% of patients who consult for vertigo “, specifies Loïc Vest. There is a desynchronization of perception between body movements and visual information. Most of these patients complain, for example, of dizziness in crowded spaces such as department stores or halls in which they have difficulty finding a fixed landmark that matches the information sent by the inner ear. These are often patients whose medical examinations show no abnormalities but whose function is disturbed.
  • Benign paroxysmal positional vertigo (BPPV) accounts for approximately 25-35% of vertigo causes and is diagnosed at any age (18-90). ” It is linked to the detachment of tiny crystals from the inner ear (the otoconia) which begin to float in the liquids it contains “, indicates Loïc Vest. When changing position, it causes dizziness, nausea, and vomiting.
  • Hydrops (including Meniere’s disease) is a chronic condition characterized by attacks of vertigo, progressive loss of hearing, and tinnitus (‘ghost’ noises). It is due to an imbalance of pressure in the fluids circulating in the inner ear.
  • Acute vestibular deficit (including vestibular neuritis) is a viral or vascular disease that causes inflammation of the vestibular nerve connected to the inner ear and therefore a disorder in the transmission of information to the brain. It is manifested by a violent attack of dizziness for several hours or even several days, accompanied by nausea and vomiting, and strong instability.

“Certain risk factors such as anxiety or fatigue can also increase dizziness and balance disorders,” adds the physiotherapist. An age-related sedentary lifestyle is also an aggravating factor “because the organ of balance is disturbed after a long period of immobility ”.

It should be noted that there are various associations of patients suffering from vestibular disorders in France.

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Q5. How does vestibular rehabilitation take place?

” First of all, you must carry out an assessment to highlight the sensory disorders at the origin of the problem, whether they are visual, vestibular, or proprioceptive (sensitivity to posture and movement information) “, indicates Loïc Vest. ” Depending on the disorder, we can establish a personalized program ” including several types of exercises. For example:

  • Liberating manipulation is intended to replace the crystals of the inner ear in the right place to correct positional vertigo.
  • Active gaze stabilization exercises (moving the head while staring at an object, for example).
  • Habituation exercises intended to accustom the brain to dizziness or visual flow that would tend to disturb the patient. This can go through virtual reality or optokinetic stimulation (which aims to reduce the importance of the eyes. By placing the patient in the dark, to work on the proprioceptive and vestibular functions).
  • Exercises to reduce instability: the patient is placed on foam or moves and must keep his balance. He can also walk by shaking his head for example.

Q6. How many sessions are needed?

It all depends on the origin of the disorder and the symptoms of the patient, his history, and his daily activity.

  • Generally, “the treatment of BPPV is very quick and a few sessions are enough,” says Loïc Vest. But it can be longer in some cases, especially in migraine sufferers or people who have suffered a head injury.
  • Count 5 to 10 sessions for an acute vestibular deficit diagnosed quite early but much more for a later diagnosis.
  • For other vestibular and neurological pathologies, 15 to 20 sessions are generally necessary.

These indications will also depend on other factors. “ The more anxietyapprehension, and a sedentary lifestyle, the longer the rehabilitation will take. This is why it is necessary to involve the patient in his rehabilitation so that the effects are beneficial”, specifies the physiotherapist. In any case, the exercises performed and not limited to those performed in the presence of your physiotherapist. The latter will tell you exercises to do at home for optimal recovery.

Q7. What reimbursement is in France?

This practice, when carried out by physiotherapists, is 100% covered by social security and mutual insurance companies, provided it is prescribed by a doctor. However, there may be fee overruns depending on the practitioner.

Q8. How long does vestibular rehabilitation take to work?

Vestibular rehabilitation typically takes between six and twelve weeks to work. There is no one-size-fits-all approach, as the length of time it takes for a person to regain their balance and coordination may vary depending on their individual condition and previous level of function. Some common exercises that are part of vestibular rehabilitation include balancing exercises, balance training, proprioception training, and functional exercise.

Q9. How much does a vng test cost?

A vestibular rehabilitation (VR) test is a way to measure how well your balance and coordination are. It usually costs between $100 and $200.

Often benign, vertigo is not always harmless. When the cause is pathological, medical care and vestibular rehabilitation are sometimes necessary.

If most of the time, loss of balance and feelings of dizziness are not serious, vertigo still represents 4% of admissions to emergency departments. These symptoms can result from a dysfunction of the organ of balance or of the processing of this information. The vestibular system governs the perception of movements and rotations of the head in space. In this case, it may be necessary to go to a specialized physiotherapist. But how do we know if we need vestibular rehabilitation? Explanations with Loïc Vest, a physiotherapist specializing in vestibular rehabilitation in Paris.