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What is Vestibular Rehabilitation Therapy (VRT)?

What happens in a VRT assessment?

The trained and specialized therapist does a thorough evaluation of the person’s medical history, symptoms, onset of symptoms, provocations, fall history, loss of function, and work/school/driving status. Specific movement assessments include:

What is the treatment?

Based upon the evaluation results, goals are set, and treatment begins.

Treatment consists of specific prescribed exercises that the patient does in the clinic and the patients are also provided a specific daily home program with the instructions in writing with diagrams. Categories of exercises include:

Are the exercises difficult and do they make the dizziness worse?

The exercises appear simplistic, but they are working a complicated system. Patients often have an increase of symptoms when they first begin the exercises because they are working a weak system. Just like when someone begins a physical exercise program the muscles ache before they increase in strength. Symptoms should abate within 30-60 minutes after the exercises. If they are lasting longer the therapist will modify the program to the patient’s tolerances. If the patient continues the prescribed exercises, the symptoms typically steadily improve with time and repetitions within 3-4 weeks (dependent upon the diagnosis).

Are there precautions with VRT?

The biggest precaution is safety and that the patient understands how to safely do the exercises at home, to monitor the symptoms and to have effective communications so the therapist can appropriately update or modify the programs. Specific lists of things the patient should be aware of, and to contact the therapist regarding are given to the patient and patient education is provided at each VRT session.

Does VRT work?

Yes, this is an extremely successful program with outstanding results in symptom reduction and in many cases elimination, but the success depends upon the compliance of the patient and /or family. The patient must understand that therapy is a process. In some cases, as in BPPV, there may be symptom resolution in 1-2 visits. But in many vestibular cases, it may take 2-3 months (longer or shorter dependent upon diagnosis and response to treatment) for symptom resolution.

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