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Vestibular Rehabilitation Program

Specialized exercise-based therapy for vertigo, dizziness, balance disorders, and vestibular dysfunction

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Fizik Tedavi ve Rehabilitasyon department. Book Appointment →

What is Vestibular Rehabilitation Program?

Vestibular rehabilitation therapy is a specialized form of physiotherapy targeting the vestibular system, which provides balance and spatial orientation.

Underlying mechanisms include central compensation (CNS adaptation to peripheral loss), substitution (using vision/proprioception), habituation (decreasing symptom response with repetition), and adaptation (gain modification of vestibulo-ocular reflex).

Indications: BPPV, vestibular neuritis/labyrinthitis (post-acute), Ménière disease, vestibular migraine, central vestibular disorders, age-related vestibular decline, post-concussion dizziness.

Typical course: 6-8 weeks with 1-2 supervised sessions per week and daily home exercises; resolution of BPPV often after a single canalith repositioning maneuver.

Symptoms

Vertigo (spinning sensation) with positional triggers (BPPV)
Persistent dizziness, imbalance, gait instability
Oscillopsia (visual blurring with head movement)
Increased fall risk, fear of falling, avoidance of activities
Vertigo-associated nausea, anxiety, sleep disturbance

Risk Factors

Severe cervical instability or recent neck surgery (modify maneuvers)
Severe vascular disease (vertebrobasilar insufficiency) — assess before head movements
Acute exacerbation of Ménière disease — defer until stable
Severe anxiety with vertigo (PPPD) — combined approach with CBT
Active middle ear infection or perforated tympanic membrane

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Apply for vestibular rehab referral for any persistent dizziness lasting >2-4 weeks
  • Re-evaluate any acute vertigo with neurologic symptoms (focal weakness, dysarthria, gait ataxia) — exclude central cause
  • Schedule formal vestibular assessment (HINTS examination, videonystagmography, computerized dynamic posturography) for diagnostic clarity
  • Seek immediate review for sudden hearing loss with vertigo — possible Ménière, ischemic event

Treatment Methods

01
Canalith repositioning (Epley, Semont) for BPPV with diagnostic-confirmed canal involvement; resolution typically in 1-2 sessions
02
Gaze stabilization exercises (VOR x1, x2 viewing) starting at 1 minute, progressing to 2-3 minutes per session, multiple times daily
03
Habituation exercises: graded exposure to provocative head/body movements (Cawthorne-Cooksey, Brandt-Daroff)
04
Balance training: static (Romberg, foam pad), dynamic (gait variations, tandem, head turns), functional reach, dual-task
05
Education: anatomy/physiology, expected timeline, fall prevention, anxiety management; integration with medication review and lifestyle modification

Which Department to Visit?

You can visit our Fizik Tedavi ve Rehabilitasyon department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Fizik Tedavi ve Rehabilitasyon Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.