Vestibular Rehabilitation - Treatment of Vertigo, Dizziness, BPPV, and More

Vestibular Rehabilitation is a physiotherapy treatment program that is individualized for each client. It is an exercise-based approach to relieve the symptoms and discomfort of vestibular disorders, including dizziness, unsteadiness and balance problems. There are numerous causes of these symptoms however, a large percentage originates from problems with the part of the inner ear and the brain that helps to control balance and eye movements. This is known as the vestibular system. If disease or injury damages this system, a vestibular disorder can result.


Symptoms range from mild dizziness and unsteadiness to severe vertigo. Other symptoms include:

We assess and treat:

  • BPPV (Benign Paroxysmal Positional Vertigo)

  • Mal de Barquement Syndrome

  • Undiagnosed vestibular issues

  • Secondary dizziness from acoustic neuroma

  • Age-related dizziness and imbalance

  • Concussion related dizziness and imblance

  • Pediatric vestibular disorders

  • Labyrinthitis and Vestibular Neuritis

  • A spinning sensation (frequently with changes in head position)

  • Poor balance

  • Nausea

  • Motion sensitivity (quicker movements provoke dizziness)

  • Headaches

  • Sensitivity to bright lights and noises

  • Decreased tolerance of crowds

  • Blurring of vision with head movements

  • Difficulty watching TV or movies

What Causes Vestibular Disorders?

Vestibular disorders are common and can affect people of all ages. They are most often caused by:

  • Head trauma (motor vehicle accidents, falls, sports injuries)

  • Inner ear infections

  • Illness or disease

  • Aging

  • Certain medications

  • Stroke and brain injury

Initial Assessment

Your therapist will assess functioning in the four major areas; eye and head movements, balance and walking, motion sensitivity, and the musculoskeletal system. Your therapist may or many use infrared goggle technology to aid in their assessment. This state-of-the-art technology allows certain eye movements to be detected, which provide important information about a number of conditions and help us determine the underlying problem.

Treatment Options

Treatment for vestibular disorders varies according to the clinical findings when you're assessed. Vestibular rehabilitation is a drug free approach involving specific exercises to improve balance function, decrease dizziness symptoms and increase general activity levels. Frequently, the physiotherapist may guide you through a series of head movements for one of the more common vestibular disorders. Your program may include one or more of the following:

  • Balance retraining exercises

  • Specific vestibular or habituation exercises

  • Exercises to improve visual or gaze stability (adaptation exercises)

  • A supervised and/or home exercise program

  • Reposition manoeuver for a problem termed BPPV (Benign Paroxysmal Positional Vertigo)

  • Postural Control Exercises, fall prevention, and re-conditioning activities