Physical therapists who provide vestibular rehabilitation often help patients recover balance and gait, controlling their dizziness or vertigo. But what they're really doing is helping them regain their lives.
When Jasmine Edwards, PT, DPT, was working with patients in an outpatient brain injury clinic, a 69-year-old man presented with a diagnosis of paraneoplastic cerebellar degeneration. Because of his cerebellar impairment, his central vestibular symptoms were so intense that even the most basic of activities — such as performing supine to sit — resulted in significant vertigo, leading to vomiting. Edwards recalls that this would occur many times each day with all his mobility activities. Not surprisingly, the patient and his wife were tired and frustrated while trying to manage his symptoms.
Edwards, a board-certified clinical specialist in neurologic physical therapy, says, "One of our goals for therapy was to decrease his symptoms so that he could perform mobility activities without constant vomiting. To address this goal, we used vestibular rehab."
During the next several months, Edwards says that they performed habituation exercises that incorporated compensatory techniques to manage his symptoms. "I will never forget the excitement of both the patient and his wife when they informed me that since his last visit, he had only one episode of vomiting during mobility activities. They were both ecstatic and so was I!" Edwards recalls. "What made this even better was that it was not a one-time occurrence, and we were able to maintain these improvements. Vestibular rehab not only improved his symptoms, but it also improved his quality of life and decreased the caregiver burden on his wife."
This is just one example of how vestibular rehabilitation, when done by a properly experienced and trained physical therapist, can result in great life changes for the patients and their families. Because it can involve so many different body systems, though, physical therapists working in this specific area of physical therapy need to know when they can treat and when they need to refer patients to another practitioner.
Before getting to that, let's start with the basics.