Brain relies on vestibular organs to obtain accurate information about equilibrium and motion. When vestibular organs are damaged, brain can no longer rely on it which results in dizziness, vertigo, balance problems and other symptoms. Many people recover from these symptoms in few weeks as the brain adapt to it. This is process is called vestibular compensation. In the cases where the vestibular compensation is unsuccessful people tend to rely on the input from eyes and muscles and joint to avoid the symptoms such as dizziness and nausea. The patients may develop new pattern of body movements to compensate with situation.

Goal of VRT
The only goal of VRT is to retrain the brain to recognize and process signals from vestibular system in coordination with vision and proprioception
How physical therapist can help?
An experienced Physical therapist will do a thorough evaluation of medical history. It also includes observing and measuring postures, balance and gait as well as compensation strategies. In addition, eye-head co ordination tests are done. The patient is asked to fill the questionnaire to measure the frequency and severity of symptoms. Using the results physical therapist design specific head, body and eye exercise which can be done in therapy setting as well as home.Thus brain is retrained to recognize and process signals from vestibular system in coordination with vision and proprioception. This often involves desensitizing the balance system to movements that provoke symptoms. Increasing home based activities and exercise will help the patient t to strengthen muscles. Sometimes exercise and activities may increase the symptoms as the brain is trying to adapt to new movement patterns. Balance improves over time in most of the cases if the exercises are done correctly. It is most effective way when compared to all other treatments.
When people suffer from events such as cold or flu, minor surgery or anything that interrupts the vestibular system, the symptoms may come back as the brain “forgets”. This process is called decompensation. People can recover from this process by immediately going back to the home exercise program which was initially prescribed by the physical therapist. If the symptoms persist, you need to seek medical help as it indicates additional vestibular damage.

References
Vestibular Rehabilitation Therapy (VRT). (n.d.). Retrieved June 19, 2013, from Vestibular disorders Association: http://vestibular.org/understanding-vestibular-disorder/treatment/treatment-detail-page

Author
Dr. Sanjay Nadu (http://mayaphysicaltherapy.com/), Maya Physical Therapy Inc, 5745 S. University Drive, Davie, FL 33328, Phone:(954) 252-9619