Vestibular Physiotherapy and Balance Rehabilitation
Physiotherapy specialty dedicated to rehabilitation of balance disorders and dizziness of vestibular or central origin, combining otolith repositioning maneuvers (Epley, Semont), gaze stabilization exercises and vestibular desensitization protocols.
Presentation
Vestibular physiotherapy is a specialty focused on treating balance disorders and dizziness. The vestibular system, located in the inner ear, is responsible for detecting head movements and maintaining balance. Its dysfunction generates vertigo, nausea, oscillopsia (visual trembling during head movements) and balance disorders.
Vestibular rehabilitation relies on the principle of vestibular plasticity: the brain can learn to compensate for a unilateral vestibular deficit (central compensation) when given appropriate and progressive stimulation. The Cawthorne-Cooksey exercises, developed in the 1940s, founded this field.
Pioneers: Cawthorne (1944), Cooksey (1946) for vestibular exercises; Epley (1980) for BPPV repositioning maneuver.
Main Indications
- BPPV — Benign Paroxysmal Positional Vertigo (leading cause of vertigo, 20% of population)
- Vestibular neuritis (post-acute phase)
- Ménière's disease (between attacks)
- Post-acoustic neuroma surgery
- Cervical vertigo
- Presbyvestibulopathy (elderly vertigo)
- Post-concussion syndrome
- Post-ENT surgery vertigo
Contraindications
- Acute phase of vestibular neuritis (wait 48h)
- Acute Ménière's crisis
- Unstable cervical trauma (contraindication to maneuvers)
- Unoperated perilymphatic fistula
- Unbalanced cardiovascular pathologies
Medical Disclaimer
The information presented in this article is provided for educational and informational purposes only. It does not constitute medical advice, diagnosis, or treatment prescription. If in doubt, always consult your physician or a qualified healthcare professional. The techniques described do not replace conventional medical treatment.