


VRT can help with a variety of vestibular problems including:

  • Benign paroxysmal positional vertigo (BPPV)




Why is VRT needed?

When the vestibular organs are damaged with disease or injury, the brain can no longer rely on them for accurate information about equilibrium and motion, often resulting in dizziness, vertigo, balance problems, and other symptoms. Many people are able to recover from these symptoms on their own after a few weeks of normal activity because the brain has adapted with a process called vestibular compensation.

However, if the vestibular compensation process is not successful, a person's ability to maintain posture and coordinate balance may become overly dependent on input from the eyes (vision) and muscles and joints (proprioception). In addition, the person may develop new patterns of head and body movement in an attempt to avoid dizziness and nausea. For example, a person with a vestibular disorder might adopt an exaggerated hip sway as a method of balancing, swivel the entire body rather than just the head when turning to look at something, or always look down at the floor to avoid what appears to be a confusing swirl of activity. Unfortunately, these strategies can make vestibular compensation even more difficult, worsening symptoms and often causing headache, muscle tension, and fatigue.

The goal of VRT is to retrain the brain to recognize and process signals from the vestibular system in coordination with vision and proprioception. This often involves desensitizing the balance system to movements that provoke symptoms.

What happens during VRT?





What are the effects of VRT and how does it help?

Some of the exercise and activities may at first cause an increase in symptoms as the body and brain attempt to sort out the new pattern of movements. Because of this, people sometimes give up on VRT, thinking it is making their vestibular disorder worse. However, in most cases balance improves over time if the exercises are correctly and faithfully performed. Muscle tension, headaches, and fatigue will diminish, and symptoms of dizziness, vertigo, and nausea will decrease or disappear. Many times, VRT is so successful that no other treatment is required.


Authors: Anne Shumway-Cook, PT, PhD, FAPTA; Professor Emerita, Department of Rehabilitation Medicine, University of Washington, Seattle, Washington


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