Aquatic Physiotherapy: An Effective Vestibular Rehab Tool


Water exercises, such as swimming and aerobics, are commonly known to burn calories, improve heart health, increase muscular endurance, and reduce stress. What many don’t consider is how effective they are in reducing symptoms brought on by vestibular dysfunction. In fact, a 2008 study from the University of São Paulo showed that 66% of participants saw a decrease in dizziness after completing 12 proposed aquatic physiotherapy sessions. Such evidence confirms that aquatic physiotherapy can be an effective treatment method for patients suffering from dizziness and vertigo.

Get patients into the pool!

Symptoms brought on by vestibular dysfunction often cause people to avoid any movement or activity that worsens their dizziness. This influences a more sedentary lifestyle and, as a result, leads to other physical ailments like stiffness of joints, a decrease in muscle flexibility, and a lack of stamina. As a medical professional, you can do your part to help patients with vestibular disorders by suggesting aquatic physiotherapy as a compliment to mainstream methods of treatment like habituation exercises, gaze stabilization, and balance training.

The benefits of water therapy can leave the naysayers high and dry

Some doubt the benefits of aquatic physiotherapy in treating inner ear/balance disorders, claiming such activity is a more suitable remedy for rheumatism, arthritis and other muscle and joint disorders. Yet, as already noted, successful outcomes have supported those who recommend water exercises as part of a vestibular rehab program. These movements facilitate the stimulation of vestibular compensation since every movement of the patient’s body begins from a stable position, thus forcing a balance reaction in order for them to maintain symmetry.

There can be up to twelve phases of aquatic physiotherapy utilized to help patients with balance issues. Included are:

  • Adaptation: Maintaining orthostatic posture in the water with the help of a therapist
  • Separation: Maintaining an upright position without the therapist’s help
  • Postural: Standing up from a sitting position
  • Rotational: Performing maximum trunk rotation while in a sitting position
  • Ball Throwing: Catching and tossing back a ball thrown by the therapist to the patient’s left and right sides
  • Gait: Maintaining balance while performing walking movements;
  • Up and Down: Climbing and descending the pool ladder with eyes open and closed
  • Sitting: While on a float with limbs free, patient performs pedaling and arm-crossing movements
  • Sitting and Catching: While on a float, concentrating on catching and throwing back a ball thrown by therapist
  • Upright: Performing small jumping movements
  • Upright and Catching: Catching and returning ball thrown to left and right sides
  • Control of Movement: With water jets aimed at patient, performing up and down knee bends

In the same study referenced in the beginning of this article, titled "Aquatic physiotherapy for vestibular rehabilitation in patients with unilateral vestibular hypofunction: exploratory prospective study," YP Gabilan, MR Perracini, MS Munhoz, and FF Gananc concluded thatUnilateral vestibular hypofunction patients undergoing aquatic physiotherapy for vestibular rehabilitation achieved an improvement in quality of life, body balance and self-perception of dizziness intensity, regardless of age, time since symptom onset, and use of antivertigo medication.”

If you decide to add aquatic physiotherapy to your vestibular rehab program, advise your patients that evidence has shown that these exercises can be effective in subsiding their dizziness and vertigo symptoms. Such input will give them confidence that all of the work they will be putting in will lead to improved quality of life.