Are Your Patients Good Candidates for VRT?


Vestibular Rehabilitation Therapy (VRT) has proven to be effective for improving vestibular disorder-related symptoms, such as vertigo, imbalance, dizziness, migraines, and visual disturbances. But is it the right therapy for all your vestibular patients?

One size never fits all, especially when it comes to treating patients with vestibular disorders. There are several factors that should be considered – from the specific vestibular disorder they have, to their commitment to doing the rehabilitation exercises.

The Type of Disorder Affects Recovery

Patients with a stable vestibular disorder, like vestibular neuritis or labyrinthitis, have the best chances of a satisfactory recovery. On the contrary, patients with progressive disorders (like multiple sclerosis) or fluctuating conditions (like migraines) have a lesser chance of a successful outcome.

However, these odds can often be improved by combining other treatments with VRT. Anything that stabilizes the disorder, whether it be achieved by medication, behavioral changes or other medical options, will allow the VRT a greater chance of working.

Six Factors in Determining If a Patient Is Right for VRT

  1. Commitment

  2. The exercises that patients are required to perform as part of vestibular therapy aren’t difficult to learn, but they still require commitment, as they can be tedious. It will help if your patients set up a schedule they can strictly follow. But what will help the most is if your patients have the discipline and perseverance to push through when the going gets tough.

  3. Lifestyle

  4. It’s difficult to be active when you have a vestibular disorder. The imbalance, dizziness, nausea, etc. incapacitate most patients, making it difficult for them to perform necessary rehabilitation exercises. As you know, being less active decreases a person’s tolerance to activity. To combat this, encourage your patients to be more active so their tolerance to activity increases.

    The problem is that some people are more prone to inactivity than others, whether they have a vestibular disorder or not. Finding out if your patients fall into that category might help determine if an exercise-based therapy approach is the correct one.

  5. Pain Management

  6. It will be difficult for your patients to do their vestibular exercises if they are in pain. It’s also risky. Pain increases the chance of falling while doing exercises. But full participation in the exercises is essential to recovery.

    How much pain is too much? Are there medical options that can be combined with VRT that will lessen the patient’s pain? Whatever the final decision, it begins by accurately assessing your patient’s level of pain.

  7. Medical Conditions

  8. Just like pain, other medical conditions can make VRT more difficult. If these conditions increase the risk of falling or decrease your patient’s ability to perform exercises, that’s a concern. Assessment and management of these medical conditions will be key in creating a treatment plan, or even deciding if VRT is the right option.

  9. Medications

  10. Given the age of most vestibular patients, and the exercise-based approach to VRT, falling is always the greatest concern during treatment. While medications may be necessary, and even helpful in managing a condition or disease, they also often cause unwanted side effects; the kind that increase the chance of falling (fatigue, weakness, dizziness, etc.).

    In some cases, even though it may seem like there may be a possible confliction regarding medication and VRT, it’s always a good idea to consider a few things first.

    • Is the dosage correct?
    • Is it being taken correctly?
    • Can it be eliminated?
    • Is there a better alternative?
  11. Emotional Issues

Anxiety and depression are common side effects for those suffering with vestibular disorders. It’s not easy feeling like you’ve lost your freedom of movement. While it’s natural to want to restrict activity as much as possible, that’s the wrong approach.

If emotional concerns are an issue with one of your patients, try combining VRT with behavioral or pharmacological therapy.

The important thing to remember is that every patient is unique and has a distinct set of needs and expectations. What works for one may not work for another. This is why, when determining if VRT is right for your patients, getting to know everything about them is so instrumental to successfully treating them.