Vestibular Rehabilitation


Good balance is essential for daily life, from getting out of bed to crossing the road. A healthy balance system uses information from the brain, inner ears, eyes, and joints, and enables people to see clearly when moving their head. (1) Balance disorders and dizziness are a growing public health concern across all age groups. Prevalence increases with age and these disorders are some of the most common complaints reported to GPs by older patients.(1) Untreated, they result in worsening unsteadiness, loss of confidence and anxiety, difficulty with concentration and memory, inactivity, loss of independence, an increased risk of falls and costly falls-related injuries. (1) (2) What causes dizziness? The most common form of dizziness and balance disorder is BPPV (Benign Paroxysmal Positional Vertigo), a disorder of the inner ear resulting in episodes of intense dizziness on certain head movements. Other causes include side effects from medication or alcohol, brain disorders such as stroke, concussion or cerebellar degeneration, cardiac problems and anxiety.

What is vestibular rehabilitation ?

VR is an exercise-based programme to encourage the central nervous system to compensate for problems in the inner ear. Following thorough examination, specialist physiotherapists develop personalised exercise-based management plans including home exercise programmes. 

● 80 per cent of unexplained fallers attending A&E had possible vestibular loss, 41 per cent had vertigo, with 30-40 per cent admitted to hospital

● Untreated dizziness/balance disorders may lead to anxiety, avoidance strategies and increased risk of falling, impacting further on resources.

It is found that, over a six month period, the introduction of an award-winning Specialist Physiotherapy and Audiology service for patients referred with balance/dizziness disorders, has reduced waiting times and achieved excellent patient satisfaction. 80 per cent of patients are now managed exclusively in physiotherapy led clinics with 52 per cent assessed, diagnosed and treated in one session.


Nova Mullin, Specialist Physiotherapist Balance and Dizziness

@Aintree University Hospital NHS Foundation Trust , Liverpool.



Exercise is best for avoiding falls

STAY FIT1Physiotherapy to gain strength and better balance is clinically proven to reduce falls in older adults.

30-40% of over 65’s will experience 1 fall a year with 10% resulting in serious injuries. Common injuries include wrist, hip and pelvic fractures. Falls account for 87% of fractures in older people so being strong and healthy to avoid potential problems is the first step. Recurrent falls can also severely lower confidence, self-esteem and lead to social isolation.

Exercising regularly including strength training and balance exercises is not only beneficial for falls, but a wide range of other long term health conditions such as arthritis, high blood pressure, diabetes, osteoporosis, and mental health problems such as depression and anxiety.


How do I know if I am at risk?

Try these few simple tasks and see if you’re balance or strength is affected?

  • Stand with your feet together for 1 minute. (without using your hands for balance)
  • Standing unsupported with one foot directly in front of the other, your heel touching your toes on the opposite foot for 30 seconds. Try both sides to see if there is a difference
  • Standing on one leg for more than 10 seconds. Try both sides

Chartered physiotherapists can assess and treat a wide array of conditions. If you are concerned that your strength or balance is affecting your daily living please contact us for an assessment, and advice about what we can do to help you.

Tralee Physiotherapy Clinic runs a stay fit exercise class for older adults, which focuses on strength and balance training to help reduce risk of falls and improve physical and mental wellbeing.

By Sam Treharne, Chartered Physiotherapist Jan 2018