Vestibular rehabilitation
Restore your balance. Regain your confidence.
An exercise based programme for alleviating the symptoms of dizziness and imbalance.
First appointment
A thorough 1 hour Initial Assessment
Please note
Due to the length of time and extensive tests performed in this appointment, we recommend having someone drive you or accompany you to the appointment.
Seen by
Melanie Reis, our Vestibular Rehab Specialist. Please make sure to book with Melanie for a Vestibular appointment. As the assessment and treatments are very specialised and should only be done by a Vestibular trained Physiotherapist.
What it is
Vestibular Rehabilitation Therapy (VRT)
VRT is an exercise based programme that helps retrain your brain and inner ear to work together, reducing symptoms of dizziness, improving balance, and minimising risk of falls.
These symptoms can be caused by an inner ear problem or incorrect interpretation of signals by the brain. They can be a side effect of certain medications, or even signify a more serious problem to be further investigated.
VRT provides an individualised plan to achieve your specific goals and get you confidently back to your everyday life!
What we assess and treat
You do not have to simply live with dizziness.
Vestibular rehabilitation is a specialised form of physiotherapy designed to help your brain and balance system respond more effectively to movement. We can assess and treat a range of conditions.
BPPV
The most common cause of vertigo and spinning, usually triggered with changes in head position, such as turning in bed, looking up, or bending forwards. Melanie can diagnose and treat BPPV with specialised maneuvers in the first appointment.
Vestibular Neuritis and Labyrinthitis
Vestibular Migraine
PPPD (Persistent Postural-Perceptual Dizziness)
Ménière's Disease
Concussion and Post Concussion Syndrome
Mal de Debarquement Syndrome
Cervicogenic Dizziness
Recovery from Inner Ear Surgery
Motion Sensitivity
Falls Prevention and Balance Rehab
Other Vestibular Conditions
What to expect
Your First Appointment, Step by Step
Step 01: Preparation
Due to the length of time and extensive tests performed in this appointment, we recommend having someone drive you or accompany you to the appointment.
Questionnaire: We may send you some forms to fill out before your appointment to give us an idea of the things you are struggling with.
Prepare any medical records that could be of importance. For example, hearing tests, previous consultant letters, or previous test results.
Step 02: Comprehensive Assessment
Melanie asks about your personal journey that has led you to seek Vestibular Rehab at Total Physio with in depth questioning that helps lead us to your diagnosis.
- We perform specific tests that assess how your inner ear and brain are communicating with each other and how your body is responding to these signals.
- We use advanced technology such as Frenzel Goggles to record eye movement which helps determine peripheral or central involvement.
- Balance tests that involve eyes open and eyes closed during static and dynamic movement.
- Gait and movement analysis.
- Positional testing on the bed to determine if you have BPPV.
Step 03: Treatment and Plan Built on Findings
Your treatment plan will be based on the assessment findings, and we aim to give every patient a diagnosis of their condition and an individual treatment plan.
- Treatment in the first appointment may consist of maneuvers on the bed if you have BPPV.
- Exercise Program demonstrated and tailored to you. This may include: gaze stabilisation, balance rehab, habituation, or home maneuvers.
- Education and Advice Resources.
Step 04: Between Sessions
Communication between multi-disciplines that are involved in your care and referral to appropriate health care professionals if needed.
Exercises integrated into your day to day life to make your rehab as manageable as possible.
Step 05: Reviewed at Every Visit
We will discuss every stage with you and reassess at each treatment, so the plan keeps pace with how you are actually doing.
The amount of follow ups needed will vary depending on your diagnosis and will be discussed in your initial assessment.
Symptoms
If you notice any of the following symptoms, vestibular rehab may benefit you
Melanie Reis
Vestibular Rehab Specialist
Melanie is a co-owner of Total Physio and has developed a particular clinical interest and expertise in vestibular rehabilitation. She has over 10 years' experience as a physiotherapist and has worked across Canada and Ireland. Melanie spent two years working in the Vestibular Therapy department at the Royal Victoria Eye and Ear Hospital and achieved the Advanced Vestibular Therapist designation from the University of Pittsburgh Medical Center (UPMC) in 2022.
Dizziness can be difficult to understand, particularly when symptoms are unpredictable or difficult to explain. Melanie's approach is to first understand the individual and their symptoms, then use a detailed clinical assessment to identify the most likely contributing factors.
Qualifications
Areas of particular interest
Vestibular rehabilitation questions
Vestibular rehabilitation is a specialised form of physiotherapy that uses assessment, movement exercises and rehabilitation to help people with dizziness, vertigo and balance problems.
BPPV stands for Benign Paroxysmal Positional Vertigo. It is a common cause of vertigo that is typically triggered by changes in head position, such as rolling over in bed or looking up.
Yes. When BPPV is confirmed, specific canalith repositioning techniques can often be used to treat it.
Some vestibular exercises are designed to reproduce mild symptoms in a controlled way. This can be part of the rehabilitation process, but exercises should be appropriate to your condition and progressed carefully.
This depends on the cause and severity of your symptoms. Some conditions may improve after a small number of appointments, while others require a longer rehabilitation programme.
No, you do not require a referral. If your symptoms suggest that medical assessment or investigation is needed, we will advise you.
Bring details of any relevant medical history, medications and previous investigations if you have them. Wear comfortable clothing and footwear suitable for movement.
It can help some people who develop dizziness, balance or movement-related symptoms following concussion. An assessment is important to determine whether vestibular rehabilitation is appropriate.
Dizziness can have many causes. If your symptoms do not appear to be primarily vestibular, we will explain our findings and advise you on the most appropriate next step.
Sudden or severe dizziness accompanied by symptoms such as new weakness, difficulty speaking, facial drooping, severe headache, fainting, chest pain or other acute neurological symptoms requires urgent medical assessment rather than routine physiotherapy.
Book an appointment
Ready when you are.
You do not need a GP referral. Our aim is to offer you an appointment within one working day of your call or email, and sometimes the same day.