Benign Paroxysmal Positional Vertigo (BPPV)
BPPV is by far the most common cause of vertigo in the community. It is characterised by spinning/rotating sensations provoked by specific movement of the head, such as lying flat and rolling over in bed. There are both severe and mild forms of BPPV, which result in some different clinical presentations. Thankfully there are very effective treatments for this condition, with all of our staff are trained to treat this disorder to maximise rapid recovery for what can become an extremely disabling condition.
Vestibular Neuronitis is characterised by severe and sudden onset vertigo, often accompanied by nausea and vomiting. It can be extremely distressing, sometimes leading to hospital admission for further examination. Vestibular rehabilitation (VR) is the most effective treatment for this condition to allow early and efficient movement compensations to occur. VR consist of an individualised program of eye, neck and balance exercises aimed at directing recovery for each individual’s goals of returning to normal work and recreational activities. We communicate closely medical practitioners including Ear Nose & Throat specialists and neurologists to help manage symptoms and feedback during rehabilitation.
Sometimes it very difficult, particularly in the acute phase to determine the cause of somebody’s dizziness. In this situation it is important see your doctor for a check-up to ensure first to eliminate any serious problems. Following this it very useful to bee seen by experienced vestibular rehabilitation neurophysiotherapist. We can then help determine the key factors that may be causing dizziness and plan a specialist rehabilitation program. We feel it is very important to see experienced, trained neurophysiotherpists to for effective communication and education to limit the stress, fear and anxiety so often associated with undiagnosed dizziness.
Falls and Fear of Falls
Many factors contribute to falls in the elderly and in those with neurological disorders such as stroke, Parkinson’s and Multiple Sclerosis. It is essential to have an assessment that screens many of the physiological systems that contribute to falls risk. Individualised treatment and exercise followed by subsequent group or home exercise is important to reduce falls risk, increase safe activity, confidence and independence.
Poor co-ordination, tremor and reduced postural stability and balance can create difficulties with many activities of daily living. We develop treatment and exercises that focus on re-learning new strategies to enhance stability and enable more fluent, controlled movements. There area a number of conditions that can cause ataxia including stroke, multiple sclerosis and brain injury.
Migraine is a common disorder of central sensory processing. It can lead episodic symptoms, the most common of which is headache. However, migraine does not always cause headache, with some rare forms of migraine leading to dizziness. Other symptoms such as nausea, vomiting and light and noise sensitivity are common. We feel it is important to determine the many factors that can contribute to episodic symptoms, and will often liaise closely with you doctor or specialist. Neck and head control, motion sensitivity, visual dependence can all respond to careful physiotherapy and vestibular rehabilitation, while education about the brain and sensory processing can assist people identify triggers and assist to self-manage their migraine over time.
Meniere’s disease is a rare, chronic disorder that lead to episodic attacks of dizziness, nausea and vomiting, often with gradual deterioration in some ability to balance and one-side hearing loss. We can assist with balance and posture exercises to prevent secondary posture issues, and treat muscle tension so often associated with this kind of dizziness and balance disorder.
Endolymphatic hydrops can result in episodes of dizziness, imbalance and hearing changes. We can help with strategies that help maximise vestibular adaption and compensation while helping with early prevention of secondary postural changes can lead to other issues such as reduced confidence, anxiety and muscle tension and pain.
Labyrinthitis is an infection within the inner ear, and can cause vertigo and imbalance sensations. The aim of vestibular rehabilitation is to accelerate recovery using exercise that help with adaptation and compensation. This will assist in maximising recovery while monitoring for secondary balance and postural issues can be addressed in a timely manner.
High Level gait disorders
Many people can develop problems with walking, such as intermittent difficulty starting walking, reduced confidence, and slow or shuffling steps. We can help identify motor control strategies to help with mobility and design fitness and strengthening exercises. Reduced confidence and fear of falls can have devastating effects on people’s mobility over time.
In some situations problems with the neck can lead to feelings of dizziness and disequilibrium. This can present after acute injuries, such as whiplash, or may have developed slowly over time with chronic degeneration in postural control. Localised neck treatment combined with exercises that aim for stability and head control can help improve symptoms and develop better postural control.
The world health organisation defines rehabilitation as
“a process aimed at enabling them to reach and maintain their optimal physical, sensory, intellectual, psychological and social functional levels. Rehabilitation provides disabled people with the tools they need to attain independence and self-determination.”