We have often heard of vertigo – a sensation of the world whirling around and a temporary loss of balance, which could be very debilitating and disturbing.
There are different types of vertigo and many causes for it. But the most common type of vertigo is Benign Paroxysmal Positional Vertigo (BPPV).
The gold standard treatment for BPPV is positional movements and exercises of the head. Not many people are aware that this can be effectively performed by physiotherapists.
My first introduction to BPPV was 21 years ago when I was taught the Epley manoeuvre as a young physiotherapy intern in India. I was fascinated by the fact that a few positional manoeuvres of the head could abolish symptoms of vertigo. I was able to successfully treat many BPPV patients thereafter. But my foray into vestibular rehab was limited to BPPV.
Along the years my interests moved to neuro rehab and pain science. I started learning about the role of brain in pain and in modulating adaptive strategies to overcome various musculoskeletal and neural impairments in our body. It was fascinating and life changing to know that we can control the way our body reacts to the various impairments we encounter as a high functioning living being. The secret to it lies in training the brain. With that knowledge also came the realization that training the brain is not an easy proposition and it involves consistency, perseverance and proper guidance. There began my journey in understanding and learning the role of our nervous system in therapeutic healing. Vestibular rehabilitation (VRT) fits perfectly into this paradigm.
The Vestibular system in our body is primarily responsible for balance. Vestibular problems can be temporary (BPPV) or permanent.
VRT is about understanding the impairment and to train the nervous system to develop strategies, to either habituate to permanent changes or produce adaptive mechanisms. The goal is to improve our quality of life. VRT uses exercises based on eye movements, positional variations, coordination and balance.