Vestibular Rehabilitation

What vestibular rehab does

The vestibular system (inner ear, eyes, and brain) keeps you steady and oriented. Injury or dysfunction can cause vertigo, dizziness, imbalance, nausea, and “busy background” blur. Vestibular rehabilitation uses specific maneuvers and exercises to retrain this system.

Reduce vertigo and dizziness
Improve gaze stability and reduce visual motion sensitivity
Restore balance and confidence in daily activities
Teach self-management to prevent recurrences

What to expect

Clear, plain-language explanation of your specific dizziness
Gentle testing of eye movements, balance, and positional triggers
A precise plan: canalith repositioning, gaze exercises, habituation, and balance drills—tailored to you

Common conditions we treat

BPPV (Benign Paroxysmal Positional Vertigo)

Brief spinning with rolling in bed, looking up, or bending
Treated with repositioning maneuvers (Epley, Semont, BBQ roll)
Self-care tips and recurrence prevention

Vestibular Neuritis / Labyrinthitis

Acute vertigo followed by lingering imbalance and motion sensitivity
Adaptation (gaze-stabilization VOR x1/x2) and balance retraining
Graded return to normal activities

Menière’s Disease

Episodic vertigo with ear fullness, tinnitus, and hearing changes
Stability training between attacks; flare management strategies
Education and coordination with your physician/ENT

PPPD / Motion Sensitivity

Persistent dizziness worse in busy places, screens, or walking
Habituation and graded visual-motion exposure
Breathing/pacing strategies to reduce symptom focus

Concussion / Whiplash-related Dizziness

Neck and eye-movement contributors screened
VOR training, balance and dual-task progression
Return-to-learn/work/sport guidance

Age-related Imbalance & Falls Risk

Strength, sensory integration and reaction training
Home safety and walking aid advice
Community activity confidence building

BPPV Maneuvers Gaze Stabilization Habituation Balance Training Falls Prevention

Your first visit (45–60 minutes)

Assessment

Detailed history of triggers, duration, ear/hearing symptoms, migraines, and medications
Oculomotor tests (smooth pursuit, saccades), head-impulse (VOR), positional testing (Dix-Hallpike, roll test)
Balance and gait tests (Romberg, tandem, single-leg)

Treatment & plan

Immediate maneuvers if BPPV is confirmed
Home program: 2–4 short sessions/day of targeted exercises
Progression milestones and follow-up schedule

Bring & wear

List of medications and recent medical findings
Glasses you normally use; avoid heavy eye makeup if possible
Comfortable clothing and flat shoes

How we treat

Canalith repositioning: Epley/Semont/BBQ roll variants for the affected canal
Adaptation: gaze-stabilization (VOR x1/x2), head-eye coordination
Habituation: graded exposure to provoking head/visual movements
Balance & gait: stance progression, dynamic walking, dual-tasking
Neck & visual contributors: cervical mobility, oculomotor drills
Education: sleep, hydration, pacing, flare management, relapse prevention

Typical care pathway

BPPV: many improve in 1–3 sessions; recurrences are common but usually resolve quickly with repeat maneuvers and home strategies.

Unilateral hypofunction / neuritis: often 4–8 visits over 4–8 weeks with daily home exercises.

Complex cases (PPPD, post-concussion, Menière’s): usually 6–12+ visits across 8–12+ weeks with careful progression and medical coordination.

Safety first

Vestibular rehab is safe and effective when tailored to you. Mild temporary dizziness during exercises is expected and part of retraining.

Seek urgent medical care if you have

Sudden severe headache, double vision, slurred speech, facial droop, limb weakness/numbness
Chest pain, fainting, or new neurological symptoms
Acute hearing loss in one ear—contact your doctor/ER promptly

Insurance & Direct Billing

Vestibular therapy provided by licensed physiotherapists is billed as physiotherapy. In NL you can book directly; some plans may require a physician’s referral for reimbursement. We offer Direct Billing to many insurers.

FAQ

Will the maneuvers make me very dizzy?

They can briefly provoke vertigo, which is expected, but episodes are short. We guide breathing and pacing to keep you safe.

How long until I feel better?

BPPV often improves immediately or within a few days. Hypofunction and post-concussion dizziness improve steadily over weeks with consistent home practice.

Will it come back?

BPPV can recur; we’ll teach recognition and self-care. For other conditions, staying active and continuing a few maintenance drills helps durability.

Do I need imaging or a referral?

No imaging is typically required, and you can book directly. If we suspect a medical issue, we’ll liaise with your physician or ENT.

Vestibular Rehabilitation (Dizziness & Balance)