A customised vestibular rehabilitation therapy (VRT) programme is an important treatment modality in patients with vestibular dysfunction resulting in motion-provoked vertigo, oscillopsia (gaze instability), disequilibrium and gait disturbances. We discuss in this paper the patient selection criteria for VRT, rehabilitation strategies for unilateral and bilateral vestibular deficits, and some of the compelling evidence to support the use of VRT in treating such patients.
The use of vestibular exercises to treat patients with persistent symptoms of positional vertigo and disequilibrium has been around for many years. The Cawthorne and Cooksey exercises, developed in the 1940s, consist of a series of eye, head and body movements aimed at treating patients with unilateral vestibular paresis and post-concussion syndrome. The rationale for the exercises, which originated from the observation that patients who were active recovered faster, was based on the supposition that the head movements that provoke the patient’s dizziness play an important role in hastening the recovery process.
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