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ADVANCE Perspective: Physical Therapy & Rehab Medicine

Final Session of Vestibular Therapy

Published October 19, 2011 7:57 AM by Rebecca Mayer
It may have been my last therapy session, but my work is far from over. As my Physical Therapist, Mark LeBoeuf, MSPT, at Hawthorn Medical Associates explained, "This is a marathon, not a sprint."

In the last month and a half, Mark has given me the tools I need to challenge my vestibular system in various ways. The hope is that, over time, my system will become more tolerant to the type of stimuli I experience on a boat and in a car that bring on my symptoms of motion sickness.

My last session began with a final testing for Benign Paroxysmal Positional Vertigo (BPPV), again just to rule it out. Mark determined that I didn't show any nystagmus, or rapid involuntary oscillation of the eyeballs.

Next, Mark took me through a series of exercises on a rocker board and a trampoline. He had me stand between the parallel bars in case I lost my balance. The exercises got progressively more difficult as they began to challenge my vestibular system more and more.

One exercise that I found particularly challenging (I was feeling a 3 out of 10 on level of symptoms aggravated) was doing squats with eyes fixed on a target that Mark was moving in front of me. Mark explained that by lowering my center of gravity, my vestibular system was more challenged, making it more difficult to focus on the moving target.

Then we moved on to a series of catching and tossing a ball while balancing on one foot and then in a lunge position. Again, my center of gravity was off, so the symptoms were more intense.

We moved to the treadmill, where I was instructed to walk at 2.0 mph and look at a fixed point on the wall to my right and then turn to the left to focus on an object that Mark was moving. At first I joked that 2.0 was way too slow for me to have any issues but once my dizziness hit a 3 out of 10 again, I admitted I was wrong! I was having difficulty walking in a straight line on the treadmill.

Mark suggested that I try to replicate some of these exercises at home. He explained that I need to make the prescribed exercises more difficult by changing my focus, adding uneven surfaces and combining the exercises with moving surfaces (at a safe speed), such as walking in a field or on a treadmill.

His final suggestion was that I consider seeing an otoneurology physician who can more specifically address the imbalance between the ear and brain. These two organs are designed to work in concert to produce and process the information we interpret as sound and our sense of balance and position. And for some reason, mine do not work that way.

Under his direction, I will continue to work on my visuo-vestibular habituation exercises independently but I know he's available should I have any questions or problems. He mentioned that if ever I find I'm experiencing more severe symptoms of dizziness, I should come in for more testing.

I feel more than prepared for this marathon. Let's go!


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