Vestibular rehabilitation: A patient-centered approach

Vertigo and imbalance are common complaints for individuals after vestibular disease. Vertigo can be both scary and disabling, with patients reporting lower quality of life, more frequent falls, and higher financial burdens. Fortunately, the unpleasant symptoms that accompany vestibular disease improve using a conservative intervention known as vestibular rehabilitation. Vestibular rehabilitation is an exercise-based approach designed to reduce symptoms of vertigo, nonspecific dizziness, and disequilibrium for individuals with peripheral or central vestibular disease. Trained clinicians select individualized symptom provocative exercises to reduce patient symptoms over time through mechanisms of neuroplasticity, sensory substitution, and sensory reweighting ultimately improving balance and quality of life. Vestibular rehabilitation is a well-established treatment for the symptoms of vertigo and imbalance and should be initiated early in the care of patients presenting with vestibular disease.