Vestibular Rehabilitation

The vestibule and the semicircular canals, and the membranous labyrinth contained within them, serve a wide variety of functions that contribute to our sense of orientation in space and equilibrium. These structures also aid in compensation in eye movement and posture using the centrally located vestibular neural circuits like vestibulo-ocular and vestibulospinal pathways. The vestibular system also plays an important role in consciousness, and dysfunctions of the same may cause cognitive deficits related to spatial memory, learning, and navigation. The use of vestibular exercise-based programs to treat vertigo and balance dysfunction is not novel and has been in existence for over 70 years. Evidence supports the use of vestibular rehabilitation in vestibular disorder patients to improve symptoms of imbalance, falls and fear of falling, oscillopsia, dizziness, vertigo, motion sensitivity, nausea, and anxiety through central compensation. Anatomy and physiology of the vestibular system, role of the vestibular system in the maintenance of postural control, clinical manifestations of common peripheral and central vestibular disorders, neurological assessment, and management of vestibular disorders are discussed in this chapter.