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Treatment and Rehabilitation

While determining the root cause of your balance and dizziness symptoms is a crucial first step, what we are ultimately trying to determine is how we can help you get better.

Treatment and Rehabilitation - Alberta Balance Centre

What can be done about your dizziness?

While there may be a wide range of potential causes for your specific symptoms, there are two main treatment paths that are proven to be most effective for the vast majority of balance & dizziness-related disorders.

They are vestibular rehabilitation therapy (VRT), and canalith repositioning maneouvers (CRMs). CRMs are used specifically for the treatment of a common condition called benign paroxysmal positional vertigo (BPPV), whereas VRT has been shown to be highly effective at treating a broad range of disorders and deficits. In some less common cases, VRT may not be an appropriate or effective option, however, the detailed diagnostic data we collect will allow us to determine exactly what is best for you.

Additionally, there may be a pharmacologic or surgical component that must be managed by a physician such as your family Dr, ENT, or neurologist. In cases of cervicogenic dizziness, specialized cervical chiropractic care may also be required. If those potential needs are identified we will refer you to the appropriate specialty and help ensure you get the care you need. 

Vestibular Rehabilitation Therapy (VRT)

Vestibular Rehabilitation Therapy (VRT) - Alberta Balance Centre

VRT is a systematic progression of exercise protocols designed to improve or restore balance and equilibrium function, as well as the coordination of head and eye movements to reduce or eliminate blurred vision with head movement. Protocols are based on the 3 core principles of: Adaptation, Habituation, and Substitution.

Because our overall balance function depends on multiple different systems, when one of those systems is damaged we become more dependent on the remaining ones. If the damaged system is completely non-functional, we may need to strengthen the remaining systems in order to compensate for what has been lost, however, if the damaged system still has even some (albeit impaired) function, we may actually need to reduce your reliance on the remaining systems in order to strengthen the damaged one. These are both principles of substitution.

In many cases people become quite fearful and avoidant of any activities, movements, or situations that might provoke their symptoms, which is entirely understandable given how distressing they can be, however, this can unfortunately lead to increased severity of symptoms when they do inevitably occur, as well as an increased sensitivity to the provoking circumstances. This is where the VRT principles of adaptation and habituation come in. By slowly progressing through a set of carefully selected exercise protocols that actually provoke your symptoms in a tolerable way, your brain and body are able to adapt or habituate to the point where situations that used to provoke your symptoms, no longer do – or to a greatly reduced degree.

VRT is not a “one size fits all” standard protocol though. In order to be maximally effective it must be targeted to your specific problems or deficits, which requires detailed diagnostic data. Without an accurate assessment of all the various systems contributing to your overall balance function, it is difficult to create a maximally effective VRT protocol. The comprehensive nature of our diagnostic test battery gives us the data that will allow for the creation of the most effective treatment protocol possible.

It is also very important to note that VRT is sometimes NOT the most effective, or even appropriate, treatment option. There are certain conditions that do not respond well to VRT, or that may require specialized medical referral to a neurologist or ENT. This is obviously important to know before you invest time, effort, money, and hope, embarking on a treatment path that may not be appropriate. Again, this is where the detailed diagnostic data we collect through our comprehensive testing can give you peace of mind that you are pursuing the best treatment path possible.

Repositioning Maneuvers for
Benign Paroxysmal Positional Vertigo (BPPV)

Canalith Repositioning Maneuvers for Benign Paroxysmal Positional Vertigo (BPPV) - Alberta Balance Centre
BPPV is the most common cause of true vertigo, and the #1 cause of dizziness in people over 60. In fact, by age 70, 50% of people will have experienced at least one episode of BPPV, but it can occur at any age (American Institute of Balance). It is also one of the most distressing vestibular disorders due to its sudden onset and severe nature. Even though it has the word “benign” in its name, BPPV feels anything but benign to the person experiencing it. The word benign is actually referring to the fact that BPPV in itself is not life-threatening, although it can lead to falls or accidents, which certainly can be. Fortunately, BPPV is also very treatable and can typically be resolved with 1 or 2 office visits during which canalith repositioning maneuvers are performed by a trained professional.
These maneuvers carefully move displaced canaliths/otoliths (or “crystals” as you may have heard them called), back into their proper position within the inner-ear. In addition to determining if you do in fact have BPPV, the comprehensive assessment you receive at our clinic will determine exactly which of the semicircular canals, and which ear(s) is/are affected, which allows us to employ the most appropriate, safe, and effective maneuvers that correspond to your specific case.