If you’ve been diagnosed with unilateral vestibular hypofunction—meaning you have reduced vestibular function on one side—you’re probably wondering: “What treatments or support are out there to help me get back to feeling balanced and grounded?” Let’s walk through it together.
Vestibular Rehabilitation Therapy (VRT)
Vestibular rehabilitation therapy (VRT) is an evidence-based approach and gold standard treatment for unilateral vestibular loss. It involves a comprehensive exercise-based program targeting specific impairments and functional limitations. VRT is provided specifically by trained therapists who have certifications or extensive coursework in this area.
How VRT works
The goal is compensation—your brain learns to substitute visual and sensory cues for the vestibular deficit, improving balance, gaze stability, and reducing vertigo.
Types of exercises
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- Habituation: Repeated, controlled exposure to movements that provoke dizziness, helping desensitize your system.
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- Gaze stabilization: Exercises that improve your ability to focus while moving your head.
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- Balance and gait training: Improving stability, awareness in space, and gait on even and uneven surfaces.
- Conditioning/Endurance: It is common for individuals suffering from UVL to stop moving and avoid activity; therefore, it is essential to perform exercises to prevent deconditioning.
Effectiveness
Strong evidence shows that VRT offers significant benefits for those with subacute and chronic unilateral vestibular hypofunction vs medications. Recovery is promising when a diagnosis is achieved early, followed by prompt VRT.
Supervised VRT and Home exercise programs: Finding Your Balance
You will benefit from the combination of in-clinic supervised VRT supplemented with a daily home exercise program.
Supervised VRT
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- Acute/subacute: Weekly sessions for ~2–3 weeks.
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- Chronic: 1-2 sessions/week for ~4–6 weeks.
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- Bilateral hypofunction: weekly sessions for 8-12 weeks.
Home-based exercise program
Gaze-stabilization exercises may be prescribed up to three times a day, ranging from 12 minutes to 20 minutes, depending on your diagnosis.
Teamwork makes the dream work
The combination of supervised VRT and home therapy is a must! This combination will support continuous progress and aid recovery. Home practice helps build consistency and integrate improvements into daily life. You will learn how to maintain your recovery when you are done with in-clinic physical therapy.
Tailored to You: Personalized Programs & Considerations
Everyone’s journey is different. VRT is most effective when tailored to your unique situation. What to expect with VRT:
- Initial assessment: Your PT will perform a comprehensive exam to include: your medical history, symptom patterns, triggering activities, how those impact your daily life, and much more.
- Treatments: Your PT will prescribe a specific treatment program based on symptoms and deficits. This program will evolve as you progress. It may include any of the four components listed above.
- Consideration of comorbidities and other factors: Conditions like anxiety, depression, or diabetic neuropathy can affect outcomes. Lack of sleep, poor diet, social issues, and more may also affect your recovery. It is essential to have a team of providers to address the additional problems to have the best outcomes.
Mind-Body Strategies & Self-Care
Beyond vestibular rehabilitation exercises, there are complementary therapies that can help you support your mental and emotional wellness:
- Mindfulness & stress reduction: Techniques like meditation can calm anxiety, improve focus, and help your brain adapt more efficiently and reduce symptoms.
- Managing fatigue: Vestibular disorders often cause physical fatigue. Techniques such as journaling triggers, pacing yourself, and planning rest can help. Self-compassion and cognitive-behavioral approaches can also make a real difference.
Support, Resources & Forward Momentum
- Finding a trained clinician is key: physical therapists and occupational therapists will assist you on your journey to recovery. Ask your doctors, consult PT and OT websites and companies to help with this.
- Stay informed: VeDA’s website offers many helpful guides, tips, and patient stories to keep you informed and encouraged.
- Build a support network: Connecting with others, via support groups or loved ones, can reduce isolation and increase understanding.
Summary: Your Path to Recovery
What to Do
- Confirm diagnosis: Avoid self-diagnosis. It is necessary for a trained professional to confirm your diagnosis. This will ensure that an accurate treatment program is prescribed.
- Begin a vestibular treatment program (VRT): Your trained professional will start you on a customized and comprehensive exercise program, which may include gaze stabilization, habituation, balance training, and conditioning.
- Stick to a plan: Plans vary based on the individual’s needs. Typically, PT is prescribed twice a week for up to six weeks. PTs rely heavily on patients to be vigilant with their home exercise programs. These are performed daily, up to three times a day.
- Address emotional and holistic needs: Your trained professional will guide you on how to seek help to address mindfulness, fatigue, anxiety, depression, sleeplessness, or any other comorbidities that would affect your progress and ability to participate in therapy.
- Build resilience: Stay strong in body and mind. Seek help when needed. Educate yourself on your diagnosis and specific needs. Connect with others who share similar stories. Have a stress outlet. Be your own cheerleader. Advocate for yourself as you regain balance and confidence.
You’re not alone on this journey. Vestibular rehabilitation is a powerful ally in regaining balance, reducing dizziness, and restoring your quality of life. With the proper support and tools, you can move forward—steadily, surely, and with renewed hope.
Read more about unilateral vestibular hypofunction.
By Fiona Flamingo, with help from Denise Schneider, DPT, FAAOMPT, ATC
