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Concussion and Vestibular Therapy

Concussion and Vestibular Rehabilitation Therapy

Vestibular rehabilitation therapy is a type of treatment that focuses on the connection between the inner ear, brain, eyes, muscles, and nerves. Concussion and Vestibular Therapy is typically given to post-concussion patients at REFORM Physiotherapy Clinic.

Our Burnaby physiotherapists will assess balance, strength, range of motion, eye movements and mental awareness during evaluation to generate a plan of care with treatments tailored to the patient’s needs.

What is Assessed At Vestibular Evaluation?

What to Expect in Physiotherapy Treatments

Patients generally anticipate being in treatment for 4-8 weeks, with sessions three or four times a week. Initially, cognitive behavioral therapy for concussions will focus on easy activities that target dizziness and neck discomfort, but not other concussion symptoms like headaches.

As the patient’s vestibular concussion symptoms abate, their treatments will become more multifaceted, incorporating balance exercises with vestibular activities and focusing on restoring maximum function. The goal is to make patients as comfortable as possible and get them back to participating in sports or other activities with concussion physical therapy exercises.

Get The Most Effective Vestibular Rehabilitation Therapy for Concussion Symptoms

Dizziness. Nausea. Balance issues. Car sickness. Vestibular dysfunction following a head injury causes a few of the unpleasant symptoms listed above. Fortunately, they don’t have to be permanent; most patients experience significant improvement with the help of vestibular physical therapy exercises for concussions.

After a brain injury, one of several systems in your body that can deteriorate is the vestibular system, which aids your brain in determining your position in space. The brain itself and the autonomic nervous system are two more systems that may become damaged (which might also contribute to symptoms such as vertigo).

Up to 30% of concussions patients experience persisting symptoms that last months or years after their concussion. Post-concussion syndrome (PCS) is a condition that develops after any minor traumatic brain injury (mTBI). It can include persistent vestibular problems, which are symptoms experienced by some individuals following an mTBI.

Vestibular therapy is one of the treatments we offer at our Burnaby Physiotherapy clinic for patients with post-concussion syndrome. While it isn’t enough to cure all concussion symptoms, it will aid in treating vestibular dysfunction-related problems.

How Could Concussion Influence The Vestibular System?

A concussion is a type of brain injury that can occur after any blow or jolt to the head, including whiplash. Even if you don’t lose consciousness, a concussion can still damage any part of your brain. A concussion doesn’t cause structural damage; a regular MRI won’t reveal it.

A concussion disturbs the delicate but vital communication patterns between neurons and the blood vessels that supply them (known as neurovascular coupling, or NVC). Sometimes, this inefficient communication is only temporary as you recover from the immediate bruising and inflammation following brain trauma. But NVC dysfunction continues for up to 30% of concussion patients, causing symptoms for months or even years after the injury.

Concussion and Vestibular Rehabilitation
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These symptoms can signal a more severe problem, such as a stroke. SEEK MEDICAL ADVICE IMMEDIATELY IF YOU EXPERIENCE ANY FORM OF FACIAL WEAKNESS!

Burnaby Physio Clinic
For Vestibular Rehabilitation Therapy

What Does Vestibular Therapy Involve?

Although vestibular therapy is often revered for its ability to treat, it begins with a thorough diagnosis. Many people suffering from mild symptoms don't garner the attention of a neurologist or other medical professional. However, even if you don't have any noticeable deficits, there may be functional difficulties that can still be treated by vestibular therapy.

Vestibular therapy, at its most basic level, corrects your brain to recognize your real position in space, which goes well beyond merely standing on a balance board. Balance training is required, but you must also engage your visual system and move your head around to get treatment to work.

Treatments For Vestibular Disorders

The first goal of vestibular rehabilitation is to restore your vision to be clear and stable during head movement! We utilize a technique known as gaze stabilization to achieve this. 

Many patients report an almost immediate improvement in their balance after completing gaze stabilization exercises. After that, we’ll focus on activities that require more mobility and coordination.

For example, after patients activate the respective sides or canals that need work with gaze stabilization exercises, they perform full-body catching a ball while standing on an unstable surface. Patients also walk in Infinity patterns around obstacles while keeping their eyes focused on one point. 

At our REFORM Physiotherapy Burnaby, we teach patients good breathing techniques too. Proper oxygenation facilitates your body and speeds up vestibular concussion recovery time.

Some people have only eye problems, while others have vision and vestibular issues. Many people suffer from both. The specific difficulties you’re experiencing will determine the type of therapy you receive and how many treatments it will take. You may require a vision therapist if your problem is difficult to treat.

Working with a physiotherapist will not only help you make progress during appointments, but you’ll be given exercises to do at home as well. These additional reinforcement activities will ensure that the improvements you make are long-lasting.

The Best Vestibular Exercises for Concussion

Our registered physiotherapists will develop a customized, evidence-based vestibular treatment plan to meet your unique demands.


To recover optimally, you must engage both your peripheral and central vestibular systems and visual systems. This often involves moving your head around and shifting your eyes appropriately to maximize the effect of vestibular therapy and improve function.

Standard rehabilitation methods used in vestibular therapy include gaze stabilization, habituation exercises, balance, and exertional training.

Burnaby Vestibular Therapy
Exercises to Help Vestibular rehabilitation

Physical Therapist Exercise Program

Gaze Stabilization

After a brain injury, the vestibulo-ocular reflex helps you to keep your focus on an object even as your head moves. This reflex can be damaged following a concussion, causing dizziness and vertigo. Eye activities may aid in improving gaze stability and restoring the vestibulo-ocular reflex after a concussion.

The following are the exercises that most often need to be performed:

Draw an X in the center of a piece of paper while sitting up straight in a chair.

Holding the paper in your hand at arm’s length, keep it level with your eyes.

If you can, focus your gaze on the X and turn your head side to side. Try moving as quickly as possible without the X becoming blurry.

The workout’s difficulty can be increased or reduced to meet your desired comfort level. For example, while aiming to complete the activity for 1 minute, you should start with a lower goal of a few seconds. And work your way up as you get better for long-term results.

Habituation Exercises for Concussion

The second most common vestibular therapy exercises are habituation exercises. They assist patients who experience disorienting dizziness when they move. By slowly increasing exposure to the movements that trigger this sensation (i.e., bending down to pick up an object), habituation exercises help lessen feelings of dizziness overall.

A habituation exercise may include:

Moving from a sitting position to lying down on your back

To stand and then sit.

Sitting up and bend forward until your head is between your knees.

The goal is to gradually increase the movements until they no longer trigger or cause motion sickness. Our professional physiotherapists in Burnaby ensure the exercise is both challenging and manageable to prevent overexertion.

Balance and Exertional Training

Balance and exercise training is another frequent vestibular therapy for concussions. This style of training focuses on increasing endurance, balance, and strength. Because it increases stamina and improves steadiness while enhancing cardiovascular capacity, balance, and exertional training are particularly beneficial to athletes with a concussion.

Depending on your skill level, it’s critical to address other symptoms (such as dizziness) ahead of time to avoid exhausting yourself or other risk factors. If you detect vestibular difficulties while working out, stop immediately or take a break. Our Burnaby physio experts can provide more guidance and ensure that the vestibular physical therapy treatments they prescribe are appropriate and safe for you.

Additional Vestibular Rehabilitation Techniques

Other vestibular rehabilitation techniques that may be useful include:

Proper breathing: this can help reduce symptoms such as dizziness and nausea. While improper breathing may not be a vestibular issue, studies show that specific breathing techniques are highly effective for those undergoing concussion rehabilitation.

Did you know that when one sense is impaired, others can be sharpened to compensate for it? For example, suppose a person still has their vision. In that case, they may be able to train themselves to rely more on eyesight rather than balance.

Please get in touch with REFORM Physiotherapists Burnaby today if you are also looking for vestibular therapy after TBI.

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