Vestibular Therapy and Dizziness

Enough to Make Your Head Spin

By: Jeff Ladinsky, PT, DPT, MTC, CCI


With approximately 90 million American adults having experience some form of vestibular disorder, management of these patients can be challenging and be among the most rewarding experiences for both patients and clinicians. Patients no longer must learn to live with the debilitating effects as vestibular rehabilitation programs may provide those affected with alternative management strategies.

Are balance disorders a big deal?  You bet!  Dizziness/loss of balance is the third most common complaint to primary care practitioners by patients over the age of 65 years old.  This diagnosis one of the leading causes for both admission and readmission to primary care facilities.  These disorders can frequently lead to reduction in a patient’s force production capabilities as well as lending to abnormal movement pattern coordination deficits that may affect normal activities of daily living.   It is estimated that we spend well over $30 million on the aftercare treatment of a fall.

Balance is a complicated function that is carried out by three sensory systems – visual, vestibular and somatosensory.  These send afferent signals to the brain where motor planning strategies are organized and sent efferently to be carried out by the visual and somatosensory systems.  Therefore, impairments within one or more of these systems could mean difficulty in assuming and maintaining normal equilibrium in our never-ending battle against gravity.

Balance disorders can be effectively addressed through a specific program called vestibular rehabilitation therapy (VRT).  VRT involves special movements and exercises to diminish recurrent aberrant neurological signals.  It is based on the concept the very movement that may make the patient dizzy can eventually be used to relieve the symptoms through repetition – the theory of neuroplasticity. By repeatedly bombarding the brain with the correct movement pattern coordination, the brain is forced to accept and adapt by reinterpreting the faulty signals as correct.

Does VRT work?  An overwhelming number of studies have indicated that vestibular therapy can help most patients to improve their activities of daily living to some degree and reduce their fall risk.  What it cannot do is keep your patient’s 25 year old mind from getting their senior aged body in trouble!

Join me for my live course, “Integration Evidenced-Based Strategies for Fall Prevention”. This evidence-based course will provide you with the cornerstones to effectively integrate and adapt manual and vestibular therapy skills to prevent falls reduce fall risk and improve outcomes in acute, outpatient, rehab center, and home health settings. You will be able to determine whether dysfunction may exist within the vestibular, visual, or somatosensory systems or if there may be faulty integration. Once identified the therapist will be able to correct dyskinesia and reduce fall risks using this eclectic and effective approach. This comprehensive program will feature an integrated format of lecture, lab, case studies, and open discussion that will help you better assess movement deficits, prepare the body for optimal movement through manual therapy, and design effective plans of care that target patient specific deficits. Participants will take home hands-on, practical techniques that can be used right away in any rehabilitation setting.

Jeff I. Ladinsky, PT, DPT, MTC, CSCS is a licensed physical therapist with over 26 years of clinical experience in treating vestibular and movement disorders. He has received his Advanced Vestibular Rehabilitation Certification from the American Institute of Balance and is certified in the LSVT BIG program to treat Parkinson’s disease and related movement disorders. Dr. Ladinsky is a Certified Clinical Instructor and Manual Therapist having served as an adjunct instructor at the University of St. Augustine and Polk State College.  Dr. Ladinsky is the former Director of Rehabilitation Services at Highlands Regional Medical Center and is currently the Vestibular Committee member and Clinic Manager for CORA Physical Therapy. Dr. Ladinsky graduated from Stetson University with a Bachelor of Science degree, received his Master of Science degree in Physical Therapy from the University of Miami and was awarded his Doctor of Physical Therapy from the University of St. Augustine. He is a member of the American Physical Therapy Association and has also been a platform presenter at the APTA National Conference.