Vestibular rehabilitation Bascharage

When it comes to vestibular rehabilitation, it’s important to focus on the peripheral vestibular system. It consists of 5 different types of sensors in each ear: the semicircular canals of which there are 3 (horizontal, anterior vertical and posterior canals) and the otolith organs 2 (utricle and saccule), for a total of 10 receptors. Sensory cells are ciliated cells whose cilia are immersed in the endolymphatic fluid. The otolith sensory cells are covered by a tectorial membrane encrusted with small calcium carbonate crystals or otoconia (more commonly known as crystals).

The semicircular canals detect the amplitude of angular rotation of the head in all three spatial dimensions. The otolith organs are sensitive to the vertical (saccule) or horizontal (utricle) linear acceleration of the head in space, and detect its inclination to gravity.

In addition to vestibular inputs, these nuclei receive visual and proprioceptive inputs. The vestibular nuclei are therefore not simply relays of information from the inner ear, but true centers of sensory-motor integration. Central vestibular neurons then project to the oculomotor nuclei to stabilize gaze, or to the medulla to stabilize posture.

Vestibular rehabilitation

Vestibular rehabilitation is a speciality of physiotherapy that provides relief for patients suffering from pathologies of the vestibular system, including :

  • Central Nervous System disorders
  • Balance disorders
  • Walking disorders
  • The inner ear

These various pathologies manifest themselves as sensations of vertigo (rotatory, linear, imbalance or oscillopsia).

In medicine, the term vertigo refers to an illusion of movement, usually rotatory, which can be compared to that experienced after turning rapidly on a merry-go-round, and results from an asymmetry of activity in the left and right vestibular nuclei. In pathology, it reflects a dysfunction of the vestibular system. In everyday language, patients often use the word vertigo to describe any instability. But the term vertigo must be distinguished from the notion of instability (lack of balance). These dizzinesses are usually associated with nausea, vomiting or other falls.

During the vestibular physiotherapy consultation, an anamnesis is carried out to reconstruct the history of the disease and its antecedents (personal data, description of the crisis, associated signs, etc.). Various tests are then carried out to diagnose the problem (proprioceptive test, vestibulospinal reflex test, oculomotricity test, vestibulo-ocular reflex test).

Depending on the pathology diagnosed, the liberatory maneuver will be performed to treat the seizures. The patient will also be given a range of advice and exercises, followed by rehabilitation to prevent relapses.

To better meet your expectations in vestibular physiotherapy, our Pôle Équilibre & Santé practice in Bascharage is equipped with video-nystagmoscopy (a tool for measuring vestibular symmetry or asymmetry). This vestibular instrument is connected to specialized computer software called FramiGest. We have also acquired a rotatory chair in order to carry out the necessary assessments and offer optimal rehabilitation for vertigo and instability.

The main pathologies treated by vestibular physiotherapy are :

  • BPPV (Benign Paroxysmal Positional Vertigo)
  • Vestibular neuritis (Neuronitis Vestibularis)
  • Meniere’s disease
  • Balance and gait disorders
Vestibular rehabilitation therefore involves harnessing the plasticity of the Central Nervous System, i.e. its ability to develop new balancing strategies in the face of damage to the peripheral vestibular system. Sometimes, there is no peripheral vestibular deficit, but an alteration in central use (two types of mechanism exist: habituation and adaptation).