{"title":"Vestibular rehabilitation","image":"https://pes-luxembourg.lu/bascharage/wp-content/uploads/sites/2/2019/07/Reeducation-Vestibulaire-1-300x294.jpg","content":"\n**The world spinning when you move your head, a constant feeling of drunkenness, the fear of falling at the slightest movement: vertigo and balance disorders spoil daily life, but they can be treated effectively.** At Pôle Equilibre & Santé in Bascharage, vestibular rehabilitation relies on an instrumented assessment and proven manoeuvres to quickly relieve attacks and prevent recurrence — an expertise still rare in Luxembourg.\n\nOur specialised site [kine-vertige.lu](https://kine-vertige.lu/) presents in detail our approach to vertigo, the situations we treat and practical advice for preparing your appointment.\n\n## Who is it for?\n\nVestibular rehabilitation is for people who experience **vertigo** (an illusion of movement, often rotational, comparable to the sensation after a merry-go-round ride) or **instability** (a lack of balance without rotation). These symptoms are frequently accompanied by nausea, vomiting, sensitivity to light or significant fatigue.\n\nIt can support **benign paroxysmal positional vertigo (BPPV)**, **vestibular neuritis**, **Ménière's disease** or any disorder of the inner ear, but also balance and gait disorders related to age. It concerns the young person who has repeated brief attacks as much as the older person who has repeated falls. Care is always provided in coordination with the ENT specialist or GP, who makes the medical diagnosis; it does not replace this follow-up.\n\n## Where does vertigo come from?\n\nBalance relies on three sources of information that the brain constantly integrates: the inner ear (the vestibular system), vision and proprioception (the perception of the body's position). When the inner ear malfunctions, this information no longer matches: this is vertigo, a signal of movement that the eyes and body do not confirm.\n\nThe good news is that the central nervous system is able to reorganise itself: it is on this **plasticity** that much of rehabilitation is based. By training the brain to make better use of vision and proprioception, we help it compensate for a faulty inner ear and regain stable balance.\n\n## The assessment: the key to the right treatment\n\nEverything begins with a precise assessment, because each condition calls for a different treatment. The practice is equipped with [videonystagmography (VNG)](/bascharage/equipement/vng), which films the micro-movements of the eyes — nystagmus — to measure the asymmetry between the two inner ears, including in darkness. A rotary chair completes the exploration of vertigo and instability.\n\nThe physiotherapist also observes standing balance, gait and the head movements that trigger symptoms. Targeted positional tests identify a BPPV and the canal involved. This assessment is used to make the right functional diagnosis, to guide care and to identify signs that require medical advice before continuing.\n\n## Goals of rehabilitation\n\n- **Make positional vertigo disappear** using repositioning manoeuvres when a BPPV is identified.\n- **Train central compensation** so that the brain relies on vision and proprioception after an inner ear disorder.\n- **Reduce instability and fear of movement** by gradually re-accustoming the head and gaze to movement.\n- **Lower the risk of falling**, particularly in older people, by working on balance and gait.\n- **Regain independence and confidence** in daily activities, with exercises to continue at home.\n\nThe aim is not to do as many exercises as possible, but to choose useful stimulations, dose them and progress without triggering unnecessary attacks.\n\n## What happens during a session?\n\nExercises are selected after the assessment and reassessed at each session. Depending on the disorder identified, care may combine:\n\n- **repositioning manoeuvres** (repositioning the crystals) in case of BPPV;\n- **oculomotor** exercises: following a target with your eyes, fixing a point while moving your head;\n- **habituation** exercises: reproducing, in a controlled way, the movements that provoke vertigo so that the brain adapts to them;\n- **balance and posture** work, with eyes open then closed, on a stable then unstable surface;\n- **gait rehabilitation** and changes of direction;\n- advice and exercises to repeat at home to consolidate progress.\n\nBrief, transient vertigo may appear during certain exercises: it is temporary and often a sign that we are working in the right place. Intensity and breaks are adapted to your tolerance and how you feel that day.\n\n## BPPV: when one manoeuvre is enough\n\nBPPV is one of the most frequent causes of vertigo: intense but brief attacks, triggered by a change in head position (lying down, turning over in bed, looking up). It is due to small crystals displaced within a canal of the inner ear. A well-performed **repositioning manoeuvre** repositions these crystals and is often enough to make the vertigo disappear in one to a few sessions.\n\nConversely, these manoeuvres should never be repeated indefinitely: beyond two or three attempts without result, the diagnosis must be re-examined. This is precisely the value of an instrumented assessment, which distinguishes a BPPV from another disorder and avoids multiplying useless movements.\n\n## Neuritis, Ménière's and chronic instability\n\nAfter **vestibular neuritis** (sudden rotational vertigo, without hearing disturbance), rehabilitation relies on **compensation** to regain stable balance, through oculomotor, posture and habituation exercises. In **Ménière's disease** (attacks of vertigo, tinnitus and hearing loss), it complements ENT follow-up by working on balance between attacks and reducing apprehension of movement.\n\nIn older people, chronic instability and fear of falling respond well to a progressive balance and gait programme, which clearly reduces the risk of falling. A programme spans on average a few weeks, but the exact duration depends on the cause and your recovery.\n\n## Persistent postural-perceptual dizziness (PPPD): when unsteadiness lasts\n\nSometimes, after BPPV, vestibular neuritis or another vestibular episode, a sense of unsteadiness **persists for more than three months** even though the inner ear has already stabilised. This is called **persistent postural-perceptual dizziness (PPPD)**: floating or drunken-like sensations, often worse when standing, moving, or in visually busy environments (supermarket aisles, screens, traffic).\n\nIt is not “all in your head” in a dismissive sense, nor a permanent ear injury. The balance system stays over-vigilant. **Personalised** vestibular rehabilitation — graded exposure to movement and visual stimuli, progressive balance work — clearly reduces dizziness-related handicap in recent evidence (2025 meta-analyses using the *Dizziness Handicap Inventory*). The programme is built with you at a tolerable pace: too much intensity at once can slow progress rather than speed it up.\n\nAssessment also separates cervical dizziness from a true vestibular disorder: [VNG](/bascharage/equipement/vng) and positional tests help avoid mixing them up. When needed, your physiotherapist refers you to an ENT specialist or your doctor.\n\n## When to seek emergency care?\n\nCertain signs must alert you and prompt an immediate call to **112**: vertigo accompanied by sudden speech disturbance, weakness or numbness on one side of the body, facial drooping, double vision, a very intense and unusual headache, sudden difficulty walking or loss of consciousness. These symptoms may signal a neurological emergency and not a simple inner ear disorder.\n\nLikewise, sudden hearing loss or vertigo occurring after a head injury requires prompt medical advice. Vestibular rehabilitation does not replace urgent medical evaluation.\n\n## Your specialists at the practice\n\nAt the practice, vestibular rehabilitation is provided by three physiotherapists trained in this field: **[Nathan Klopp](/bascharage/kinesitherapeute/nathan-klopp)**, **[Amandine Lotti](/bascharage/kinesitherapeute/amandine-lotti)** and **[Julien Kune](/bascharage/kinesitherapeute/julien-kune)**. You will be directed to them for this type of care.\n\n## Frequently asked questions\n\nWhat is PPPD and can rehabilitation help me?
\n\nPPPD is non-spinning dizziness or unsteadiness lasting at least three months, often after a vestibular episode. Adapted, progressive vestibular rehabilitation is among the non-drug approaches used; gains are measured mainly on daily handicap (balance, activities, fear), not on a one-session “cure”.\nDo I need a prescription?
\n\nYes, vestibular rehabilitation is carried out on medical prescription to be reimbursed, and the practice handles the administrative steps for you. The full process — prescription, reimbursement and steps — is explained on the [The physiotherapy consultation](/bascharage/kinesitherapie/consultation-kine) page.\nHow long does it take for vertigo to disappear?
\n\nThat depends on the cause. A BPPV often resolves after one or a few manoeuvres. Neuritis or chronic instability requires a programme of a few weeks. The initial assessment makes it possible to estimate the pathway from the first consultation, without promising an identical timeframe for everyone.\nAre the manoeuvres and exercises unpleasant?
\n\nThey may trigger brief, transient vertigo, the time to reposition the crystals or accustom the brain to movement. It is temporary and often a sign that we are acting in the right place. Everything is explained and carried out at your own pace, with breaks adapted to your tolerance.\nWhat is videonystagmography (VNG) for?
\n\n[VNG](/bascharage/equipement/vng) films the micro-movements of the eyes to reveal an imbalance between the two inner ears, even in the dark. Painless, it guides the diagnosis and makes it possible to adapt rehabilitation precisely to your situation.\nShould I do exercises at home?
\n\nYes, when the physiotherapist has shown and adapted them for you. Habituation, oculomotor and balance exercises at home complement the sessions and speed up compensation. They do not replace follow-up or the precautions specific to your situation.\nIs vestibular rehabilitation effective in older people?
\n\nYes. A progressive programme of balance, gait and habituation clearly reduces instability and the risk of falling. Exercises are dosed according to fatigue, treatments and any other conditions, in coordination with the GP if necessary.\nHow do I book an appointment?
\n\nYou can [book online](https://fr.doctena.lu/cabinet/Pole_Equilibre_Sante-281318) or call the Bascharage practice on [+352 26 65 28 42](tel:+35226652842). If you are unsure about the urgency of your symptoms, call 112 rather than waiting for an appointment.\n