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New Program Helps Patients
with Chronic Dizziness
Headed by Therapist Who Once Had Dizzy Spells
Five years ago, Linda Vetere, P.T., a New York physical therapist, was suffering from disabling dizziness and imbalance. She was diagnosed by Christopher Linstrom, M.D., the director of Otology and Neurotology at The New York Eye and Ear Infirmary, as having vestibular neuritis, an inflammation of the inner ear, and entered a special rehabilitation program. After two months of therapy, her symptoms were reduced dramatically. Linda Vetere was so impressed with her therapy that she now coordinates a new, four-year old Vestibular Rehabilitation Program at The New York Eye and Ear Infirmary. She teaches the same types of exercise therapy that helped her to decrease the symptoms of chronic dizziness, imbalance and nausea to the patients in her program. Approximately one in three American will in their lifetime experience or seek treatment for dizziness, so there is a growing need for such programs, which emphasize a home-based exercise program to return patients to normal physical functioning.
Patients Need Physician Referral
"All patients who enter the exercise program, which is part of The New York Eye and Ear Infirmary's Center for Communicative Sciences, must first be diagnosed as having a vestibular problem and be referred by a physician," said Ms. Vetere. "They are then evaluated and put on an individually tailored program of exercise to address their specific disabilities for a period of two to eight months. The goal of this therapy is to improve their safety levels, achieve normal physical function, and experience significantly decreased symptoms." Vestibular Rehabilitation "The vestibular system is part of inner ear and the brain that helps to control balance and eye movements," said Dr. Linstrom, M.D. "When these structures become damaged by disease or injury, vestibular disorders may result." Gaze Stabilization Many patients with vestibular dysfunction suffer with symptoms of dizziness, imbalance, nausea, and an inability to concentrate. Gaze stabilization exercises are taught to help decrease or eliminate these symptoms. These exercises help patients retrain a faulty reflex that is sending incorrect information from the inner ear to the brain and to the eye muscles. Training involves having patients fixate their eyes on a specified object (such as a one inch letter on a checkerboard) and turn their heads in several directions until, over time, patients are able to fixate their gaze at a normal speed. "This repetition of movements allows for compensation of the faulty reflex to occur," said Vetere.
Balance Retraining Patients in The New York Eye and Ear Infirmary's Vestibular Rehabilitation Program are taught exercises to retrain their ability to stand and walk without losing balance. Static, or standing, balance retraining consists of doing exercises standing in a heel-to-toe position or standing on one leg for 60 seconds, with eyes open and closed. Over time, the surface on which the patient is standing is altered from rigid and firm (floor surface) to pliant (foam) to flexible (trampoline). Dynamic balance retraining involves walking with varied head and body turns, turning in a circle and walking backwards without becoming dizzy. Motion Sensitivity Patients who experience "positional imbalance" become dizzy from such movements as turning over in bed, bending or lying on one side. They are given repetitive exercises that habituate them to their symptoms and, gradually, these symptoms disappear.
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