When the vestibular / inner ear organs are damaged with disease or injury, the brain can no longer rely on them for accurate information about equilibrium and motion, often resulting in dizziness, vertigo, balance problems, and other symptoms. Many people are able to recover from these symptoms on their own after a few weeks of normal activity because the brain has adapted with a process called vestibular compensation.
However, if the vestibular compensation process is not successful, a person’s ability to maintain posture and coordinate balance may become overly dependent on input from the eyes (vision) and muscles and joints (proprioception). In addition, the person may develop new patterns of head and body movement in an attempt to avoid dizziness and nausea.
For example, a person with a vestibular disorder might adopt an exaggerated hip sway as a method of balancing, swivel the entire body rather than just the head when turning to look at something, or always look down at the floor to avoid what appears to be a confusing swirl of activity. Unfortunately, these strategies can make vestibular compensation even more difficult, worsening symptoms and often causing headache, muscle tension, and fatigue.
The task demands relate to the body’s ability to cope under different situations e.g the unexpected, such as slipping on a rug, or moving beyond one’s point of control such as reaching or stepping out too far.
Environmental factors may include community demands e.g the terrain, opening doors, covering a distance or moving at speed.
Balance senses therefore have to be specifically targeted when designing balance re-training programmes, which may necessitate accessing specialists other than neuro-physiotherapists to ensure all the senses are addressed effectively e.g Audiovestibular Physician, Behavioural Optometrist.