Vestibular Rehabilitation

Vestibular Testing

Your Vestibulo-Ocular reflex (VOR) stabilizes your environment to prevent nystagmus, saccadic intrusions, square wave jerk, blurriness and more.

A comprehensive Videonystagmography (VNG) is performed on each patient to determine the specific nature of the vestibular dysfunction and then an individualized treatment plan can be developed.

The basis of a vestibular rehab program is to use the already existing neural pathway mechanisms for adaptation, plasticity, and compensation in the human brain. 

Vestibular exercises will be based on your VNG, Computerized Balance testing, neuro and vestibular exam.


VNG is a test of the inner ear and portions of the brain. Are you performing vestibular exercise and have not even had a vestibular test?


Vestibular Rehabilitation and Treatment

Individuals that are suffering from a vestibular disorder will most likely complain of some type of symptom related to vertigo, dizziness, migraines, blurry vision, light sensitivity-photophobia, eye fatigue, sound sensitivity, double vision, reading difficulties, etc. This is not a problem with vision but the areas of the brain that control the stability and integration of the  vestibulo-ocular reflex (VOR).

There are numerous types and causes of vestibular based problems; if left untreated, many vestibular patients can suffer devastating and debilitating consequences.

IF you have BPPV (Canal or Cupula) you can expect 2 at the most treatments.  Its called positional for a reason….. you can specify the exact position.

If you do not have the VNG binocular goggles to observe the nystagmus, you can not see when and if the crystals are cleared and they may end up in the cupula instead of the canal


 VNG will help understand the cause of dizziness and balance problems.  Vestibular is NOT about shaking your head……. it “stabilizes” your targets and inhibits the surround ‘as’ you have a head movement.

We rehabilitate a wide range of conditions that can result in vertigo, dizziness and imbalance—including, but not limited to:

  • Peripheral Vestibulopathy eg. BPPV
  • Central Vestibulopathy
  • Suboccipital Migraine
  • Cervicogenic Dizziness/Vertigo
  • Cerebellar Ataxia
  • Dysautonomia eg. POTS
  • Acoustic neuroma, Brainstem tumor, Cerebellar Tumor
  • Traumatic brain injury (TBI), Post-concussion syndrome
  • Post Stroke
  • Movement Disorders – Parkinson, Essential tremor, Tardive Dyskinesia, Dystonia

Rebuilding Sidney Crosby’s brain


Patient with Post Concussion is receiving Vagus nerve stimulation that is being paired with optokinetic stimulation and balance training.

Patient is fixating on a smooth moving vertical pursuit while getting VNG testing.

Patient being assessed on the VNG to determine the nature of their vestibular dysfunction.