Dizziness and Motion Sensitivity

Motion Sensitivity Testing in a Vestibular Rehabilitation Assessment

Finding the movements that make you dizzy helps vestibular rehab professionals to tailor your exercise program

How Do We Measure Dizziness?

Dizziness is very subjective, making it difficult to measure.   In an attempt to quantify it and to be able to record improvement over time, one of the things often done in a Vestibular Rehabilitation assessment is called Motion Sensitivity Testing.  This involves a series of movements or position changes, where a person rates their dizziness after the movement on a 0-5 scale, and we compare that to the person’s baseline rating prior to the movement.  We also measure the length of time it takes to return to baseline after each movement.  These numbers can be calculated into a final Motion Sensitivity Quotient, and tracked over time. The movements are just one at a time, with a rest after each one to allow your symptoms to settle back down, so most people tolerate the testing well.  If too provoking, we would just modify the test or wait until later for testing when your dizziness is not so strong.

Finding the movements that make you mildly or moderately dizzy helps us to tailor a vestibular rehabilitation exercise program to your individual needs, as the brain needs to be exposed to these types of movements in order to be able to compensate for a vestibular imbalance.  With controlled exposure to the movements that make you dizzy, the brain can begin to habituate so that the movement becomes less and less bothersome.  Reduction in the intensity and/or duration of your motion-provoked symptoms is a good indicator that your vestibular rehabilitation exercises are helping you improve.

Should You Avoid the Motions That Make You Dizzy?

Research shows that avoiding exposure to the movements that trigger the error signals and make you dizzy actually delays recovery. The brain needs to see these mismatched signals in order to come up with strategies to adapt and compensate.  The mismatched vestibular signals may still be there, but in most cases the brain can make adjustments so that you don’t feel the symptoms anymore through a process called Habituation.

Feel free to contact us – we are here to help you!

Does Vestibular Rehab Help Ringing in the Ears?

What Causes Ringing in the Ears?

Ringing in the ears is referred to as "tinnitus" and is usually assessed by an ENT doctor and an audiologist

Ringing or buzzing in the ears is referred to as “tinnitus” and is usually assessed by an Ear, Nose, Throat doctor and an Audiologist.  Tinnitus is typically a symptom of a related problem with hearing nerves, different parts of the ear, or the part of the brain that interprets information.  According to the Tinnitus Association of Canada, “150,000 Canadians experience a degree of tinnitus that significantly affects their quality of life”.

The Canadian Academy of Audiology reports that the exact mechanism underlying tinnitus is not known, but that some of the causes can include:

• Outer ear disorders such as excessive ear wax, a hair touching the eardrum or a perforated eardrum
• Middle ear disorders such as an ear infection
• Inner ear disorders like damage due to noise exposure, hearing loss related to aging, or Meniere's Disease

How Does Vestibular Rehabilitation Differ from Tinnitus Treatment?

It is important to understand that Vestibular Rehabilitation DOES NOT address tinnitus.  If you have dizziness, unsteadiness and sensitivity to motion in addition to your hearing-related issues, then Vestibular Rehabilitation can be helpful with those symptoms, but you should not expect your tinnitus to change.  

Having said that, research is finding that some peoples’ tinnitus has an element of mechanical contribution to it that can come from the jaw-joint (TMJ) or neck.  If you seem to be able to alter your tinnitus with certain head, neck or jaw movements, posture, or trigger points, then it’s possible that therapy focused on these areas may help reduce tinnitus.  This is referred to as ‘somatically related tinnitus’ and research is showing positive outcomes with treatments such as TENS, therapeutic exercise, manual therapy, biofeedback/stress reduction and education. 

Contact us to find a vestibular specialist near you.

What to Expect During Vestibular Assessment and Treatment

Dizziness or Balance Disorders Can Be Caused By a Number of Different Conditions

At LifeMark we give clients different tests to narrow down what may be contributing to their dizziness

There are many, many different conditions that can contribute to dizziness or balance disorders. To help narrow down a clinical diagnosis, at LifeMark we give clients a number of different tests and evaluations. One of the first steps of the assessment process is the Dizziness Inventory that we ask clients to download from the website and fill in before your first appointment. This questionnaire allows us to identify difficulties that you may be experiencing because of your dizziness or unsteadiness, and gives us some valuable clues about what conditions you might be dealing with.

Vestibular Assessment Includes Infrared Video-Analysis of Eye Movements

LifeMark's vestibular assessment is extensive and includes infrared video-analysis of eye movements, which provides information about the inner ear and its connections in the brain. Many of these eye movement clues cannot be detected in room light. Treatment can involve a combination of stationary and moving balance retraining, gaze stabilization to help you focus during head movement, training for motion sensitivity, and canalith resposition manoeuvres for BPPV; the results are often dramatic.

The balance retraining component is also effective for clients who don't necessarily have a vestibular problem, but have muscle and joint problems, brain-related disorders, sensation problems, or vision changes affecting their equilibrium. LifeMark is actively involved in collecting outcome measures to make sure what we do is making people better, and is committed to utilizing the most current, evidence-based tests and techniques in its training and treatment programs.

Vestibular Assessment Also Includes Motion Sensitivity Testing, Static and Dynamic Balance Testing and TMJ Testing

As part of your vestibular assessment we go through many of these tests, as determined by the nature of your symptoms:

• We take a thorough history
• We take your blood pressure both when standing up and lying down
• We perform motion sensitivity testing, scoring both the intensity and duration
• We perform static and dynamic balance tests, to compare to normative and fall risk data
• We test for TMJ (temporomandibular joint disorder) and cervical spine mobility
• We screen for any serious problems with the following:

1. Cranial nerve scan
2. Vertebral artery scan
3. Carotid pulse
4. Carebellar tests
5. Scans for upper motor neuron lesions
6. Ligamentous stability of the upper cervical spine

What is Vestibular Rehabilitation?

Vestibular Rehabilitation is a proven, research-based branch of physiotherapy where specific individualized techniques are used to maximize the brain's compensation for vestibular pathology, or where manoeuvres are done to correct mechanical dysfunctions in the vestibular apparatus.

What Can Cause the Problems?

Vestibular disorders can come from pathologies in any area of this complex system. They can be insidious ("out of the blue") or due to factors such as trauma (motor vehicle accidents, falls, contact sports, blows to the head), infections, aging, medications, brain-related problems, or secondary to other diseases or injuries. Symptoms can include dizziness, imbalance, blurry vision, motion sensitivity, nausea, poor concentration, muscle guarding/restriction of movement, decreased activity levels or social interaction, anxiety and depression.