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!

5 Symptoms of Vestibular Disorders

Changes to Parts of the Inner Ear and Brain Controlling Balance Can Cause a Vestibular Disorder

Problems with balance and spatial orientation can include difficulty walking straight or turning a corner

According to the Vestibular Disorders Association if the vestibular system gets damaged or altered, a vestibular disorder can result. The vestibular system includes the parts of the inner ear and brain that control eye movements, perception of head movement and balance. Therefore, problems in any of these areas or pathways can create dizziness, unsteadiness or visual issues.

Besides dizziness or vertigo, five of the most common symptoms of a vestibular disorder are:

1. Imbalance or falling
2. A rocking sensation
3. A sense of exaggerated or "after-motion" when you move
4. Nausea or vomiting
5. Visually provoked dizziness (see below), or blurry/'jumpy' vision during head movement

Problems with balance and spatial orientation can include a tendency to touch or hold onto something when standing, difficulty maintaining straight posture, clumsiness or stumbling, and difficulty walking straight or turning a corner.

With visually provoked dizziness, there can be sensitivity to light or certain types of computer monitors, poor depth perception, trouble reading or watching TV, and discomfort in busy visual environments like crowds, traffic, or stores.

Some people with an inner ear disorder can experience these as well as other symptoms, and an inner ear disorder can even be present without any obvious symptoms at all. It is important to seek professional help and get a vestibular assessment if you are experiencing any of the issues noted above.

Contact us - we are here to help!

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.