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Vestibular physiotherapy
Videos, webinars, and other references on vestibular physiotherapy.
Videos are shared for reference purposes only. Each patient with ataxia has specific needs and should consult a physiotherapist to determine which activities are appropriate for their case. Some exercises require supervision by a qualified professional to ensure safe execution.
Figure 1 - AI-generated image with ChatGPT
Dizziness and vertigo in ataxias
Dizziness and vertigo may be associated symptoms to some types of ataxias . Although ataxias often cause motor imbalances and instability, dizziness and vertigo are not mandatory symptoms.
Dizziness
Many patients with ataxia experience dizziness when moving (turning) their head. Eye movements (looking sideways, or up and down) and head movements, or when changing positions (lying to sitting, sitting to standing, changing direction when walking, etc.) can indeed cause dizziness. This may result from problems in the "central vestibular nucleus" (or central vestibular system), which is linked to the cerebellum. The cerebellum interacts directly with this central vestibular system to maintain balance and motor coordination.
This is a neurological dizziness , which is distinct from dizziness problems related to the inner ear (vestibular system), and can manifest even without any eye or head movement. This condition can be difficult to stabilize and treat and can be more disabling in terms of maintaining balance than the "traditional" imbalance caused by ataxia itself.
Figure 2 - AI-generated image with ChatGPT
Vertigo
Some patients with ataxia experience vertigo, which is different from dizziness. Dizziness is a sensation similar to being in a boat, while vertigo is a sensation that the environment is spinning.
Vertigo is generally associated with the peripheral vestibular system (inner ear), such as benign paroxysmal positional vertigo (BPPV), which can be confused with symptoms of ataxia. Dizziness (associated with ataxia) is more commonly central (involving the cerebellum or central pathways of the vestibular system), as mentioned previously.
It is important to keep in mind that there are several other causes of dizziness and vertigo that have nothing to do with ataxia (for example, circulatory problems, changes in blood pressure (hypotension), side effects of medications, oculomotor problems, etc.), so if these symptoms arise, it is important to investigate the possible causes with your doctor, to see what the best approach for treatment is.
Depending on the cause (and that's why it's important to understand the cause ), there are medications that can help.
For example:
• If the dizziness comes from the brain's connection to the inner ear, in some cases there are medications that can help (e.g. Meclizine, Bonine, etc.).
• In dizziness associated with ataxia, there are cases where Dalfampridine (a drug approved by the FDA for Multiple Sclerosis, but which is used off-label for other conditions (including ataxias), and in certain cases may help with dizziness) has been prescribed.
• If dizziness is caused by abnormal eye movements (nystagmus), other medications may be helpful in reducing the abnormal eye movements that can cause dizziness. For example, medications such as gabapentin and baclofen may be indicated in cases of central (non-vestibular) nystagmus, when the eye movement is chronic and disabling.
Remember that all medications can have side effects and must be prescribed by a doctor.
In any case, whether the problems have a peripheral or central cause, patients with vestibular symptoms can resort to specialized physiotherapy for vestibular problems , which is the topic of this page.
Monica Araujo Cardoso - Neurofunctional and Vestibular Physiotherapy
monicaaraujophysiotherapist
Monica Araujo Cardoso
Physiotherapist
Specialist at Albert Einstein Hospital in 😵💫Dizziness/Vertigo/Body Imbalance
Neurofunctional Physiotherapist
📱(47)99645-4808 (Joinville - Santa Catarina)
linktr.ee/monicafisioterapeuta + 1
The videos in this section are shared with the kind permission of physiotherapist Monica Araujo Cardoso, to whom we are grateful. The videos are reproduced from Monica's Instagram profile and feature Live sessions with an emphasis on vestibular physiotherapy to reduce dizziness, vertigo, and the risk of falls for the elderly, patients with ataxia, and other neurological conditions. Permission is also granted to use the images of Monica's guests in each Live session.
About Vestibular Physiotherapy
Vestibular physiotherapy is a specialized area of physical therapy focused on the rehabilitation of disorders of the vestibular system, which includes structures in the inner ear and parts of the brain that help control balance and spatial orientation. This therapy uses specific exercises to reduce symptoms such as dizziness, vertigo, nausea, and balance problems, promoting compensation and adaptation of the vestibular system.
For patients with ataxia, a condition that affects coordination and balance due to neurological damage, vestibular physical therapy is crucial. Ataxia, which can be caused by hereditary conditions, injuries, or acquired illnesses, compromises postural stability, making it difficult for patients to walk, perform daily tasks, or even stand safely. Vestibular physical therapy for these patients includes coordination and muscle strengthening exercises, as well as activities to improve posture, stability, and mobility safety, aiming to reduce the risk of falls.
The benefits of vestibular physiotherapy for patients with ataxia include reduced feelings of imbalance and dizziness, the ability to move more safely, which improves autonomy, and a reduced risk of falls.
These gains are essential to improving quality of life, reducing the impact of ataxia and helping the patient adapt to their limitations in a safer and more comfortable way.
The illustration at the top of the page was generated by ChatGPT . It shows a typical vestibular physiotherapy exercise, in which the physiotherapist guides the patient through balance and postural control exercises. The use of unstable surfaces, such as foam on the floor, is common to stimulate the vestibular system and improve the body's response to imbalance. These exercises often involve head movements and changes of direction, which challenge the vestibular system, and the physiotherapist is nearby to assist and ensure the patient's safety. Other typical exercises may include eye movements, obstacle course training, and activities that challenge proprioception, all aimed at helping the patient adapt and improve balance.
Videos and various references on concepts and exercises in Vestibular Physiotherapy
Content translated with AI support. Please read the Disclaimer .
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