Good balance is essential for daily life, from getting out of bed to crossing the road. A healthy balance system uses information from the brain, inner ears, eyes, and joints, and enables people to see clearly when moving their head. (1) Balance disorders and dizziness are a growing public health concern across all age groups. Prevalence increases with age and these disorders are some of the most common complaints reported to GPs by older patients.(1) Untreated, they result in worsening unsteadiness, loss of confidence and anxiety, difficulty with concentration and memory, inactivity, loss of independence, an increased risk of falls and costly falls-related injuries. (1) (2) What causes dizziness? The most common form of dizziness and balance disorder is BPPV (Benign Paroxysmal Positional Vertigo), a disorder of the inner ear resulting in episodes of intense dizziness on certain head movements. Other causes include side effects from medication or alcohol, brain disorders such as stroke, concussion or cerebellar degeneration, cardiac problems and anxiety.

What is vestibular rehabilitation ?

VR is an exercise-based programme to encourage the central nervous system to compensate for problems in the inner ear. Following thorough examination, specialist physiotherapists develop personalised exercise-based management plans including home exercise programmes. 

● 80 per cent of unexplained fallers attending A&E had possible vestibular loss, 41 per cent had vertigo, with 30-40 per cent admitted to hospital

● Untreated dizziness/balance disorders may lead to anxiety, avoidance strategies and increased risk of falling, impacting further on resources.

It is found that, over a six month period, the introduction of an award-winning Specialist Physiotherapy and Audiology service for patients referred with balance/dizziness disorders, has reduced waiting times and achieved excellent patient satisfaction. 80 per cent of patients are now managed exclusively in physiotherapy led clinics with 52 per cent assessed, diagnosed and treated in one session.


Nova Mullin, Specialist Physiotherapist Balance and Dizziness

@Aintree University Hospital NHS Foundation Trust , Liverpool.