Dizziness is a common complaint in the elderly people and presents the doctor with a difficult dilemma. The evaluation of the dizzy people may sometimes present an interesting diagnostic exercise but at other times may create enough frustration to cause dizziness in the physician and the physiotherapist. This article discusses current ideas about physiotherapy for dizziness and imbalance, also called "vestibular rehabilitation", or more generally, "balance rehabilitation". While there is some data regarding the efficacy of vestibular rehabilitation (e.g. Cowand et al, 1998), much remains to be done.
The vestibular system is sensitive to two types of information: the position of the head in space and sudden changes in the direction of movement of the head. Although we aren’t consciously aware of vestibular sensation, as we are of the other senses, vestibular inputs are important for the coordination of many motor responses and help to stabilize the eyes and to maintain postural stability during stance and walking. Dysfunction of the vestibular system gives rise to sensations such as dizziness or unsteadiness as well as problems with focusing our eyes and in keeping our balance.
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