Bases physiopathologiques et pratiques de la rééducation vestibulaire

Abstract

Today vestibular rehabilitation has an important place in managing chronic vertigo and balance disorders. It is based on the principle of completing and/or accelerating the physiological processes of central compensation when, for one reason or another, these processes cannot be put in place to offset a vestibular deficit. From a practical point of view, this compensation uses and reinforces the compensatory strategies that are activated spontaneously, but incompletely, by the patient, i.e., adaptation, substitution, and habituation strategies. These techniques call on physical exercises and/or instrumental techniques that should be adapted to the patient based on the clinical workup and paraclinical instrumental assessment done by a trained specialist, which will identify side involved, the central or peripheral character of the disorder, the current degree of central compensation, and the patient's ability to use various sensory inputs. In addition to the acute vestibular deficits, the best indications are chronic dizziness stemming from unilateral or bilateral peripheral vestibular deficit, or a nonprogressive central but stabilized deficit, with incomplete compensation, whatever the patient's age. Measures should be applied to the disorder as the patient describes it, with the number of sessions specified.