Vestibular rehabilitation therapy is a structured exercise programme that retrains the balance system after inner-ear or central vestibular problems. It uses controlled, repeated exposure to movements that provoke symptoms so the brain gradually recalibrates. It is delivered by trained physical or vestibular therapists, and it is not the treatment for BPPV, which responds to a repositioning manoeuvre instead.
Vestibular rehabilitation therapy is a structured exercise programme that retrains the balance system after inner-ear or central vestibular problems. It uses controlled, repeated exposure to movements that provoke symptoms so the brain gradually recalibrates. It is delivered by trained physical or vestibular therapists, and it is not the treatment for BPPV, which responds to a repositioning manoeuvre instead.
The principle is compensation. When the balance system is damaged, the brain can learn to rely differently on vision, on sensation from the feet and legs, and on the remaining vestibular input. That learning requires controlled exposure to the movements that provoke symptoms, which is the opposite of what instinct suggests. Avoiding movement feels better in the short term and reliably delays recovery, because the brain gets no signal to adapt to.
Programmes are individualised but generally include gaze stabilisation, where you keep your eyes fixed on a target while turning your head; habituation exercises, repeating specific provoking movements until the response diminishes; balance and gait retraining on varied surfaces and with reduced visual input; and general conditioning. Sessions are supplemented by a home programme, and the home component is where most of the benefit comes from, so consistency matters more than intensity.
It is most useful for unilateral vestibular loss, such as after vestibular neuritis, for persistent unsteadiness after a vestibular insult, and for balance problems in older adults. It is not the treatment for BPPV, which responds to a repositioning manoeuvre instead, and giving general exercises when a repositioning manoeuvre would resolve it in one session is a common misstep. The therapy itself is delivered by trained physical or vestibular therapists; neurology establishes the diagnosis, and VNG balance testing is performed at both offices.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: MedlinePlus: dizziness and vertigo; National Institute of Neurological Disorders and Stroke; MedlinePlus, National Library of Medicine.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.