Vestibular Rehabilitation

What is vestibular rehab?

The vestibular system is comprised of our inner ear, brain, and postural stability muscles. Each of those systems work together to tell us where we are in space and allow us to see clearly when moving. When they are not communicating well with each other, we can experience dizziness. Unfortunately, medications will only make this worse. Specially trained physical therapists are one of the only ones who can help improve these systems to get you moving better! Your treatments will consist of exercises for gait and balance, motion habituation, clear vision with head movements, repositioning maneuvers, and education about your diagnosis and how to remain safe in the future.


Dizziness is the most common complaint for people over the age of 70, and can be complex to diagnose. There are many causes of dizziness that your physician can screen for to rule out anything serious. But beyond that, vestibular physical therapists are more specially trained to diagnose those conditions and help treat them, as well as any secondary problems that arise because of them (decreased activity levels and endurance, weakness, general mobility difficulties, fear of falling). Another big concern with dizziness is that it puts you at an increased fall risk. Falls are the leading cause of death in people over the age of 65. Physical therapy can help reduce this risk and keep you safe.

Common conditions that can cause dizziness:

  • Concussion or other head trauma/brain injury
  • BPPV (vertigo)
  • Stroke
  • Migraines
  • Multiple Sclerosis
  • Neck pain
  • Cardiovascular issues
  • Medications

Other vestibular disorders

  • Vestibular Neuritis and Labyrinthits
  • Superior Canal Dehiscence
  • Perilymphatic Fistula
  • Acoustic Neuroma or Vestibular Schwanoma
  • Chiari Malformation and cerebellar degeneration
  • Persistent Postural Perceptual Dizziness


The most common vestibular disorder is benign positional paroxysmal vertigo (BPPV) which makes you feel as if the room is spinning for a short period when you move your head. It may produce nausea and vomiting, and make you feel off balance thereafter. This is caused by crystals in the inner ear that break loose and float in your ear canal making you feel as if you are moving when you are not. Half of the population of aging adults will get BPPV at some point in their lifetime. It is very easy to treat with a few simple repositioning maneuvers and typically only takes 1-3 sessions to fix. Additionally, those who have sustained a concussion can also experience symptoms of dizziness both from BPPV and other trauma to the system that can be treated with vestibular therapy.


Concussions are mild traumatic brain injuries and should be taken seriously. If not treated properly right away, they can lead to long term adverse effects that will impact performance at work or school. If another concussion is sustained before the initial one has healed, it can even lead to death. Concussions are caused when the connective tissue in the brain is overstretched and the brain makes contact with the skull. This triggers a complex chemical cascade that can lead to a variety of symptoms such as: fatigue, headache, dizziness, sleep changes, difficulty thinking, memory deficits, nausea, imbalance, and personality changes. These symptoms can occur immediately or days after the event. Physical therapists can develop a specialized treatment plan while monitoring your symptoms and safely progressing your activities to get you back to functioning normally.

Allison Kleiner, PT

Allison Kleiner, PT, DPT graduated from Marshall University in 2008 with a bachelors degree in psychology and from the University of Pittsburgh’s doctoral physical therapy program in 2011. She then worked as a traveling physical therapist all over the country for 6 years prior to joining the staff at APTS in 2017. She was certified by the American Institute of Balance in 2018 to treat vestibular disorders and post concussive patients. At your visit, she will obtain a thorough history and perform a physical assessment to determine your diagnosis before creating an individualized treatment plan to get you moving better!