Clinically proven therapies
The Science of StabilitY
Vestibular Rehabilitation Using Dynamic Posturography
Eytan A. David, MD, FRCSC and Navid Shahnaz, PhD
Therapies
Fall
Prevention
Falls can pose a significant risk for those with vestibular disorders or balance impairments due to vertigo, concussion, age-related changes, and more.
StabilityLAB CVRT treatment has been shown to decrease fall risk factors, and improve balance and stability. CVRT treatments can enhance coordination, decreasing the risk of injury at any age.
The transformative potential of CVRT is a proactive strategy in safeguarding against falls and promoting safety, independence, and well-being for individuals of all ages.
Falls represent a significant risk, particularly for older adults and individuals with vestibular disorders or balance impairments.
CVRT is an innovative approach used to address these challenges, consisting of targeted exercises and techniques that can strengthen the vestibular system, improve balance and stability, and ultimately reduce the risk of falls.
With the advanced technology used by StabilityLAB, individuals can seek a non-invasive and effective solution for their balance issues.
What Causes Falling?
Falling can be caused by various factors, including:
- Vertigo is a sensation of spinning or dizziness that can result from various causes, including inner ear disorders, vestibular migraines, or benign paroxysmal positional vertigo (BPPV). When individuals experience vertigo, they may feel unsteady on their feet or have difficulty maintaining balance, increasing the likelihood of falls.
- Concussions, which are a type of traumatic brain injury, can disrupt normal brain function, leading to symptoms such as dizziness, imbalance, and cognitive impairment. These symptoms can interfere with coordination and spatial awareness, making individuals more prone to falls, particularly in situations that require rapid movements or changes in direction.
- Physical Factors incuding muscle weakness, impaired balance, vision problems, or gait abnormalities that can affect stability and coordination.
- Certain medical conditions such as Parkinson’s disease, stroke, arthritis, or neurological disorders can impact balance and mobility, increasing the likelihood of falls.
- As people age, they may experience declines in muscle strength, flexibility, and reaction time, making them more susceptible to falls.
- Vertigo is a sensation of spinning or dizziness that can result from various causes, including inner ear disorders, vestibular migraines, or benign paroxysmal positional vertigo (BPPV). When individuals experience vertigo, they may feel unsteady on their feet or have difficulty maintaining balance, increasing the likelihood of falls.
“Individual with persistent unilateral vestibular deficits experience a loss of quality of life and increased risk of falling. In a recent study, patients reported increased confidence, decreased disability, and reduced perceived fall risk after 12 sessions of CVRT.
David & Shahnaz, 2022
View all Publications
Dynamic posturography after computerized vestibular retraining for stable unilateral vestibular deficits
Eytan A. David, MD, FRCSC
and Navid Shahnaz, PhD
ALSO PUBLISHED IN
What is CVRT?
Vestibular rehabilitation is a form of physical therapy used to treat vestibular disorders or symptoms. Exercises are designed to reduce or eliminate issues affecting overall stability and daily function.
One newer approach to vestibular rehabilitation is computerized dynamic posturography–assisted vestibular retraining, or “computerized vestibular retraining therapy” (CVRT) for short. This is a non-invasive technique that uses interactive technology to support balance retraining.
The technology measures how your sensory systems are helping you stay upright in different conditions. Training exercises become more challenging as you move through treatment to improve your overall stability.
Who is a Candidate
for Fall Prevention
with CVRT?
Vertigo, or continuous vertigo resulting from a concussion. Ongoing reports of imbalance, sensitivity to motion, or dizziness persist despite interventions aimed at vestibular rehabilitation.
The target population for the CVRT protocol is anyone with:
Reduced Fall Risk Factors
CVRT addresses underlying factors contributing to
fall risk, such as vestibular dysfunction or impaired gait helping individuals mitigate these risk factors and prevent falls.
Improved Balance and
Stability
CVRT exercises target the vestibular system, enhancing balance, and stability, which are essential for preventing falls, particularly in older adults or individuals with vestibular disorders.
Enhanced Coordination
CVRT helps improve coordination and proprioception, allowing individuals to react more effectively to changes in their environment and maintain postural control, reducing the risk of falls.
Avoid Frailty. Be able to fall and brush it off. Train for stability as well as strength.
To avoid injury, Stability is the key ingredient.
Stability is how efficiently and safely forces can be transmitted through our bodies.
To avoid injury, Stability is the key ingredient.
The Diagnostic Battery for Concussion Treatment
Objective tests of balance function will determine the type of therapy required
Based on the pattern of intake test results, a comprehensive and personalized multi-modal computerized vestibular retraining treatment plan (the DaVID Concussion Protocol) is delivered over twelve 40 minute sessions.
Bone Conduction Vestibular Stimulation (BCVS) is used as a noninvasive method to stimulate the vestibular system. Concussion treatment and pre/post treatment objective stability metrics are provided for all products.
oVEMP (Ocular vestibular evoked myogenic potential)
Objective measurement of inner ear gravity sensor function
COG (Center of gravity measurement)
Objective measurement of stability
Hearing Test With Middle Ear Pressure And Reflex Testing
Hearing test with middle ear pressure testing
LOS (Limits of stability measurement
Objective assessment of limits of stability before falling
SOT (Sensory organization test)
Computerized Dynamic Posturography, an objective measure of global balance function
SR (Sensory ratio)
Analysis of CDP responses which can determine relative weighting of vision, joint position sense (somatosensory), and inner ear contributions to overall stability
How does a fall prevention work?
CVRT has been clinically proven to reduce disability in 85% of all dizzy patients. Greater than 90% of moderate to severely imbalanced patients experienced improvement by 3-5x the clinically meaningful margin.
Initial Assessment and
First Training Session
90 Minutes
Intake and consent forms
Three questionnaires to evaluate:
- The impact of dizziness on your daily life
- Your confidence in your balance
- Your concerns about falling
Two tests to measure:
- Your balance
- Your risk of falls and your center of
gravity
Your first training session
Training Sessions
40 minutes each
These sessions are typically scheduled twice a week and involve the following
- A technician will lead you through training exercises that progress in difficulty over the course of 12 sessions total.
- During training, you will use a machine with a safety harness, interactive surround display, and moveable platform. You will need to shift your weight forward, backward, right, and left in response to visual targets on the screen. The moveable platform you are standing on will respond to and track your movements.
- The exercises you do at each session will vary, and the visual targets on screen will become more challenging.
Final Assessment and Last Training Session
90 Minutes
In your final visit you will complete your last training session and complete a final consultation with our doctor that includes:
- A review of findings from your treatment
- Completion of the same tests and questionnaires from the first session
Risks and Complications For Vertigo Treatment
While CVRT is generally considered safe and effective, there are some potential risks associated with this therapy.
Fatigue
Performing repetitive exercises during CVRT sessions may lead to fatigue, particularly in individuals who have limited stamina or other health conditions.
Nausea or Motion Sickness
The nature of CVRT exercises, which involve visual and/or vestibular stimulation, can trigger symptoms of nausea or motion sickness in some individuals, which are typically mild and transient.
Frequently asked questions
Risk factors for falling include advanced age, muscle weakness, balance problems, vision impairment, certain medications, environmental hazards, chronic health conditions, and cognitive impairment.
CVRT exercises target specific vestibular and balance impairments, improving coordination, proprioception, and postural control. By addressing these factors, CVRT helps individuals enhance their balance and stability, reducing the risk of falls.
Yes, CVRT can be integrated into a comprehensive fall prevention program that may include other interventions such as strength training, flexibility exercises, environmental modifications, and education on fall prevention strategies.
No, CVRT can be beneficial for individuals of all ages, from children to older adults, who may benefit from vestibular rehabilitation for fall prevention and balance enhancement.
If you have fallen or have concerns about falling, it is essential to discuss them with your doctor. They can assess your fall risk, recommend appropriate interventions, and help you develop a personalized fall prevention plan.
