VESTIBULAR REHABILITATION STRATEGIES IN MENIERES-DISEASE

Once the episodic spells of vertigo associated with Meniere's disease have abated, vestibular rehabilitation exercises play an important rol e in promoting adaptation to the decreased vestibular input. Outlines of different treatment approaches for three types of patients with Men iere's disease are presented. The exercise approaches advocated here c onsist of exercises to foster adaptation of the vestibular system in c ases of unilateral loss or hypofunction and exercises to promote the s ubstitution of alternative strategies and to enhance remaining functio n in cases of bilateral vestibular hypofunction. The selection of the appropriate exercises is based on the nature of the vestibular loss, t he patient's symptoms, and the functional capabilities of the patient. Based on an understanding of the vestibular system, the balance syste m, and normal functional capabilities, appropriate rehabilitative exer cises can be designed for this group of patients.