Balance Therapy


Balance evaluation, Ear Associates, San Jose, CA
A patient undergoing a balance evaluation
What are Vestibular Disorders and What are their Symptoms?

Vestibular disorders are inner ear disorders that have varying causes and numerous symptoms. Symptoms of vestibular disorders may include one or more of the following:

  • poor balance
  • history or risk of falls
  • persistent vertigo
  • positional vertigo
  • blurred vision
  • motion sensitivity
  • headache, neck stiffness

Vestibular Disorder Diagnostic Tests

Computerized Dynamic Posturography (CDP)

A CDP test is part of the diagnostic assessment of imbalance or dizziness and is used to identify the underlying sensory (vestibular, visual, somatosensory) and motor control impairments. A CDP test is used to identify and differentiate the functional impairments associated with the disorder.

CDP Testing Procedure

During a CDP test, the patient wears a harness and stands in an enclosure that has a moveable support surface and a visual surround display. The patient is exposed to movement of the support surface and the visual surround display, during which the patient's postural stability and motor reactions are recorded. The entire test set takes approximately 45 minutes to complete. The information gathered from this test can be used to determine if a patient may benefit from vestibular rehabilitation.

ENG equipment, Ear Associates, San Jose, CA
ENG equipment


Electronystagmography (ENG)

This battery of tests is used to help assess the function of a patient's vestibular system. The vestibular system, comprising the inner ear and associated nerves, is part of a complex system that helps control eye movement and balance. Measurement of certain types of eye movement can help determine how well the vestibular system is functioning.


ENG Testing Procedure

Computer Dynamic Posturography equipment, Ear Associates, San Jose, CA
Computer Dynamic Posturography equipment

One ENG test includes an evaluation of the movement of the patient's eyes as they follow a moving target. Another portion of the test observes eye movement as the patient's head is positioned in different directions. During the caloric portion of the test, warm or cool air (or water) is briefly directed into the ear canal, stimulating a part of the inner ear that generates eye movement. This may cause a momentary spinning sensation that typically lasts about 60 seconds. The entire ENG test takes approximately 1½ hours and is not painful.

We recommend that patients have someone help them with their transportation after this visit. This is a precautionary recommendation in case patients feel dizzy or simply do not feel comfortable driving after the tests. If you would like to know whether this applies to you specifically, please ask the receptionist when you confirm your appointment.

Download Eng Instructions

Vestibular Rehabilitation Therapy (VRT) - What is It?

VRT, or balance therapy, is an exercise-based therapy program used to treat balance problems. It is designed to help patients learn compensation and habituation techniques. Our highly trained vestibular therapist provides specialized testing and customized therapy programs designed to fit a person’s specific needs. These specialized programs address problems related to decreased function of vestibular, somatosensory and visual systems related to balance skills. It is based on the body’s natural ability to compensate for balance problems. Certain exercises strengthen this ability, and with a focused exercise routine, patients can improve their balance and decrease dizziness.

Some Diagnoses that can be related to dizziness and disequilibrium:

  • Benign Positional vertigo
  • Vestibular Neuritis
  • Meniere’s disease
  • Multifactorial dizziness of the elderly
  • Migraine related dizziness
  • Head injury and vestibular trauma
  • Motion sensitivity
  • Dizziness/imbalance post vestibular surgery

How do I know if I need balance therapy?

  • Have you fallen within the last three months?
  • Are you unsteady on your feet?
  • Do you experience dizziness or decreased mobility due to poor balance?
  • Do you have a fear of falling?
  • Are you motion sensitive?

What are the program benefits?

  • Provides a thorough evaluation to identify the cause of balance dysfunction.
  • Provides a comprehensive, systematic plan of treatment.
  • Provides rehabilitation under the supervision of a certified vestibular rehabilitation therapist
  • Reduces hospital visits and hospitalization costs by reducing the risk of falls.
  • Returns patients to safe, self–sufficient daily living.

What to expect if you are a candidate.

If it is determined that you are a candidate for vestibular rehabilitation, there are several areas that you will address with your clinical team;

  • Questionnaire about symptoms and how they limit independence and impact daily routines.
  • Occulomotor assessment - a review of your eye movements and responses.
  • Physical measurements-assessing muscle strength, range of motion, posture and coordination
  • Balance assessment-assessing current balance skills
  • Movement assessment-how movements such as standing, walking, rolling and various environments affect symptoms.

What to expect in treatment

Your certified vestibular therapist will begin with a comprehensive evaluation and perform tests in order to develop an individualized treatment plan which may include:

  • Balance retraining and balance strategies: helping the body to regain balance through a variety of exercises.

  • Sensory organization techniques and gaze stabilization strategies: helping the body to use its senses to overcome dizziness and decreased balance.

  • Habituation exercises: helping the body to decrease dizziness by repeatedly exposing it to a stimulus.

  • Canalith repositioning maneuver: a maneuver performed by the physician to manipulate the calcium crystals found in the inner ear.

  • Therapy sessions vary according to your specific needs, but typically include therapy 1-2 times per week for approximately 8 weeks.

  • Individualized home exercises, based on your needs.

To learn more about Balance Rehabilitation, please contact EARS Inc. at (408)540-5400. Our clinical team is ready to help!

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