Vestibular & Balance Rehabilitation in Vellore

Vestibular rehabilitation is specialised physiotherapy for people with dizziness, vertigo, unsteadiness and balance problems. It uses precise assessment (nystagmus screening, positional testing, gaze-stability tests) and targeted exercises (habituation, adaptation, substitution) to retrain the inner ear, eyes and brain to work together again.

At Dr. Karolin Rockson PT we treat the full range of vestibular presentations — BPPV (the most common cause of positional vertigo, treated with Epley or Semont manoeuvres in 1–3 visits), unilateral vestibular hypofunction after labyrinthitis or vestibular neuritis, Meniere's disease between attacks, vestibular migraine, post-concussion dizziness, and elderly balance and falls prevention.

Assessment includes video Frenzel-style positional testing, gaze-stability tests, head-thrust and Head Impulse tests, and objective balance scoring (mCTSIB, BESTest). Treatment is graded, personalised, and re-measured every 2 weeks.

BPPV is under-diagnosed in Vellore. Many patients spend months on 'vertigo tablets' when a single 5-minute Epley manoeuvre would resolve their symptoms. We frequently see patients referred from ENT and general medicine after months of medication with no improvement.

Falls in elderly Vellore residents are a major cause of hip fractures and hospital admissions. Our balance programmes are modelled on the Otago and BEEP protocols and adapted for typical Tamil homes (thresholds, wet bathrooms, floor-level toilets, temple visits).

Distinguishing BPPV from other vertigo: BPPV is brief (seconds), triggered by head position, and shows a specific nystagmus on Dix-Hallpike. Meniere's has hearing loss and tinnitus. Vestibular neuritis has constant vertigo lasting days. We diagnose in-clinic and refer for imaging only when red flags appear.

Elderly falls prevention: the Otago Exercise Programme (5x/week, 6 months) reduces falls by ~35%. Our version adapts squats for cross-legged sitting, wall exercises for smaller Tamil homes, and includes footwear and lighting review.

Home safety review checklist: threshold heights, floor-level toilets, wet bathroom floors, loose mats, poor lighting on stairs, cross-legged floor seating. Fixes are ranked by cost and impact.

Vestibular migraine differs from typical migraine — vertigo can appear with or without headache. Trigger identification (sleep, food, screens) is central; medication is coordinated with a neurologist familiar with vestibular migraine.

Return-to-drive after BPPV: usually same day once symptoms clear. After Meniere's attacks: at least 24 hours symptom-free. Post-concussion: cleared only after formal vestibular and oculomotor screening.

Post-concussion vestibular therapy: staged VOMS (Vestibular/Ocular Motor Screening) drives the programme. Symptom-limited progression, with return-to-play only after graded exertion testing.

Evidence: vestibular rehab has strong evidence for BPPV (Level I), unilateral hypofunction (Level I), and chronic dizziness syndromes (Level II). Not helpful for pure central causes without peripheral involvement.

Insurance: vestibular physiotherapy is covered under standard physiotherapy benefits in most Indian outpatient policies with a doctor's prescription (ENT, neurology or physician).