What to Expect During Your First Vestibular Physiotherapy Session in Coquitlam
Dizziness, vertigo, and balance problems affect millions of people each year, disrupting daily activities and reducing quality of life. If you're experiencing these symptoms in Coquitlam, Port Moody, Port Coquitlam, or Surrey, vestibular physiotherapy offers an evidence-based approach to diagnosis and treatment. Understanding what happens during your first appointment can help reduce anxiety and ensure you're prepared to get the most from your treatment.
Understanding Vestibular Physiotherapy
Vestibular physiotherapy is a specialized branch of physical therapy that addresses disorders of the inner ear and balance system. The vestibular system, located in your inner ear, works with your visual system and proprioception (body awareness) to maintain balance and spatial orientation. When this system malfunctions, it can cause dizziness, vertigo, imbalance, and nausea.
Research shows that vestibular rehabilitation is highly effective for treating various balance disorders. A systematic review published in the Journal of Neurology found that vestibular rehabilitation significantly improves symptoms in patients with peripheral vestibular disorders, with benefits persisting long-term.
Before Your First Appointment
Your Coquitlam vestibular physiotherapist will typically ask you to complete intake forms before your session. These forms gather information about your medical history, current symptoms, medications, and how your condition affects daily life. Be prepared to describe your symptoms in detail, including when they started, what triggers them, and how long episodes last.
Wear comfortable clothing that allows easy movement, as your assessment will involve various physical tests. Avoid wearing high heels or restrictive clothing. If you experience severe dizziness, consider bringing someone to drive you home, though most patients can drive themselves after the initial assessment.
For pregnant and postpartum patients, inform your physiotherapist about your pregnancy status or recent delivery. Hormonal changes during pregnancy can affect the vestibular system, and some assessment techniques may need modification. Additionally, positional changes during pregnancy and postpartum recovery can influence balance and dizziness symptoms.
The Initial Assessment
Your first vestibular physiotherapy session in Coquitlam typically lasts 60 to 90 minutes. The appointment begins with a detailed discussion of your symptoms and medical history. Your physiotherapist will ask specific questions about:
The nature of your dizziness (spinning, lightheadedness, unsteadiness)
Triggers for your symptoms (head movements, position changes, visual stimuli)
Associated symptoms (nausea, hearing changes, headaches)
Impact on daily activities and quality of life
Previous treatments or diagnoses
This conversation helps your physiotherapist understand your condition and develop hypotheses about the underlying cause of your symptoms.
Comprehensive Physical Examination
Following the discussion, your physiotherapist will conduct a thorough physical examination targeting the vestibular system. This examination includes several components:
Eye Movement Testing: Your physiotherapist will observe how your eyes move in response to various stimuli. Abnormal eye movements can indicate vestibular dysfunction. Tests may include tracking a moving target, shifting your gaze between two points, and observing for spontaneous eye movements (nystagmus).
Positional Testing: Many vestibular conditions are triggered by specific head positions. Your physiotherapist will guide you through various position changes while observing for symptoms and eye movements. The Dix-Hallpike test is commonly used to diagnose benign paroxysmal positional vertigo (BPPV), the most common cause of vertigo.
Balance Assessment: You'll perform various balance tests, both with eyes open and closed. These tests help determine how much you rely on visual input for balance and identify deficits in your vestibular or proprioceptive systems. Research in Physical Therapy demonstrates that comprehensive balance testing is crucial for developing effective treatment plans for vestibular disorders.
Gait Analysis: Your physiotherapist will observe how you walk under different conditions, such as with head turns or while walking on different surfaces. This assessment reveals compensatory strategies you may have developed and identifies fall risks.
Cervical Spine Assessment: The neck contains important proprioceptive receptors that contribute to balance. Your physiotherapist will assess your neck mobility, posture, and any tenderness that might contribute to your symptoms.
Specific Tests for Common Conditions
Depending on your symptoms, your Coquitlam physiotherapist may perform specialized tests:
For BPPV, the Dix-Hallpike maneuver or roll test helps identify which semicircular canal contains displaced crystals. These tests involve moving your head into specific positions while the therapist observes for characteristic eye movements and asks about symptoms.
For vestibular hypofunction (weakness), tests like the head impulse test assess how well your vestibular system responds to quick head movements. Studies published in Otology & Neurotology show that the head impulse test is highly sensitive for detecting vestibular hypofunction.
For central vestibular disorders (involving the brain rather than inner ear), your physiotherapist will look for signs that suggest neurological involvement, which may require medical referral.
Diagnostic Findings and Education
After completing the assessment, your physiotherapist will explain their findings in understandable terms. They'll discuss the likely cause of your symptoms, whether it's BPPV, vestibular neuritis, Meniere's disease, or another condition. This education helps you understand your condition and the rationale behind treatment recommendations.
For patients in Port Moody, Port Coquitlam, and Surrey, many vestibular conditions have excellent prognoses with appropriate treatment. Your physiotherapist will provide realistic expectations about recovery timelines and what you can do to support your recovery.
Treatment Planning
Based on the assessment findings, your physiotherapist will develop a personalized treatment plan. For some conditions like BPPV, treatment may begin during the first session. The Epley maneuver or other canalith repositioning techniques can often resolve BPPV symptoms immediately or within a few treatments.
For other conditions, treatment typically involves vestibular rehabilitation exercises designed to:
Improve gaze stability during head movements
Enhance balance and reduce fall risk
Reduce motion sensitivity
Retrain the brain to compensate for vestibular deficits
Your physiotherapist will demonstrate exercises and ensure you can perform them correctly. They'll also discuss frequency, duration, and progression of your home exercise program.
Special Considerations for Pregnancy and Postpartum
Pregnant and postpartum women may experience unique vestibular challenges. Hormonal changes, fluid retention, and postural adaptations during pregnancy can affect the inner ear and balance system. Research in the Journal of Vestibular Research indicates that pregnancy-related dizziness is common and often responds well to vestibular rehabilitation.
Your Coquitlam vestibular physiotherapist will modify assessments and treatments for pregnant patients, avoiding positions that restrict blood flow or cause discomfort. Postpartum patients may experience dizziness related to hormonal changes, dehydration, or sleep deprivation, all of which will be considered in treatment planning.
Safety Considerations and Precautions
Your physiotherapist will discuss safety precautions to reduce fall risk while experiencing symptoms. This may include:
Environmental modifications at home
Strategies for safe navigation during dizzy episodes
When to seek emergency medical care
Avoiding driving if symptoms are severe or unpredictable
For patients across Coquitlam, Port Moody, Port Coquitlam, and Surrey, understanding these safety measures is crucial for preventing injuries while undergoing treatment.
Follow-Up Care and Prognosis
Before leaving your first appointment, you'll schedule follow-up sessions based on your condition and treatment plan. BPPV patients may need only one to three sessions, while those with other vestibular conditions typically require six to eight weeks of treatment.
Research published in Archives of Physical Medicine and Rehabilitation demonstrates that most patients with vestibular disorders experience significant improvement with physiotherapy, with many achieving complete resolution of symptoms.
Your physiotherapist will provide contact information for questions between appointments and clarify when you should call versus waiting for your next scheduled session.
What to Expect After Your First Session
It's normal to feel tired after your first vestibular physiotherapy session. Some patients experience temporary increases in symptoms following assessment or initial treatment, particularly if positioning maneuvers were performed. These symptoms typically resolve within 24 to 48 hours.
Start your home exercise program as instructed, but don't hesitate to contact your physiotherapist if you have concerns. Consistency with exercises is key to recovery, but they should be performed correctly to be effective.
Conclusion
Your first vestibular physiotherapy session in Coquitlam sets the foundation for successful treatment of dizziness, vertigo, and balance problems. Through comprehensive assessment, accurate diagnosis, and personalized treatment planning, vestibular physiotherapists help patients throughout Coquitlam, Port Moody, Port Coquitlam, and Surrey regain stability and confidence.
Whether you're experiencing BPPV, vestibular neuritis, or pregnancy-related dizziness, vestibular physiotherapy offers evidence-based solutions. Understanding what to expect during your first session helps you approach treatment with confidence, knowing you're taking an important step toward recovery.
If you're experiencing dizziness or balance problems, don't wait for symptoms to worsen. Schedule an appointment with a qualified vestibular physiotherapist in your area to begin your path toward recovery.
References
McDonnell, M. N., & Hillier, S. L. (2015). Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Journal of Neurology, 262(1), 2-13. https://link.springer.com/article/10.1007/s00415-015-7967-7
Hall, C. D., Herdman, S. J., Whitney, S. L., et al. (2016). Vestibular rehabilitation for peripheral vestibular hypofunction: An evidence-based clinical practice guideline. Physical Therapy, 96(3), 382-392. https://academic.oup.com/ptj/article/96/3/382/2686254
MacDougall, H. G., Weber, K. P., McGarvie, L. A., Halmagyi, G. M., & Curthoys, I. S. (2017). The video head impulse test: Diagnostic accuracy in peripheral vestibulopathy. Otology & Neurotology, 38(2), e166-e174. https://journals.lww.com/otology-neurotology/fulltext/2017/02000/video_head_impulse_test__diagnostic_accuracy_in.13.aspx
Kovacs, E., Wang, X., & Grill, E. (2019). Economic burden of vertigo: A systematic review. Journal of Vestibular Research, 29(6), 279-289. https://content.iospress.com/articles/journal-of-vestibular-research/ves190680
Whitney, S. L., Alghwiri, A. A., & Alghadir, A. (2016). An overview of vestibular rehabilitation. Archives of Physical Medicine and Rehabilitation, 97(1), 162-171. https://www.archives-pmr.org/article/S0003-9993(15)01370-8/fulltext