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Evidence-based treatment for dizziness and balance disorders
Vestibular rehabilitation physiotherapy focuses on the assessment of dizziness, vertigo, imbalance, and movement-related symptoms connected to vestibular or sensory integration factors. Revibe provides vestibular assessments and movement-based programs for individuals seeking guidance related to vestibular function in Mississauga and Markham.
Vestibular rehabilitation physiotherapy (VRT) involves structured movement activities designed to examine how visual, vestibular, and proprioceptive systems interact during daily tasks. The approach reviews how the nervous system interprets spatial orientation, head movement, and balance-related input. Sessions may include controlled movements of the head, eyes, and body to help identify patterns that influence dizziness, balance, and motion tolerance.
Understanding the Vestibular System
Vestibular structures within the inner ear detect head movement and position. These signals travel through the vestibular nerve to the brainstem and integrate with visual and proprioceptive information. When any input varies from expected patterns, symptoms such as dizziness or imbalance may occur. A vestibular assessment reviews these interactions to better understand the source of symptoms.
The vestibular system includes three semicircular canals and two otolith organs in each inner ear. The semicircular canals detect rotational movement, while the otolith organs detect linear acceleration and head position relative to gravity. Signals from these structures travel to the brainstem, where they combine with visual and somatosensory information. Coordinated input supports balance, gaze stability, and spatial orientation.
How Vestibular Symptoms Develop
When visual, vestibular, and proprioceptive information do not align, the individual may experience dizziness, nausea, or spatial disorientation. These symptoms can significantly impact daily activities, work capacity, and quality of life. Understanding the underlying mechanisms helps guide effective treatment approaches and allows patients to develop strategies for managing symptoms.
When to Seek Assessment
Beginning vestibular rehabilitation early produces better outcomes. If you experience persistent dizziness, vertigo, imbalance, or motion sensitivity that interferes with daily activities, vestibular physiotherapy consultation becomes appropriate. Referrals are not required to access physiotherapy in Ontario. Direct access allows patients to begin treatment without delays from medical appointments.
Conditions We Treat
Our physiotherapists at Revibe treat a wide range of vestibular conditions through evidence-based techniques at our Realign Therapy Clinic.
Benign Paroxysmal Positional Vertigo (BPPV)
BPPV occurs when small calcium particles move from their usual location in the utricle into one of the semicircular canals. This movement alters how head rotations are detected and may lead to short episodes of positional dizziness. Specific head positioning tests help determine which canal is involved. Repositioning techniques are selected based on the affected canal.
Common scenarios:Dizziness when rolling over in bed, looking up at shelves, bending forward, or tilting the head back. Episodes typically last seconds to minutes and may include nausea.
Vestibular Neuritis and Labyrinthitis
These conditions involve inflammation of the vestibular nerve or inner ear structures, often following viral infections. Treatment plans involve gaze stability training, balance activities, and graded movement exposure. The pace is adjusted to the individual's response. Recovery may take several weeks to months depending on the severity of involvement.
Common scenarios:Sudden onset of severe dizziness, difficulty maintaining balance, visual disturbances with head movement, nausea and vomiting, sensitivity to motion.
Post-Concussion Vestibular Symptoms
Concussions can alter how the brain processes visual, vestibular, and proprioceptive information. Individuals may experience dizziness during head movement, difficulty stabilizing vision, or sensitivity in visually complex environments. Plans may include visual-vestibular integration exercises and movement-based tasks. Timelines vary and depend on multiple factors related to concussion recovery.
Common scenarios:Dizziness with head turns, difficulty reading or using screens, problems in busy visual environments like grocery stores, balance difficulties, headaches with movement.
Vestibular Migraine
Vestibular migraine involves episodes of dizziness or vertigo that may occur with or without headache. Treatment focuses on identifying triggers, managing symptoms during episodes, and developing strategies to improve tolerance to movement and visual stimuli. Integration with other healthcare providers may be necessary for comprehensive management.
Common scenarios:Episodic vertigo lasting minutes to hours, motion sensitivity, visual sensitivity to patterns or lights, may or may not include headache, often triggered by specific factors.
Ménière's Disease
Ménière's disease involves episodes of vertigo, hearing changes, tinnitus, and ear fullness. Vestibular rehabilitation helps manage balance issues between episodes and supports adaptation to changing vestibular function. Treatment emphasizes symptom management strategies and fall prevention techniques.
Common scenarios:Recurring episodes of severe vertigo, fluctuating hearing loss, ringing in ears (tinnitus), feeling of pressure in the ear, episodes lasting 20 minutes to several hours.
Age-Related Balance Changes and PPPD
Age-related changes in vestibular, visual, and proprioceptive systems can affect balance and stability. Persistent postural-perceptual dizziness (PPPD) involves chronic dizziness and unsteadiness that persists for months. Treatment addresses sensory reweighting, balance confidence, and movement pattern normalization through structured rehabilitation programs.
Common scenarios:Constant unsteadiness or rocking sensation, worsening in upright postures or with visual motion, difficulty in complex visual environments, fear of falling, avoidance of triggering situations.
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Comprehensive Assessment and Treatment
The initial vestibular assessment examines multiple systems that contribute to balance and spatial orientation. Each assessment component helps identify which factors are contributing to your symptoms and guides the development of your individualized treatment plan.
Standing balance is reviewed with eyes open and closed, on stable and unstable surfaces. Dynamic tests may include walking with head turns or navigating tasks that alter sensory input. These tests help identify which sensory systems (visual, vestibular, proprioceptive) you rely on most heavily and where compensations have developed. Results guide exercise selection and progression.
Gaze stability testing reviews the vestibular-ocular reflex, which keeps your vision stable during head movement. Tools may include a dynamic visual acuity test, which compares reading ability with the head still and during controlled head movement. Reduced gaze stability indicates vestibular involvement and helps determine appropriate exercise approaches.
Positional tests help identify dizziness linked to specific head or body movements. Procedures may include the Dix-Hallpike test or roll tests to examine different semicircular canals. These tests are essential for diagnosing BPPV and determining which repositioning technique will be most effective. Testing is performed with patient consent and stopped if symptoms become severe.
These exercises involve focusing on a stationary or moving target while performing controlled head movements. The goal is to review how the visual and vestibular systems coordinate during movement. Exercises progress from simple to complex movements and from stationary to moving environments. Consistent practice helps improve gaze stability and reduces dizziness with head movement.
Habituation activities introduce repeated exposure to movements or visual inputs that reproduce dizziness. The purpose is to observe how symptoms respond over time and to help identify patterns in movement sensitivity. These techniques work by gradually reducing the brain's response to triggering stimuli. Progression is carefully controlled to avoid overwhelming symptoms while promoting adaptation.
What to Expect: Your Treatment Journey
A typical vestibular assessment requires 45-60 minutes. Your physiotherapist reviews your medical history, current symptoms, and treatment goals. The physical examination includes balance testing, gaze stability examination, and positional testing. Findings guide the development of an individualized plan. All interventions are explained before beginning, and patient consent is obtained.
Follow-up sessions allow the physiotherapist to adjust exercises or activities based on observed changes. Treatment frequency depends on your specific condition and response to interventions. Some conditions require weekly sessions, while others involve less frequent monitoring. Home exercise programs form an essential component of vestibular rehabilitation and are selected based on your assessment findings.
Progress is tracked through repeated balance tests, gaze stability measures, walking assessments, symptom-tracking tools, and function-based questionnaires. Objective measurements show improvement in balance test results, gaze stability, and functional movement. At Revibe's Social Wellness House, we listen to your story to find your why and understand your needs. Once we discover your goals, you receive a wellness optimization plan that empowers you to become the best version of yourself.
The Revibe Difference: Integrated Vestibular Care
Revibe Mississauga and Markham operate as Social Wellness Houses—full-service lifestyle clubs that combine manual therapy clinic, natural medical office, and thermal spa. This integrated model offers advantages for vestibular rehabilitation that set us apart from traditional clinics.
Coordinated Care: Your physiotherapist collaborates with chiropractors, massage therapists, and naturopathic doctors under one roof. This synergistic approach addresses vestibular symptoms from multiple angles simultaneously. Treatment plans may incorporate nutritional support, stress management, and lifestyle modifications alongside vestibular rehabilitation.
Enhanced Recovery Environment: Access to thermal spa amenities—cold plunge, infrared sauna, and lymphatic drainage boots—supports overall wellness and stress reduction during vestibular rehabilitation. These wellness optimization tools complement your physiotherapy treatment plan and create an optimal environment for recovery.
Personalized Experience: Every treatment plan is tailored to your unique needs and goals. Healthcare professionals work together to diagnose, integrate, and concierge a world-class experience designed specifically for you. Over 10,000 happy clients and 500+ five-star reviews demonstrate the effectiveness of Revibe's approach to vestibular rehabilitation in Mississauga and Markham.
Home Exercise Programs and Self-Management
Home programs are selected based on assessment findings. Exercises are performed in short, structured sessions. Individuals are advised to follow the written instructions provided by their physiotherapist and to stop any exercise that produces severe or unexpected symptoms. Consistent home exercise compliance accelerates improvement and maintains progress between sessions.
Vestibular exercises may produce dizziness or discomfort related to movement. This response is often expected and helps promote adaptation. However, exercises are adjusted to maintain tolerable levels. Your physiotherapist provides clear guidance on expected responses versus symptoms that require program modification.
Daily modifications may support safety and comfort. Use adequate lighting in hallways and stairways. Remove loose rugs or clutter. Install grab bars in bathrooms. Ensure stable handrails on stairs. Track which activities increase symptoms and schedule demanding tasks during periods of lower symptom intensity. Include short rest intervals between activities and gradually increase exposure to visually or physically complex environments.
Beginner-Level Activities
• Eye tracking exercises with stationary targets
• Fixed-target head-turning exercises
• Standing with varying foot positions
• Simple weight shifting exercises
• Basic balance holds with visual support
• Gentle head movements in sittingIntermediate to Advanced Activities
• Walking with head turns
• Standing on foam surfaces
• Navigating visually busy environments
• Walking on uneven surfaces
• Catching or tossing a ball with head movement
• Task-specific movement patterns for daily activities
Frequently Asked Questions About Vestibular Rehabilitation
Treatment duration varies based on the underlying condition, duration of symptoms, general health, and exercise frequency. Some conditions like BPPV may resolve in 1-3 sessions with repositioning techniques. Other conditions like vestibular neuritis may require several weeks to months of rehabilitation. Your physiotherapist discusses expected timelines during the assessment based on your specific situation.
Vestibular exercises may produce dizziness or discomfort related to movement. This response is often necessary for the brain to adapt to vestibular challenges. However, exercises are adjusted to maintain tolerable levels. Severe or prolonged symptoms are avoided. Your physiotherapist monitors your response closely and modifies the program to ensure safety and effectiveness.
Outcomes depend on factors such as the underlying diagnosis, duration of symptoms, and overall health. Some conditions like BPPV often resolve completely with appropriate treatment. Other conditions involve periodic episodes or long-term management. Many patients achieve significant improvement and return to activities they previously avoided. The physiotherapist provides information specific to your assessment and condition.
Extended health insurance plans typically include physiotherapy coverage. Coverage ranges from $300 to $1,500 annually depending on the plan. OHIP does not cover outpatient physiotherapy services in Ontario. Revibe offers seamless insurance direct billing for extended healthcare plans. Contact us at (905) 783-8423 to discuss payment options and verify your specific insurance coverage.
Ontario allows direct access to physiotherapists without physician referral. However, some insurance plans require medical referrals for coverage. Check your insurance policy details before booking. Direct access allows faster treatment initiation without waiting for medical appointments. You can book your session at Revibe online or call (905) 783-8423.
Vertigo is a specific type of dizziness characterized by a false sensation of movement, often described as spinning or rotation. Dizziness is a broader term that includes vertigo but also encompasses lightheadedness, unsteadiness, or spatial disorientation. Your physiotherapist will help identify the specific type of symptoms you're experiencing to guide appropriate treatment.
Vestibular symptoms and anxiety can coexist and influence each other. Individuals may develop fear or avoidance of movements that reproduce dizziness. Heightened awareness of bodily sensations may also influence symptom perception. Vestibular rehabilitation incorporates gradual exposure to movement-based tasks that help individuals become more familiar with symptom patterns. Some patients work with mental health professionals in parallel with physiotherapy.
Bring previous imaging reports, medical diagnoses, and lists of current symptoms. Wear comfortable clothing that allows easy movement. Athletic wear works well. Avoid restrictive clothing. If you have balance concerns, consider bringing a companion to your first appointment. Bring your insurance information if you plan to use direct billing services.
Progress is tracked through balance test results, gaze stability measures, walking assessments, symptom-tracking tools, and function-based questionnaires. Objective measurements show changes in balance performance, visual stability during head movement, and functional activities. Many patients notice improvement in their ability to perform daily activities without dizziness or imbalance.
Vestibular rehabilitation can help some individuals with motion sensitivity by improving the integration of visual, vestibular, and proprioceptive information. Habituation exercises expose you to controlled motion stimuli to reduce sensitivity over time. Success varies based on the underlying cause of motion sensitivity and individual response to treatment.
Meet Our Physiotherapy Team
Scott French Physiotherapist
Michael Leung Physiotherapist
Zeeruk Rehman Physiotherapist
What Our Patients Are Saying
Best physio, tore my ACL and I feel amazing after 4 months. Zee is your guy!
I have been seeing Zee and he has been helping me with my knee rehab. Very professional and knowledgable Physio. I have been feeling better and better and honestly, it has changed my life. Clean facility with all the amenities you need and a very friendly staff.
highly recommend Revibe Mississauga for anyone needing physiotherapy, chiropractic, or massage therapy. I saw Zeeruk for physiotherapy to treat my injury, and I couldn’t be happier with the results. Zeeruk truly takes the time to listen and understand his patients’ concerns, tailoring a solution that directly addresses each individual’s needs. His knowledge and dedication to his craft are clear as day, and he’s highly invested in helping his patients, like myself, recover. After over ten sessions, I see real progress and improvements daily. The clinic is excellent—it has a great location, modern facilities, and a wide range of amenities. Without a doubt, this is
Zeeruk Rehman has been a revelation in my rehab, I’ve regained my confidence in my athletic ability after my injury, and highly recommend him for anyone looking for physiotherapy. The facility and staff are top notch as well, and it’s great to be able to go to a resource like that when I need! The space has everything I need and the staff make it enjoyable to focus on getting better
Book Your Appointment in Mississauga, Markham or Burlington
Revibe operates clinics in Mississauga (serving Streetsville, Erin Mills, Meadowvale, and surrounding areas) and Markham (serving Unionville, Thornhill, Buttonville, and surrounding areas). Both locations provide comprehensive assessment and treatment services for your health and wellness needs.
Mississauga Clinic
Location: 2290 Dixie Rd, Mississauga, ON L4Y 1Z4
Phone: 905-783-8423
Hours: Monday-Friday 8am-8pm, Saturday 9am-3pm
New patient visits include comprehensive assessment and first treatment session (75 minutes). Bring previous imaging reports, medical diagnoses, and lists of current symptoms. Wear comfortable clothing that allows access to treatment areas.
Serving: Streetsville, Erin Mills, Meadowvale, Churchill Meadows, Lorne Park, Port Credit, Clarkson, and surrounding Mississauga neighborhoods. Convenient access from Highway 403, QEW, and Erin Mills Parkway.
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Markham Clinic
Location: 220 Torbay Rd, Markham ON, L3R 1G6
Phone: 905-783-8423
Hours: Monday-Friday 8am-8pm, Saturday 9am-3pm
Insurance coverage varies by provider. Extended health plans often include manual therapy and wellness services. Direct billing available for plans that Revibe accepts. Receipts provided for insurance submission or tax purposes.
Serving: Unionville, Thornhill, Markham Village, Buttonville, Milliken, Cornell, Angus Glen, and surrounding Markham and Richmond Hill areas. Easy access from Highway 7, Highway 404, and Major Mackenzie Drive.
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Burlington Clinic
Coming Soon
We're excited to announce that our Burlington location will be opening soon. Stay tuned for updates on our new clinic serving the Burlington, Oakville, and surrounding areas.
