Vestibular Rehabilitation and Concussion Clinic

Vestibular Rehabilitation Clinics in Toronto, North York, Burlington, Richmond Hill & Markham.

We are experienced in the diagnosis and treatment of dizziness conditions such as BPPV, vertigo, neuritis, imbalance and the management of concussion-related symptoms. Our certified vestibular physiotherapists have been helping patients recover since 2008. We understand the impact that your condition has on you and those around you.

You want your life back. We can help.

Why you can trust Cornerstone Dizziness Clinics

• We are staffed with certified vestibular physiotherapists who are passionate about helping patients with complex conditions.
• We are referral partners of many local hospitals, physicians and specialists in the medical community.
• We successfully treat hundreds of patients each year, commonly assisting patients with chronic or challenging presentations.
• We provide you with an accurate diagnosis using infrared goggle technology to measure subtle eye movements (nystagmus).
• We recognize when your condition requires a referral to a different health professional.
• Your physician and related specialists will be provided with a report outlining our findings and the recommended treatment plan.
• Your appointments are covered by most extended health insurance plans.
• We are frequently chosen as the clinic that doctors turn to, when searching for answers to challenging conditions.

WHAT HAPPENS DURING A VESTIBULAR PHYSIOTHERAPY APPOINTMENT?

Your 1st Session

Dizziness and concussion cases are complicated and unique to each patient. These types of impairments are often misdiagnosed or left undiagnosed. At Cornerstone we have created assessment procedures that capture the full scope of your condition and accurately categorize the root cause of your symptoms.

HISTORY OF YOUR PROBLEM: You’ll help us understand the full scope of your symptoms, the things that make it better and worse, your related medical history, and how it has impacted your life. You’ll need to tell us how and when your symptoms began and how your condition has changed over time.

NEUROLOGICAL TESTING: The majority of vestibular (and concussion) dysfunctions have relationships with your body’s nervous system. It is often appropriate to perform manual neurological tests to help zero in on the true cause of your symptoms. These are simple tests that can involve the movement of your arms and legs, the muscles and reflexes of your head, and tracking voluntary eye movements.

INFRARED GOGGLE TESTING: The Cornerstone Dizziness Clinic is one of the few centres that uses infrared goggle technology to measure nystagmus patterns of your eyes. Your eyes can function as a “window” into your brain. Your vestibular system has direct connections with the muscles that move your eyes. Our goggles allow us to view abnormal eye reflexes (which we term nystagmus) and more accurately categorize your condition.

**note that these tests are typically not the same as those VNG, ENG, and caloric tests administered at dizziness testing centres.

OUTCOMES: The aims of our initial assessment are to:

1. Understand your problem, and formulate a diagnosis
2. Identify any secondary dysfunctions that require a referral back to your doctor
3. Create a treatment plan that addresses your concerns and limitations

TREATMENT: The majority of our initial appointments include treatment. However, if your presentation is more complex, then we will spend the entire session assessing your condition to develop a full understanding of what is going on.

Follow Up Sessions

The number of treatments required for recovery varies from diagnosis to diagnosis, and from patient to patient. Your assessment will provide your physiotherapist with the information they need to discuss your prognosis and the expected number of sessions.

However, at our clinics, patients with a mechanical vestibular condition can feel better in as little as 1-3 sessions. Those with vestibular nerve involvement or concussion take more time to recover, but sessions are typically infrequent.

WHAT IS THE TREATMENT FOR A VESTIBULAR CONDITION OR CONCUSSION?

This depends on your diagnosis and your goals for recovery. Treatment can involve the following:

1. Repositioning manoeuvres – your head and body will be guided through patterns of motion that promote stimulation of the inner ear organ and can relocate otoliths (crystals) if your diagnosis is BPPV.
2. Vestibular Rehabilitation Therapy (VRT) exercises – these are specific home exercises prescribed based on our assessment findings. Commonly they can include eye and head stabilization, visual targeting/motion, movement desensitization, balance and body stability, gait and movement coordination, among other exercises.
3. Activity Modifications and Education – most patients receive advice on appropriate changes to their daily activities. You may be instructed to avoid certain things and do other things more often or in a different way. This may mean adaptations to work, school, and leisure, in order to maximize your recovery.

WHAT CONDITIONS DOES VESTIBULAR PHYSIOTHERAPY TREAT?

• Benign Paroxysmal Positional Vertigo (BPPV)
• Post-Concussion Syndrome
• Persistent Postural Perceptual Dizziness (PPPD)
• Vestibular Neuritis / Labyrinthitis
• Unilateral / Bilateral Vestibular Hypofunction or Loss
• Meniere’s Disease (Endolymphatic Hydrops)
• Mal de Debarquement Syndrome (MdDS)
• Vestibular Migraine (Migraine Associated Vertigo)
• Cervicogenic Dizziness / Cervical Vertigo
• Post COVID-19 Dizziness
• Acoustic Neuroma
• Dizziness and Imbalance following a stroke (CVA) or Multiple Sclerosis
• Poor balance as a result of aging or deconditioning (PVP – Presbyvestibulopathy)
• Dehiscence or Perilymphatic Fistulas
• Ototoxicity
• Anxiety-Related Dizziness
• And more

Click here for:  10 Common Causes of Dizziness

WHAT ARE THE SYMPTOMS OF A VESTIBULAR DISORDER?

Symptoms can vary, however often include:

• Dizziness (can be constant or comes and goes)
• Vertigo (spinning sensation)
• Light-headedness, feeling ungrounded
• Motion-sensitivity
• Imbalanced or feeling unstable
• Vision issues (difficulty focusing or looking at screens, shaky or unstable vision)
• Nausea, or diarrhea
• Headaches or head pressure
• Anxiety and/or Depression, difficulty with stress management
• Mild issues with memory and concentration
• Tinnitus (hearing noises such as ringing, wooshing, buzzing) or ear pressure/pain

FEE SCHEDULE

Click here to view our fees

RESOURCES

Too dizzy to travel to one of our clinics? Get started with virtual vestibular appointments through our telehealth video portal. Then attend in-clinic appointments when you are ready, or continue your treatments virtually. Learn more by Clicking Here.