Treating Dizziness and Vertigo in VR through Vestibular-Visual Desensitization Training

  • By Dizzy & Vertigo Institute
  • June 30, 2022

It’s rare for a balance disorder to be cured in one or two treatments. The typical dizzy patient needs at least a half dozen treatments and in some cases needs ongoing maintenance (i.e. once a month for a year or more). This level of treatment schedule can be a major burden, we know. Fortunately, we have a fix that makes vestibular treatment possible from anywhere at any time. 

That solution is attributed to advancements in technology and the use of virtual reality treatment.

What sets our vestibular clinic apart from others is that we’ve developed proprietary treatment protocols that can be administered through a virtual reality headset, smart TV, tablet, or desktop. This means that you can treat yourself from home, on vacation, and even during holidays with the in-laws (making for a great excuse to get away for a little break). 

What is Vestibular-Visual Desensitization Training (VVDT) with Virtual Reality (VR)?

Vestibular-Visual Desensitization Training (VVDT) with Virtual Reality (VR) is based on the principles of Vestibular Rehabilitation Therapy (VRT). VRT is a fancy way of describing treatments designed to fix any malfunctions in your balance system and strengthen your body’s ability to balance. Thus, it targets the systems of the body that help us balance. These systems are the eyes, the muscles (sense of touch), and the vestibular system (your body’s GPS, located in the inner ear).

Virtual reality (VR) treatment is not the first line of treatment though, most patients will start on a Smart TV, desktop, or laptop computer to ease into the new visual stimulation.

After a dizzy patient, perhaps like yourself, has battled with vertigo, imbalance, or a form of dizziness for some time, your balance system is weakened and confused. Your eyes, muscles, and vestibular system aren’t properly communicating about how your environment is changing and thus cannot accurately tell your muscles how to rebalance.

When you first enter our doors at the Dizzy & Vertigo Institute, we’ll run a battery of tests designed to find exactly where the miscommunication is happening between the balance inputs (eyes, muscles, and vestibular system). With an understanding of your problem, we can then design the solution. The solution for a lot of patients, as we said, is a technologically advanced rendition of VRT that focuses on the reflex between the eyes and the vestibular system called the vestibular ocular reflex (VOR). 

Traditional VRT is based on the following methods:

  • Visual and optokinetic motion desensitization – Strengthens the visual and vestibular reflex
  • Sensory reweighting – Helps the brain integrate sensory information properly
  • Habituation – Building up a patient’s internal defenses against dizziness triggers.
  • Balance Training – Strengthening the muscles used to balance.
  • Canalith Repositioning – Re-aligning the inner ear instruments used to detect balance.

Some parts of VRT must be done in the office. For example, the last two on the list require hands-on work with a trained vestibular specialist and benefit most from in-clinic sessions. But the top three on the list we’ve incorporated into our vestibular-visual desensitization treatments (VVDT) with a VR headset, Smart TV, tablet, or desktop making things efficient and effective. 

It’s important to start with in-office treatment to ensure that your balance systems are properly responding to the therapies. But ultimately, once we’ve made progress on your treatments at our office, we can switch over to the technologies at home. In other words, we would compare it to hiring a physical trainer at the gym who will help you get down the proper form and training regimen, but ultimately you’ll be able to work out on your own once you’ve got the process down and can access the correct equipment.

It’s difficult to describe VVDT simply, without truly encapsulating its impact. But in essence, you put on the headset, sit or stand in front of the Smart TV, tablet, or desktop and are immersed in visual stimuli. It’s like watching moving objects pass you by or going up and down a simulated elevator with ease. This desensitizes your visual system gently and systematically while allowing redundant communication with the vestibular system. It allows the eyes and vestibular system to work together again with a reduction in colors, shapes, or speeds that might normally trigger your dizzy symptoms.

The trick is to ease into the difficulty of these visual triggers, like working your way up in weights for curls. The key is that our vestibular specialists monitor your progress and routinely meet with you to ensure that you’re working through the vestibular-visual desensitization training (VVDT) at the right pace and not overwhelming your system. This process works as a bridge between your current tolerance levels and what is necessary to thrive in the real world again. 

A large portion of our patients will end up using vestibular-visual desensitization training (VVDT) because it’s so convenient and great for ongoing balance maintenance. Virtual reality treatments are also extremely effective, as Mark Cuban described in his testimonial.

Getting the Most From Vestibular-Visual Desensitization Training (VVDT) 

You need to be in the right state of mind and health for any vestibular rehabilitation therapy (VRT) program to work its magic. This is because balance disorders can be affected by so many health systems. Therefore, in order for vestibular-visual desensitization training (VVDT) to be most effective, there are a number of psychological changes and lifestyle changes we suggest our patients make.


The Right State of Mind:

As you progress through vestibular rehabilitation therapy (VRT) and the use of vestibular-visual desensitization training (VVDT), there’s a right way to think about it.

Don’t Overwork Yourself. Restoring your health and creating new routines should not feel like punishment. It is important to nourish your body all around and ultimately work toward a better state of recovery. Embrace this journey and switch your mindset.

Slow and steady. Try not to do too much too soon. We don’t want you to feel overwhelmed. Breaking down new habits into phases is a lot easier than doing everything all at once.

Listen to your intuition. Your instincts are powerful. If something feels off, connect with us and let us know what’s going on. Understanding how your body responds to stimuli is important and you know YOU best!

Self-kindness is a thing. Having compassion for yourself is important and setbacks are ok. Each day is an opportunity to move forward. Be patient and kind to yourself. 

Give yourself encouragement. Celebrating your milestones and small steps forward is important. Little wins are vital and they build-up to the big ones. 


The Right State of Health: 

Diagnosis and VRT play an integral role in healing the vestibular system but ignoring certain lifestyle factors can prevent a smooth recovery. Below are some important health changes that we will address throughout our time together.

Stress management. Stress is your body’s reaction to a new challenge or change. Consistent stress can be a big problem and can cause a weakened immune system, inflammation, or even hormone imbalance. In addition, stress can be a trigger for certain balance disorders. Managing stress is so important. Some simple techniques include (more in the link above):

  • Perform breathing exercises
  • Get a massage or acupuncture
  • Start a new hobby or class you enjoy (reading, painting, cooking)

Quality sleep. Adequate sleep is NON-NEGOTIABLE. We all need sleep for rest and recovery of our physical and mental health. Quality sleep is key to recovering from balance disorders. Getting 7-9 hours of sleep each night is the goal. Some tips and tricks for improving your sleep include (more in the link above):

  • Design a bedtime routine consistently each night, falling asleep at the same time, and waking up at the same time. 
  • Two hours before bed, eliminate blue light exposure (this includes work screens and social media). Opt instead for more relaxing wind-down techniques.
  • Design your bedroom to be cool, dark, and calm.

Move your body consistently. This doesn’t have to be sweaty exercise. When you are recovering, engaging in too much can push your body too hard and even do more harm than good. That’s why easy and consistent movement is important. For example:

Get some sunlight. Vitamin D is vital for good health and plays a large role in how our immune system and even the vestibular system work. Sunlight is one of the best ways to get the ‘sunshine vitamin’ since very few foods have significant amounts of vitamin D. 

  • Sun exposure of 20-30 minutes per day maximum
  • Set a goal of sun exposure three times a week following your dermatologist’s recommendations regarding the use of sunscreen
  • Have your current vitamin D levels tested by your physician or dietitian to determine if a supplemental dose is needed; we suggest Non-GMO, third-party tested brands.  

Get rid of toxins in your environment. Toxins are everywhere: in our foods, cleaning supplies, personal care products, and even in our water. When our immune system comes into contact with them it is activated. Eliminating these toxins is important so it’s not on high alert. The easiest way to do this is:

  • Clean up your cleaning supplies. Purchase cleaning products that have plant-derived ingredients, essential oils, hydrogen peroxide, or vinegar instead. 
  • Use quality ingredients on your skin and hair. Toxins like parabens, phytates, and sodium lauryl sulfate can be in your lotions, shampoos, and makeup disrupting your endocrine system. Use products without them. 
  • Ideally, drink water from the source (spring, artesian, glacier, etc.) or use water filters for your tap water to filter out toxins like lead, chlorine, or even arsenic.  

Get the Help You Need

You are not alone in your fight with dizziness. We’ve been at this for over a decade and have come across nearly every case imaginable. A major benefit of working with the Dizzy & Vertigo Institute is that we will personalize a treatment regimen that isn’t disruptive to your life. As we stated above, VVDT is super helpful for remote treatment and may end up being perfect for you.

If you’d like to understand our treatment process in further detail, then please check out our article How We Treat Dizziness: What To Expect Working with the Dizzy & Vertigo Institute.

Otherwise, If you or someone you know is struggling with symptoms of dizziness or vertigo, then please reach out to us at (310) 683-4679 or by filling in our contact form here.

We hope to hear from you soon!

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