Mindfulness physical therapy, pain management, rehabilitation

Mindfulness and Vestibular Rehabilitation

In the past year, I have worked closely with a PT vestibular rehabilitation specialist, often seeing her patients who were progressing slower than expected. Once these patients gain skills in mindful awareness and the self-regulation of the stress reaction, they frequently make greater progress with their vestibular rehabilitation. This sparked my interest in how mindfulness training can help patients with vestibular disorders.

I found one study in the medical literature on this topic. Nader and colleagues note the shared neural networks for the vestibular system and emotional processing and suggest a relationship between vestibular dysfunction and anxiety.1 They analyzed pre- to post-group treatment data for 51 patients seen at a neurotology clinic. Groups of 3 to 8 participants were co-led by a physical therapist and neuropsychologist and met every other week for 5 sessions. Participants were taught new skills each session that included mindfulness principles and practices, cognitive behavioral therapy strategies and vestibular exercises.

After group treatment, patients reported improved mood, physical and mental health, functionality, coping and skill use. They reported significantly less impairment  (P<.0001) and fewer limitations from dizziness (P<.0001). Higher pretreatment levels of depression and poorer mental or physical health predicted a better outcome. Patients were highly satisfied with the program and found it more effective than previous treatments. These initial results are positive, however further research is needed. This could include the addition of vestibular rehabilitation alone to determine whether the inclusion of mindfulness and CBT strategies promote symptom improvement beyond standard treatment.

1Naber CM, Water-Schmeder O, Bohrer PS, et al. Interdisciplinary treatment for vestibular dysfunction: the effectiveness of mindfulness, cognitive-behavioral techniques, and vestibular rehabilitation. Otolaryngol Head Neck Surg. 2011;145(1):117-24.