Vestibular Evaluation and Rehabilitation: A Team Approach for Audiologists and Physical Therapists

By Brad Stewart and Kristen Crawford

This article is a part of the May/June 2020, Volume 32, Volume 3, Audiology Today issue.

Dizziness and imbalance are complex and, often, multifactorial conditions that require skilled evaluation, sometimes by multiple health-care providers.

As audiologists, our role is largely diagnostic in nature. We are able to perform a variety of tests to help identify or rule out the site of lesion. Working in a collaborative team with physical therapists who are specifically trained in vestibular rehabilitation provides a comprehensive and dynamic approach to treating these patients.

We have the privilege to operate a multidisciplinary clinic of audiologists and physical therapists who are skilled in vestibular rehabilitation. As audiologists, we are able to benefit from the unique perspective that physical therapists bring to the table. Their focus is on improving function, with less emphasis on diagnostics. Our role in these patients’ care is outlined in the American Academy of Audiology’s Scope of Practice statement: “Audiologists also are involved in the treatment of persons with vestibular disorders. They participate as full members of the balance treatment teams to recommend and carry out treatment and rehabilitation of impairments of vestibular function” (2004).

“The goals of vestibular rehabilitation therapy (VRT) are to (1) enhance gaze stability, (2) enhance postural stability, (3) improve vertigo, and (4) improve activities of daily living,” according to Han et al (2011).

That is not to say that physical therapists are not interested in diagnoses or sites of lesion. In our experience, well-educated physical therapists who care for vestibular clients will take patient diagnosis and clinical findings into strong consideration when developing a treatment plan for their patients.

To outline the working clinical relationship between audiologists and physical therapists in practice, we would like to share a case study that demonstrates the clinical role that these two specialists bring to the care of vestibular patients.