Specifically designed VRT exercise protocols take advantage of this plasticity of the brain to increase sensitivity and restore symmetry which results in an improvement in vestibular ocular control, an increase in the gain of the vestibular ocular reflex, better postural strategies, and increased levels of motor control for movement. Goal Goat of VRT is to improve balance, minimize falls, and decrease dizziness by restoring normal vestibular function and promoting mechanisms of central adaptation and compensation. Compensation results in a progressive waning of symptoms of imbalance, disequilibrium, and motion-induced unsteadiness. When compensation occurs for a vestibular deficit, the remaining CNS processes allow sufficient control of eye, head, and body movements to maintain stable gaze, posture, and position. VRT takes advantages of the adaptive characteristics of the CNS to reestablish homeostasis within the vestibular system.
Adaptation serves to extinguish symptoms of dizziness provoked by motion or visual stimulation.
Substitution strategies utilize alternate sensory inputs to drive motor output, alternate secondary motor responses instead of the primary motor responses, and incorporate strategies of prediction and anticipation of intended motor behavior. Several factors must be considered when designing a VRT program for an individual patient. Therapeutic efficacy may be limited by the extent and location of damage to the vestibular system. Status of visual and proprioceptive systems, physical strength, motor skills, and integrity of the cerebellum are critical to the successful application of a VRT program. Other factors that play a role in the outcome of a VRT program include general physical health, decision-making and cognitive abilities, age, memory, and the presence of psychological and anxiety disorders.