Victoriya Brener, M.D.
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Dr. Frenkel Obstetrician-Gynecologist  
Balance and Vestibular Training

Balance and vestibular (inner ear) problems are far more common than you may think. Don’t let dizziness, spinning, motion sickness or feeling off balance interfere with your life.

Balance Problem Statistics
  • Approximately 8 million people visit their doctor for treatment of dizziness annually.
  • According to the National Institutes of Health, 40-50 percent of people over the age of 40 experience dizziness or balance problems at some point in their life.
  • Falls are the leading cause of injuries in people age 65 and older in the United States.
  • Of all falls suffered by older adults, 50 percent can be attributed to some degree of vestibular dysfunction.
  • BPPV is a very common vestibular disorder with an incidence of one in every five people with vertigo. BPPV stands for Benign, Paroxysmal (sudden, without warning) Positional (in response to movement of the head) Vertigo (abnormal sensation of movement).
About Program
A physical or occupational therapist will assess individuals needing balance and vestibular training. Following the assessment, participants will be placed in either individual therapy or group balance training as determined by the therapist.
Physical Medicine & Rehabilitation Services offers a comprehensive balance and vestibular training program that meets the specific needs of individuals. Participants receive education, balance and vestibular exercises and strategies to help them reach their full potential. Objective testing is performed to measure each participant’s progress toward balance goals.
Who Benefits from the Training?
People most appropriate for this program include anyone experiencing dizziness, vertigo, imbalance, gait instability, falls or fear of falling. Other vestibular disorders may include labyrinthitis, BPPV, vestibular neuronitis, unilateral or bilateral peripheral vestibular dysfunction, meniere’s disease or motion intolerance.
What is VNG testing?

Videonystagmography (VNG) testing is considered the new standard for testing inner ear functions over Electronystagmography (ENG), because VNG measures the movements of the eyes directly through infrared cameras, instead of measuring the mastoid muscles around the eyes with electrodes like the previous ENG version. VNG testing is more accurate, more consistent, and more comfortable for the patient. By having the patient more comfortable and relaxed, consistent and accurate test results are more easily achieved.

VNG testing is used to determine if a vestibular (inner ear) disease may be causing a balance or dizziness problem, and is one of the only tests available today that can decipher between a unilateral (one ear) and bilateral (both ears) vestibular loss. VNG testing is a series of tests designed to document a persons ability to follow visual objects with their eyes and how well the eyes respond to information from the vestibular system.

This test also addresses the functionality of each ear and if a vestibular deficit may be the cause of a dizziness or balance problem. To monitor the movements of the eyes, infrared goggles are placed around the eyes to record eye movements during testing. VNG testing is non-invasive, and only minor discomfort is felt by the patients during testing as a result of wearing goggles. Appointments usually last about 1.5 hours, and testing is covered by all insurances.

Tips for Preventing Falls:
  • Have your vision and hearing checked regularly
  • Get up slowly
  • Exercise regularly in a controlled environment
  • Remove raised doorway thresholds in all rooms
  • Keep electrical cords and furniture out of walking paths
  • Avoid difficult-to-reach shelves
  • Be sure stairways and entryways are well-lit and have sturdy hand-rails or grab handles
  • Install grab handles and nonskid mats outside of showers and tubs
  • Put a light switch by bedroom door and by your bed so you don't have to walk across a dark room
  • Follow your physician's advice before beginning any exercise program

Once our experienced physical therapist completes comprehensive neuromuscular assesment, he develops a customized rehabilitation program to restore your balance and confidence. He takes into account your medical condition, lifestyle and individual needs. Aa a result, you will enjoy a dramatic improvement in your daily life while reducing your risk of falling.

  Dr. Brener is a physiatrist. She has been affiliated with Beth Israel Medical Center.
She earned her M.D. from Vinnitsa Medical Institute of N.I. Pirogova and completed her residency in physical medicine & rehabilitation at Downstate & Kings County Hospital Center.
Dr. Frenkel is an obstetrician-gynecologist at Bay OB/GYN, P.C. in Brooklyn. He has been affiliated with New York Methodist Hospital and Lenox Hill Hospital.  
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