Join us to refresh your knowledge of the vestibular system. It is so central to our ability to be upright against gravity, move through space and even to be able to feel safe lying still. It is very flexible and very neuroplastic. This is an important feature of the vestibular system, making it easily adaptable to altering circumstances in the environment we are moving in. It is commonly known that the vestibular system is critical to balance, however, increasingly, research suggests an association between vestibular function and psychiatric and cognitive symptoms, even when balance is not affected. Refresh your knowledge and how important this sensory system is below.


Rogge et al in 2018 made a compelling argument about the impact of movement on structural plasticity. This lends evidence to how fun playful movement included in occupational therapy and physiotherapy intervention sessions utilising Ayres’ Sensory Integration may facilitate change to cognition via changes in brain areas associated with spatial orientation and memory.

Physical exercise has been shown to induce structural plasticity in the human brain and to enhance cognitive functions. While previous studies focused on aerobic exercise, suggesting a link between increased cardiorespiratory fitness and exercise-induced neuroplasticity, recent findings have suggested that whole-body exercise with minor metabolic demands elicit beneficial effects on brain structure as well. In the present study, we tested if balance training, challenging the sensory-motor system and vestibular self-motion perception, induces structural plasticity. Thirty-seven healthy adults aged 19-65 years were randomly assigned to either a balance training or a relaxation training group. All participants exercised twice a week for 12 weeks. Assessments before and after the training included a balance test and the acquisition of high-resolution T1-weighted images to analyze morphological brain changes. Only the balance group significantly improved balance performance after training. Cortical thickness was increased in the superior temporal cortex, in visual association cortices, in the posterior cingulate cortex, in the superior frontal sulcus, and in the precentral gyrus in the balance group, compared to the relaxation group. Moreover, there was evidence that the balance training resulted in decreased putamen volume. Improved balance performance correlated with the increase of precentral cortical thickness and the decrease in putamen volume. The results suggest that balance training elicits neuroplasticity in brain regions associated with visual and vestibular self-motion perception. As these regions are known for their role in spatial orienting and memory, stimulating visual-vestibular pathways during self-motion might mediate beneficial effects of physical exercise on cognition.

Rogge, Ann-Kathrin & Roeder, Brigitte & Zech, Astrid & Hötting, Kirsten. (2018). Exercise-induced neuroplasticity: Balance training increases cortical thickness in visual and vestibular cortical regions. NeuroImage. 179. 10.1016/j.neuroimage.2018.06.065.



Vestibular processing difficulties are ubiquitous with anxiety – in literature both within and without occupational and physiotherapy eg as in the anxiety seen in vertigo/MH etc. Vestibular processing difficulties can be quite discrete, and less obvious than  “traditional” dyspraxia. This can be why they are sometimes missed. Often people thinking about dyspraxia think about a common interpretation of the term, with a view of the child being very obviously ‘clumsy’.  A dyspraxic pattern on VBIS is often more subtle/discrete, showing up later with difficulties common in organisational skills and feedforward/consequences to actions. Increasingly sensory integration and processing difficulties in both children and adults with very mild differences are identified by occupational therapists working in CAMHS and Mental Health Teams.




Vestibular Function in Children with Neurodevelopmental Disorders- A Systematic Review