Claire Potter is a dedicated vestibular physiotherapist at a central London trust. Her journey into physiotherapy was inspired by a personal experience, her mother’s recovery from a serious knee injury through physiotherapy. Initially interested in musculoskeletal care, Claire soon found her passion in neurological rehabilitation, eventually specialising in vestibular physiotherapy over the past three and a half years.
Working with patients suffering from chronic balance disorders, some with symptoms lasting up to 20 years, Claire finds reward in both the complexity and the life-changing potential of her field. From treating Benign Paroxysmal Positional Vertigo (BPPV), often with immediate results, to supporting those with Persistent Postural-Perceptual Dizziness (PPPD) and Functional Neurological Disorder (FND), her work blends science, empathy, and collaboration with psychology. Her enthusiasm for meaningful, measurable outcomes makes her a strong advocate for tools like the BalanceBelt.
Pushing Boundaries Despite Limited Resources
Claire is deeply committed to improving patient outcomes, yet she acknowledges the constraints of working within the NHS. While complex vestibular cases, particularly patients with conditions like PPPD or Functional Neurological Disorder, can benefit greatly from long-term care, NHS resources often limit treatment provision within the confines of economic viability. In her private practice, she has seen how patients thrive with extended care, highlighting a gap in what public services can currently provide.
Despite these limitations, Claire is grateful to be part of a well-resourced and forward-thinking team. The multidisciplinary team (MDT) includes consultants, audiologists, and a strong cohort of physiotherapists, all supported by an encouraging management team. This collaborative environment enables continued professional development, networking, and active involvement in clinical research.
The service has evolved significantly in the past decade, particularly during COVID, to embrace remote care and increase patient access. Claire and her colleagues are also working to elevate their service to a national center of excellence.
Treating Severe Vestibular Disorders: A Holistic, Structured Approach
Claire explains that treating patients with severe vestibular dysfunction, particularly those with bilateral vestibular loss, is highly complex and must be tailored to different subgroups. Some patients come with rare conditions like Neurofibromatosis type 2 (NF2), while others suffer from age-related decline or unexplained progressive vestibular loss in midlife. These individuals often experience debilitating symptoms such as oscillopsia, veering while walking, and repeated falls, often after years of misdiagnoses and specialist referrals.
For this group, Claire emphasises a holistic and psychologically sensitive approach. Many patients arrive feeling demoralised, especially once they understand their condition is chronic. Initial treatment includes reviewing vestibular test results, discussing home and environmental modifications (e.g., better lighting, removing rugs), and introducing strategies to manage anxiety and fear of falling.
Rehabilitation plans typically include daily walking routines and balance training exercises to optimise the 3 balance systems.
Until recently, Claire notes, options beyond this core rehab program were scarce, a gap that new tools like the BalanceBelt could help fill.
Introducing the BalanceBelt: From Cautious Curiosity to Clinical Impact
Claire Potter first learned about the BalanceBelt through her clinic’s monthly journal club, where her team discussed one of the early research papers. At the time, they viewed the device with interest but caution, assuming it would be difficult to introduce into the NHS without more robust data. However, a hands-on demonstration at a professional event (ACPIVR) changed that. After trying the belt herself and receiving a trial unit from the BalanceBelt team, she took the initiative to lead internal testing.
Initially skeptical, Claire questioned whether the device’s non-directional vibratory feedback would be tolerated or helpful for patients. However, given the lack of alternative treatment options for complex bilateral vestibular loss, she decided it was worth trying. The clinical rationale was: “It can’t hurt, and if it helps, that’s a win.” She began trialing the belt on selected patients under strict agreements, making it clear they would need to self-fund if they found it beneficial.
Interestingly, one patient with a functional neurological disorder (FND) felt worse when the belt was active, but better simply wearing it, suggesting that even the physical presence of the device may enhance truncal awareness for some. This highlighted the nuanced ways the belt might interact with different pathologies, especially in patients prone to sensory hyper-awareness or internalisation.
Despite that outlier, Claire reports that most patients with bilateral vestibular hypofunction showed clear improvement. One woman, who had not been able to run for three years, was so moved by her restored ability that she cried during the session. Such moments reinforced the belt’s potential to offer life-changing outcomes when used appropriately.
Case Summary: The Impact of the Balance Belt on a Patient with Severe Vestibular Dysfunction
A patient in her 50s was referred to the balance clinic by her GP, following a history of debilitating vestibular symptoms, including oscillopsia and profound imbalance. She had become unable to drive, leaving her socially isolated and dependent on her husband for mobility. The impact on her personal life was significant, she could no longer care for her two teenage children as she once had, and she experienced panic attacks and anxiety due to her condition.
Upon referral, she was assessed in the multidisciplinary team (MDT) balance clinic, which includes physiotherapists, audiologists, and medical specialists. Diagnostic testing revealed bilateral vestibular hypofunction affecting both semicircular canals and otolith organs. Initial physiotherapy focused on home safety, gentle balance exercises, and lifestyle adaptations, including a referral for occupational health support. However, progress was limited, and her symptoms remained highly provoking.
A pivotal moment came with the introduction of a BalanceBelt despite sizing limitations, the belt provided immediate and visible improvement. During outcome testing, which included mobility and confidence assessments, her performance improved significantly. Notably, she no longer clung to her husband’s arm and was visibly more confident, even smiling for the first time in therapy.
Although the belt did not address all symptoms (e.g. oscillopsia), it successfully boosted her confidence and allowed her to begin re-engaging in physical activity and daily routines. The team emphasised setting realistic expectations for the device: while it does not restore vestibular function, it serves as a powerful adjunct to help patients regain independence and improve quality of life.
Summary: Clinical Insights and Future Implications of the Balance Belt
The BalanceBelt does not replace or restore the vestibular system itself, it does not resolve symptoms like oscillopsia or directly substitute vestibular input. However, what it does, is provide an adjunctive sensory cue that improves confidence, postural control, and functional mobility, making it particularly valuable for patients with bilateral vestibular hypofunction.
Claire notes that the belt could also benefit individuals with unilateral vestibulopathy, especially when one side is severely affected, and compensation is limited. Furthermore, it may have potential applications for patients with persistent postural-perceptual dizziness (PPPD) and other chronic balance disorders but further research is required.
Importantly, Claire emphasises the need for careful patient selection and setting realistic expectations. Future implementation should be backed by further clinical trials and research to identify which subgroups will benefit most. Despite the need for more evidence, the early results suggest the BalanceBelt could fill a critical gap in treatment where current medical and physiotherapy options are limited.
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