 vestibular disorders
8
Patients with vestibular (inner ear) disorders are often referred to physical and/or occupational therapy for primary symptoms of balance disorders and movement-related dizziness. In addition, many of these patients have developed secondary symptoms associated with reduced activity levels, such as decreased strength, loss of range of motion, and increased tension, leading to muscle fatigue and headaches. Therapy helps to alleviate primary and secondary symptoms
The vestibular problem of dizziness and disequilibrium is second only to low-back complaints in frequency of occurrence among adults. Dizziness in itself is not a disease, rather the symptom of a problem within the peripheral and/or central nervous system. There are many causes of dizziness; however, it is estimated that 85% of dizziness is a result of pathology within
the peripheral vestibular system.
- Vertigo (dizziness).
- Nausea.
- Balance and equilibrium problems.
- Poor tolerance for change in direction and speed of movement.
- Gravitational insecurity.
- Poor awareness of position in space.
- Difficulty with motor planning and execution of movements.
- Visual motor problems.
- Anxiety and stress.
Vestibular rehabilitation is an exercise approach to resolve disequilibrium and dizziness symptoms. Therapy intervention is directed to provide activities for the vestibular system’s gradual reeducation and reintegration. Therapy begins with lower-level movement exercises and calming activities, and progresses to increased movement and visual motor experiences as tolerated. Movement and visual compensation techniques are included to help the patient adjust to the problems of dizziness and balance.
Activities are presented to help the body relearn how to adjust and adapt. A customized home exercise program helps patients to increase trunk stability for movement coordination.
In assessing a patient with a vestibular disorder, SR focuses on five major areas:
- Musculoskeletal assessment
- Eye-Head Coordination and Gaze stabilization.
- Postural control
- Gait analysis.
- Vertigo Assessment: includes provocation test.
Musculoskeletal assessment: This test includes range of motion, strength, sensation and coordination.
Eye-Head Coordination, Gaze stabilization: Oculomotor control is tested and visual-vestibular interaction and gaze-fixation suppression are assessed.
Postural control: This examination includes sitting, standing, movement- strategies, and sensory organization.
Balance and Gait Assessment: Static and dynamic balance skills are assessed, including balance during gait. The patient’s use of appropriate movement strategies in balance control is also examined.
Vertigo Assessment:A questionnaire and movement tests are used to identify triggers of dizziness, its frequency of occurrence, symptom severity, and lifestyle impact. .
After vestibular assessment, a list of patient problems is generated, short- and long-term goals are established, and the patient is placed on an appropriate exercise program.
The exercise treatment of a patient with vestibular disorder focuses on improving balance function, decreasing dizziness symptoms, and increasing overall activity levels for long-term retention of gains made in therapy. A patient may receive only vestibular habituation exercises, if balance function is not affected.
Vestibular Habituation Exercises: repetitive exposure and exercises to help the brain habituate or attenuate the vertigo response
Balance Retraining Exercises: exercises to improve coordination of muscle responses and organization of sensory information for balance control
General Stamina and Endurance: a home-centered program of aerobic activity to ensure that the patient maintains vestibular improvements.
At SR, a licensed physical or occupational therapist with specialized training in vestibular therapy and rehabilitation is authorized to perform the treatment.
We recommend comfortable clothing with an elastic waistline, such as shorts. Jogging suits and shoes are also suitable.
|
