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Treatment Considerations for the Vestibular Patient

Treatment Considerations for the Vestibular Patient. Treatment Considerations: Balance and Vestibular Activities. Think of activities that can provide the most “bang for the buck” for your patient. Always consider your patient’s goals and your clinical goals for treatment.

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Treatment Considerations for the Vestibular Patient

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  1. Treatment Considerations for the Vestibular Patient

  2. Treatment Considerations: Balance and Vestibular Activities • Think of activities that can provide the most “bang for the buck” for your patient. • Always consider your patient’s goals and your clinical goals for treatment. • Be sure to assess the patient’s balance and gait before formulating a treatment plan i.e Berg or DGI • A Home Exercise Program is the first step for treatment of the dizzy patient.

  3. HEP Eye Exercises: What are the Positive Findings for Treatment? Positive Findings Treatment Considerations • Smooth Pursuits • Saccades • Vergence • VOR Cancellation • Smooth Pursuit exercise • 2 Target Exercises • Pencil push-ups, Brocks String. • Head turns with target moving in same direction.

  4. HEP VOR/Gaze Stabililization Exercises Exercise Rationale and Goals • X1 Viewing • X2 Viewing • X1 Walking (Hall 2016) • Promotes VOR in sitting, standing and with gait. • Goals: • Reduce dizziness • Improve DVA

  5. Combining Balance and Vestibular Activities (McDonnell, 2015) Activity Rationale • Alternating Tap Ups , Step Ups with Head Turns using 2 Targets • Foot on step with head turns • Promotes rhythmic weight shift, coordination and vestibular function • Promotes vestibular function and single leg stance

  6. Combining Balance and Vestibular Activities Activity Rationale • Standing with head turns using 2 targets on variable surfaces. • Walking and sidestepping with head turns • Over the shoulder ball toss on variable surfaces and with gait. • Promotes vestibular function and balance strategies • Promotes vestibular function and gait stability. • Promotes vestibular function and balance strategies.

  7. Patient Example • 40 year old patient with c/o severe dizziness several months ago, now presents with mild oscillopsia, intensity 6/10. Script states R42 Dizziness and Giddiness • Positive tests include: • Pos head thrust to the right, head shake with left-beating nystagmus, abnormal DVA with 0.7 logmar • Berg: 45, DGI: 18

  8. Patient Example • What is your clinical diagnosis? • What are some treatment considerations? • What are your goals for treatment?

  9. Questions?

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