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vestib rehab

What is cupulolithiasis? part of otoconia is floating in canal and sticks onto cupula. With Dix, >60s duration of nystagmus
What is canalithiasis? free floating debris in canal bounce off of cupula in certain positions. WIth Dix, <60 s duration of nystagmus
what type of vestibular dysftn is BPPV? distorted- different positions will cause nystagmus/vertigo sensation
what type of vestibular disorder is Post Vestibular Neuritis? hypoftn due to viral infection of CN 8/ idiopathic
s/sx of PVN? severe rotational vertigo, spontaneous horiz nystagmus, imbalance, nausea
what are causes of hypofunction? viral infection, age related changes, ototoxicity, trauma, cancer
what is the px for PVN? improves in 48-72 h, resolves w/in 6 wks
what is the px for Meniere's? most acute sx resolve 24-36 h, near recovery days to wks, cumulative loss over time
what are s/sx for Meniere's? episodes of hearing loss/ vestibular dysftn caused by blocked endolymph flow
what type of vestibular disorder is perilymph fistula? fluctuating ftn disorder caused by fistula bt middle ear and perilymph. some kind of auditory stimulus then vestib sx. Caused by head trauma (eg diving)
what type of information does the ABC scale provide? 16 items of everyday tasks: walk around house, reaching at eye level, pick up slipper from floor, walking in crowded mall, step onto/off escalator. Can pt perform w/o loss of balance/becoming unsteady?
What is the singleton's test? Pt walks forward with EC for 3-4 steps, pivots and stops without falling/loss of balance
what is the fuduka's marching test? pt marches in place for 50 steps with EC on a grid. Obs whether pt moves fwd/bkwd, side-side
what is the dixi-hallpike test used for? it is a DX test for BPPV in the A/P canals.
Describe the Dix Hallpike Manuever Pt begins in long sitting, head is turned to 45 degrees. Pt is quickly put into supine, inverted head to 30 degrees. Note onset, duration and direction of nystagmus
What is the adaptation approach? Used to address hypofunction pathology. Try to rebalance tonic activity in vestibular nuclei.
What is the substitution approach? Helps to address absent vestibular ftn and central deficits. Trying to reweight use of sensory systems, i.e. with visual/somatosensory information
What is the habituation approach? Useful for distorted vestibular ftn, like BPPV. Increasing stimulus will decrease respone over time
What is the point of using repositioning manuevers? This is used in hopes of moving loose debris through the canal and back into the otolith
Explain an example of the adaptation approach with VOR/gaze stability. Visual fixation with head turning. Variables: increase speed of turning, visual background, direction of head mvmt, size of word, sitting/standing, walking on uneven surface
Indication for Epley? For canalithiasis of A/P canals
Indication for Brandt-Daroff ex? Cupulolithiasis of A/P canals, recalcitrant canalithiasis, habituation
Indication for habituation exercises? Nonspecific positional dizziness, central deficits. Sx should decrease with exercises
What are some exercises for substitution approach in gaze stability? visual fixation on a stat target; active eye-head mvmt bt two targets, imaginary targets
Goal is to decrease visual over-reliance. What can you do for Rx? provide accurate somatosensory inputs, gradually reduce visual inputs, gradually increase need to process visually complex info
Goal is to decrease over-dependence on somatosens inputs. What can you do for Rx? reduce ss inputs, gradually reduce surface and visual cues. EX: balance activities on foam, carpet, progress to less visual cues
Goal: enhance use of vestibular inputs. What can you do for Rx? Gradually reduce visual/ss inputs. EX: balance activity on foam with decrease BOS, progress by reducing visual cues
Goal is to improve verticality/alignment. What can you do for Rx? Use knowledge of results with re: body position, increase sensory fdbk. EX: mirror,midline orientation, cognitive/perceptual retraining
Goal is to retrain perceptioni of LOS. Use knowledge of results with sway and stability limits, encourage conscious use of surface and visual orientation Use knowledge of results with sway and stability limits, encourage conscious use of surface and visual orientation inputs. EX sway practice with EO, EC
Created by: 2rabbits