Vestibular Rehabilitation (Main Lecture + Vestib Review and Lab)

Question 1

Things included in the hx of Vestibular impairment

Answer 1

Cause? Hx of dizziness? How long does it last?

Question 2

Following hx, try to determine nature of vestibular impairment by comparing what 2 things?

Answer 2

Peripheral (inner ear) vs. Central (BS/CNS)

Question 3

Peripheral Vestibular Impair typ includes what?

Answer 3

• Vertigo
• Sx’s provoked by change in position/head mvmt and fluctuates
• SUDDEN ONSET

Question 4

Central Vestibular Impairment

Answer 4

• Sx’s more persistent (lousy all day long)
• Typ have other sx’s/complaints
• Sx’s often more vague

Question 5

How should you structure your Tests & Measures during vestibular exam?

Answer 5

Base them on suspected cause

Question 6

Central vs. Peripheral Tests

Central

Answer 6

• Smooth pursuit
• Saccade
• VOR cancellation
• Vergence
• Optokinetic nystagmus
  
  • nystagmus changes patterns
  • you should be able to trigger nystagmus

Question 7

Central vs Peripheral Tests

Peripheral

Answer 7

• Head Thrust
• Head Shaking → if B/L
• Dynamic Visual Acuity
  
  • eye chart one
  • *remember→ nystagmus beats to side of stronger side bc it gets pulled over

Question 8

Central vs Peripheral Tests

Mixed Tests

Answer 8

• Gaze holding
• Balance testing
  
  • SOT
• Bucket Test

Question 9

Central vs Peripheral Tests

Other tests

specifically Strabismus (lazy eye)

Answer 9

Cover/Cross Cover

Question 10

Findings: Central vs Peripheral

Central:

Answer 10

• Purely horiz. or vert. nystagmus
• Nystagmus that changes directions
• Often diffuse balance diff.
• Unremitting positional nystagmus

Question 11

Findings: Central vs Peripheral

Peripheral

Answer 11

• Nystagmus will follow Alexander’s Law
  
  • Look in direction of nystagmus= when nystagmus is stronger
• Impaired VOR
• BPPV
  
  • Benign Paroxysmal Positional Vertigo

Question 12

BPPV is a _______ problem

Answer 12

mechanical

Question 13

Describe BPPV

Answer 13

Crystals (otoconia) are dense and move into the canal

*creates a false sense of mvmt

Question 14

Different types of BPPV?

Answer 14

• Canalithiasis
  
  • Free floating crystals
• Cupulolithiasis
  
  • crystals stuck in gel materials

Question 15

How common is BPPV?

Answer 15

VERY!!!

Question 16

Tests and Measures for BPPV?

Answer 16

See Rachel quizlets

Question 17

+ Finding for BPPV?

Answer 17

Vertigo

Nystagmus

Question 18

How do you know which canal the crystals are in for BPPV?

Answer 18

• LOOK AT NYSTAGMUS!!
  
  • UPbeat== Posterior canal
  • DOWNbeat== Anterior canal

Question 19

Tx maneuver recommended for Posterior Canalithiasis?

Answer 19

Mod. CRT/Epley’s

Question 20

When is follow-up for BPPV Tx?

Answer 20

• Tell them NOT to limit anything
• No serious restrictions
• Do what you’d normally do
• Teach them self-Tx

Question 21

pathological features of PD