Vestibular Disorders Flashcards
What are VRT exercises useful for?
They are useful for both peripheral and central vestibular disorders that benefit from movement retraining.
What is the purpose of VOR x 1 exercise?
To improve visual acuity and decrease blurring of the head with movements.
What is the primary goal of VOR x 2 exercise?
To train the patient to maintain focus on a moving target while the head is moving in the opposite direction.
How should VOR exercises be performed for effectiveness?
They should be performed at a challenging speed where the target can still be kept in focus with effort.
What is the role of retinal slip in VOR exercises?
It creates an error signal to the brain, leading to recalibration and improvement of the VOR.
What is the importance of gaze shifting exercises?
They are easier for some patients to tolerate and are useful for severe vestibular loss.
What are 2 Target VOR exercises?
Exercises where the patient alternates focus between two targets, moving eyes first, then the head.
What is the purpose of habituation exercises?
To reduce symptoms by repeated exposure to movements that produce dizziness, leading to desensitization.
Who benefits most from habituation exercises?
Patients with motion sensitivity after a vestibular problem, especially in subacute/chronic stages.
What is the typical prescription for habituation exercises?
3-5 repetitions of the provoking movement, 3-5 times a day, with pauses for symptoms to subside.
What are static balance activities for vestibular patients?
Balancing without upper extremity support, ball toss, weight shifting on various surfaces.
What are some dynamic balance activities for vestibular patients?
Gait with head turns, eyes open/closed, multidirectional stepping with head turns.
What does the Clinical Practice Guideline (CPG) say about VRT outcomes?
There is strong evidence that VRT improves outcomes, especially with earlier intervention.
What is the recommended gaze stability dosage for acute/subacute UVH?
3-5 times per day, with a total of 12 minutes per day for 4-6 weeks.
What is the recommended gaze stability dosage for chronic UVH?
3-5 times per day, with a total of 20 minutes per day for 4-6 weeks.
What is the recommended gaze stability dosage for BVH?
3-5 times per day, with a total of 20-40 minutes per day for 5-7 weeks.
What balance exercise dosage is recommended for chronic UVH and BVH?
20 minutes per day for 4-9 weeks.
Why is patient education crucial in vestibular rehabilitation?
Educating the patient on the importance of the exercises and how they contribute to recovery.
How should patients be educated about provoking dizziness during exercises?
Explain that dizziness is part of the process and should subside quickly after the exercises.
What precautions should be taken in VRT for patients with migraines?
Start slowly, and progress exercises gradually to avoid exacerbating symptoms.
What are contraindications for VRT?
Unstable vestibular disorders, uncontrolled migraines, sudden hearing loss, CSF leaks.
What is the importance of using visual fixation during acute vestibular episodes?
To compensate for lost VOR by focusing on a visual target while walking.
What is the role of assistive devices during vestibular rehabilitation?
They provide stability and support, helping the patient regain confidence and balance.
How can balance exercises be progressed in vestibular rehabilitation?
By gradually increasing the difficulty level and incorporating more challenging tasks.
What are some strategies to improve patient adherence to VOR exercises?
Use creative strategies like reading charts, balancing on challenging surfaces, and dual tasking.
What is the significance of the Dix-Hallpike and Roll Test?
Tests used to diagnose Benign Paroxysmal Positional Vertigo (BPPV).
What interventions are indicated for BPPV?
Canalith Repositioning Maneuvers.
What training strategies should be used once movement is tolerated in vestibular patients?
Progress gaze stability, habituation, balance exercises, and overall conditioning.
How should you start VOR exercises for a patient with severe vestibular loss?
Start slow and with plain backgrounds, progressing as tolerated.
What is the role of relaxation and breathing exercises in VRT?
They help manage anxiety and prepare the patient for the exercises.
