Vestibular Practical

Question 1

Three types of vestibular dysfunctions

Answer 1

imbalance (postural), vertigo/dizziness, oscillopsia/blurred vision

Question 2

postural imablance is a ____ tract problem

Answer 2

vestibulospinal

Question 3

caused by impaired ability to resolve sensory conflicts/head positions

Answer 3

vertigo/dizziness

Question 4

caused by dysfunction of VOR control

Answer 4

blurred vision

Question 5

Best impairment level measure for VOR testing

Answer 5

Head thrust test

Question 6

helps determine most provocative movements while also acting as an intervention

Answer 6

motion sensitivity quotient

Question 7

postural imbalance outcome measures for vestibular dysfunction

Answer 7

rhomberg, SR, SLS
CTSIB
Berg Balance Scale (not impairment lvl)

Question 8

pt. is unable to stabilize vision during head movement

Answer 8

VOR impairment

Question 9

pt. is unable to distinguish self movement from environmental/visual movement

Answer 9

dizziness/vertigo

Question 10

pt. is unable to maintain balance, posture, and gravity orientation

Answer 10

disequilibrium (VST)

Question 11

“I lose my balance and fall a lot”

Answer 11

VST balance dysfuntion

Question 12

“I have blurred vision or bouncing vision”

Answer 12

VOR problem

Question 13

“The room is spinning”

Answer 13

vertigo

Question 14

“I feel dizzy or drunk”

Answer 14

sensory conflict

Question 15

How would you differentiate between vertigo and sensory mismatch

Answer 15

vertigo is positional change-use Motion Sensitivity Score
Sensory mismatch can be from dizziness with visual conflict- use VMS (pt holds thumb in front of them while facing a busy part of the clinic, they move as a unit, and tries to keep focus on their thumb. Ask about dizziness VAS)

Question 16

Error signal for balance

Answer 16

falling, increased sway

Question 17

error signal for sensory conflict

Answer 17

dizziness

Question 18

error signal for VOR

Answer 18

double-vision or blurring

Question 19

Interventions for balance

Answer 19

establish ability to use hip, ankle and stepping strategies in the correct context

Question 20

Interventions for Dizziness

Answer 20

use visual and/or somatosensory cues to re-educate vestibular system and then gradual withdraw those cues. Treat in 1st position which provokes symptoms

Question 21

interventions for VOR

Answer 21

improve visual blurring-fixate on thumb maintaining clear image during head motion at 2 Hz or above and progress to image on the wall.
Gaze stabilization - walking with fixation, progress to head turns in walking with fixation and perhaps slow run

Question 22

General principles of vestibular rehab

Answer 22

change environment to require adaptability.
treatment begins at the level that symptoms occur.
exercises must provoke the symptoms.
2-3 weeks to improve on the exercise program

Question 23

Vestibular Rehab exercises

Answer 23

do about 4 exercises max 3-5x/day.

Provide an exercise for each of the symptoms (imbalance, blurred vision, dizziness)