Vestibular rehab

Question 1

categories of dysfunction

Answer 1

• peripheral dysfunction: unilateral hypofunction, bilateral hypofunction, BPPV

Question 2

treatment of hypofunction

Answer 2

• goal for balance and gaze stabilization
• faciliatate recovery as much as possible
• facilitate compensation

Question 3

general gaze stabilization

Answer 3

• uses an error signal to stimulate adaptation of the CNS
• CNS attempts to reduce the error signal by modifying the gain of the vestibular system
• adaptation takes time
• stimulus specific
• adaptation is affected by voluntary motor control
• patient should work to their limit

Question 4

adaptation take time..

Answer 4

• CNS needs 90 sec- 2 mins of a consistent error signal in order for adaptation to occur
• the brain is trying to reduce the error signal during that time
• tolerance of 2 minutes is of paramount importance when progressing VOR

Question 5

indications of gaze stabilizations

Answer 5

• dizziness with hea dmotions
• poor visual acuity with hea dmotions
• movement of visual worls with hea dmotions

Question 6

treatment variables of gaze stabilization

Answer 6

- duration
background
position
speed
freq
distance
weighting systems

Question 7

gaze stabilization functional goals

Answer 7

• turn head while talking to others
• brush teeth
• ADLs: cooking ,cleaning, making beds
• walk through a grocery store
• cross a busy street
• scroll down a document on the computer

Question 8

balance training

Answer 8

• should foster the use of the visual somatosensory and vestibular cues by alternately stressing the various systems

Question 9

common balance complaints

Answer 9

• disequilibrium with hea dmotions
• loss of balance with head motions
• high risk of falls with head movements
• loss of balance with walking
• dizziness while walking
• difficulty ascending and descending stairs
• difficulty walking on uneven terrain

Question 10

altering the visual environments

Answer 10

• eyes open to close
• light to dark
• simple to complex visual environments
• small to large range head motions
• slow speed to fast speed head movements
• straight plane to combiniation plane motions
• quiet to progressively busy environments
• clear path ambulation to obstacles courses

Question 11

altering somatosensory cues

Answer 11

• feet apart to feettogetehr to one in front
• firm surface to complaint surface/uneven surface
• sitting to standing to walking
• walking forward to backward to sideways
• clear hallway to obstacle course

Question 12

balance variables

Answer 12

-speed of ambulation
distance
direction
base of support
hea dmotion