Vestibular Rehabilitation Flashcards
What are the reported symptoms when a client is dizzy and what are the reported symptoms of vertigo or oscillopsia?
Vertigo: Sense of self-movement or spinning with a stationary environment.
Oscillopsia: Self is stationary and objects in the environment are moving.
Dizziness:No specific symptoms, “Light-headed”
What are the anatomical components of the peripheral vestibular system?
•Otolith Organs
- Utricle
- Saccule
•Semicircular Canals
- Anterior
- Middle/Horizontal
- Posterior
What are the three parts of the central processing system?
- Vestibular Nuclei
- Receives input from the vestibular nerve
- Provides reflexive motor outputs
- Vestibular Cortex
- Cerebellum
- Receives input from the vestibular nerve
- Modulates motor activity
What is the VOR and the VSR and what is the function of each?
- Vestibulo-Ocular Reflex (VOR)
- Connection between vestibular nuclei and extra-ocular eye muscles
- Keeps gaze on an object
- Fixates on a visual target
- Vestibulospinal Reflex (VSR)
- Direct connection of vestibular nuclei to paraspinal muscles for an auutomatic reflex
- Cerebellum adjusts vestibular processing and reflexes
What is the difference in symptoms between a peripheral and a central vestibular pathology?
Peripheral vs. Central Pathology
Peripheral-organs/easy to treat
- Intermittent
- Motion Provoked
- Nausea and vomiting
Central-brain/ higher level processing-not easy to treat
- Constant
- Not dependent on motion
- Fluctuations in intensity
How is the vestibular system assessed? Which assessment indicates a peripheral pathology and which assessment indicates a central pathology?
Symptoms demonstrated with:
- Position changes
- Rotation of the head
- Visually tracking a moving target
- Weather or temperature changes
- Driving
- Moving in standing or sitting
- Intensity, frequency, and duration
Central Vestibular Pathology
Demonstrate symptoms with:
- Smooth pursuit
- Saccades
- VOR
- Visual acuity
Peripheral Vestibular Pathology
•Hallpike-Dix Maneuver
What is the VOR assessment?
•VOR
–Look at pen
–Move head left and right
–Move head side to side
Identify interventions for vestibular deficits.
Central Pathology:
- Gaze Stabilization x1 Viewing.
- Fix eyes on target and move head side to side
- Gaze Stabilization x2 Viewing
- Stare at one object
- Shift eyes only toward second object
- Move head toward other object
- Gaze stabilization of visual target
- Stare at object and then close eyes
- Turn head, keep eyes closed, and keep eyes in direction of object
- Open eyes and check for accuracy
- Progress sitting to standing
- Progress with plain background to busy background
Intervention- to grade, remove one of these other components
Balance
- Proprioception
- Visual
- Vestibular
- •Static standing
- Reaching
- Catching
- Dynamic
- Combine
