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Management of patients with vestibular disorders is a complex problem. Dizziness and balance problems account for 5% to 10% of all physician visits and affect 40% of people over age of 40. Dizziness is the number one reason for physician visits by people over the ago of 45.
Indications:
- Benign Paroxysmal Positional Vertigo
- Labyrinthitis
- Vestibular neuronitis
- Chronic vestibulopathy
- Disequilibrium of aging
- Post-surgical imbalance
- Connective tissue disorders
- Bilateral vestibular weakness from ototoxicity
- Meniere’s syndrome
- Perilymph fistula
- Vertigo of unknown etiology
Referral Sources:
A referral for physical therapy should be made after appropriate medical diagnostic testing has been completed.
- Otolaryngologists
- Neurologists
- Any physician
Physical Therapy Evaluation consists of the following:
- Extensive interview with the patient regarding symptoms, chief complaint and functional limitations.
- Neuromuscular examination (muscle strength, range of motion, sensation, posture, tone)
- Oculomotor exam (smooth pursuit, vestibulo-ocular reflex, saccades)
- Positioning exam (Hallpike-Dix, Motion Sensitivity Qoutient)
- Balance/postural control evaluation (using functional, outcome-based measures)
Treatment Program:
Each program, individualized for the patient, may include:
- Education
- Home exercise program
- Habituation exercises
- Eye exercises
- Balance exercises
- General conditioning activities (e.g. walking)
- Pertinent functional activities impacting the patient’s life or work
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