BALANCE / FALL PREVENTION – VESTIBULAR DISORDERS AND REHABILITATION

Vertigo is a type of dizziness that causes the person to experience a sensation of motion, it is the most common complaint by patients when the vestibular system is involved.

This can result from a fall, stroke, brain injury or other traumatic injuries or diseases as well as from dysfunctions within the vestibular system such as Benign Paroxysmal Positional Vertigo (BPPV), peripheral vestibular dysfunction, vestibular neuritis, acoustic neuroma and migraine associated dizziness, among others. Symptoms may include the feeling of tilting, spinning or swaying and can last for a few seconds too days in some individuals.

Vestibular disorders are usually not life threatening but can result in significant disability, thus resulting in the decrease of an individual’s quality of life. It is important to first see your physician to determine the cause of your symptoms to rule out more serious medical conditions.

Our Vestibular Rehabilitation program is designed to diminish/ reduce symptoms of dizziness or loss of balance.Treatment includes risk reduction for falling or loss of balance, canalith repositioning maneuver by your physical therapist, exercises to strengthen your systems of balance and instructions on compensatory strategies that will help you adapt to improve your quality of life.

BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV)(GOODMAN & FULLER, 2009)

  • A mechanical disorder of the inner ear
  • Characterized by episodes of vertigo with changes in head position
  • May wake up dizzy after changes in position at night time.
  • Represents ~20-40% of peripheral vestibular problems
  • 20% involves more than one canal

VESTIBULAR NEURITIS (GOODMAN & FULLER, 2009)

  • The second most common cause for vertigo
  • Often caused by a viral infection
  • No cochlear involvement (hearing usually spared)
  • Head movement cause blurred vision
  • Perception of rotation (to the involved side when eyes are closed and opposite side when eyes are open)

ENDOLYMPHATIC HYDROPS (GOODMAN & FULLER, 2009)

  • Menier’s syndrome is the most common form
  • Episodes of vertigo due to pressure changes within the closed fluid system causing vestibular and cochlear dysfunction
  • Initial fullness of the ear , a reduction of hearing and Tinnitus (ringing of ears). This is followed by rotational vertigo, imbalance in posture, nystagmus and nausea.
  • Can last from hours to days

PERILYMPH FISTULA (GOODMAN & FULLER, 2009)

  • Vertigo caused by abnormal communication of the middle and inner ear spaces
  • May result from congenital malformations, pressure applied to external ear or from prior ear surgery
  • Symptoms decreased with rest and increases with activity
  • Symptoms may also increase with the Valsalva maneuver (forcibly exhaling while keeping nose and mouth closed)
  • Fistula may be caused by heavy lifting, sneezing, head trauma or overaggressive exercise.

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