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Main Clinic: Heritage Courtyard • 54 Oakway Center • Eugene, OR 97401 • 541-687-7005 | Downtown Satellite:1410 Oak Street, Suite 100 • Eugene, OR 97401 • 541-345-2064

Vestibular Rehabilitation




Jeff Giulietti
Jeff Giulietti,
MPT, ATC, OCS, CSCS, COMT, FAAAOMPT



Michale Young
Michael Young, DPT, OCS, CSCS


Eugene Physical Therapy

Vestibular Rehabilitation is an exercise approach to the remediation of disequilibrium and dizziness symptoms association with peripheral  vestibular pathology.3   In layman terms, it is the approach to using exercise to improve and/or completely resolve problems involving dizziness and balance deficits.  The use of exercises at it’s effectiveness to treat patients with vestibular dysfunction has been well documented. 1

Positional Exercises proposed by Brandt and Daroff in 1980 were among the first effective exercises. 2  The field has rapidly progressed since this time.

Treatment of the "dizzy" patient involves a comprehensive evaluation, looking at the following factors:

  1. Complete Subjective and Functional History
  2. Clinical Testing for Benign Paroxysmal Positioning Vertigo (BPPV) involving occulomotor examination.
  3. Motion Sensitivity: motion/position inducing dizziness
  4. Positional Testing
  5. Balance
  6. Gait
  7. Coordination Testing
  8. Cervical ROM testing (inclinometry)
It is rare for individuals to have a deficit in only one area, with most patients having overlapping deficits that contribute to their problem.  For example, it is common for patients to have dizziness after trauma to the cervical spine.  The upper cervical spine has a high density of mechanoreceptors involved in head and eye coordination.  If motion is not regained, the upper cervical spine also can be a source of dizziness; this area is very often overlooked, when it may either be the primary or secondary cause of the symptoms.

Our staff has the dual training of orthopedic manual therapy including osteopathic approaches, combined with training of current scientifically validated vestibular rehabilitation. Our staff has studied with staff from Johns Hopkins University and Emory University, two leading institutions involving research for vestibular rehabilitation.

REFERENCES

  1. Buttner U.  Vestibular Dysfunction and it s therapy.   Karger.   New York.  1999  169-174

  2. Herdman SJ.   Vestibular Rehabilitation 2nd ed.   F.A. Davis.  Philadelphia.  2000  387-424

  3. Shumway-Cook, A.   Vestibular RehabilitationVestibular Disorders Association,   Portland. Chapter F-7.  1/2001

EUGENE PT CASE STUDIES

CASE #1
CASE #2


For further information these websites may be helpful resources:

VESTIBULAR DISORDERS ASSOCIATION (VEDA)

ACOUSTIC NEUROMA ASSOCIATION

AMERICAN ACADEMY OF OTOLARYNOGOLY - HEAD & NECK SURGERY

AMERICAN NEUROTOLOGY SOCIETY

AMERICAN PHYSICAL THERAPY ASSOCIATION - NEUROGLOGY SECTION

ASSOCIATION FOR RESEARCH IN OTOLARYNGOLOGY

NIDCD - HEARING & BALANCE PATHOLOGY RESOURCE CENTER