Vestibular Rehabilitation Paper

The days seemed to go by slower and slower each day. Empty dark rooms are

4) Neurological Rehabilitation Programs - For serious conditions like Parkinson's diseases, strokes and vestibular diseases, there is a need for in-depth knowledge and customised treatment plans to render results on a long term basis.

Patients will report to physical therapists with a multitude of impairments throughout the progression of the disease. The most prominent impairments will present during cerebellar testing. Patients will show signs of dysmetria, dysphasia, dysdiadochokinesia, and ataxia primarily as a result of the atrophy and damage to the cerebellum. Instability and lack of postural control will be demonstrated during the Romberg's test. Additionally, cranial nerve testing will have positive results for many cranial nerve palsies such as CN III, V, VII, IX, and XII. Patients show weakness in their trunk and extremities during the manual muscle testing. Vestibular testing will result in abnormal VOR, saccades, smooth pursuits and nystagmus. As a result of these impairments, patients experience functional limitations. Primarily, these patients are considered to be “high fall risks,” which ultimately decreases their independence due to weakness, instability and decreased postural control. These patients will feel uncomfortable in many situations and be unable to function independently in the community. This creates an increased risk for further injury. Due to the dysmetria and weakness, patients will also experience difficulty with their daily living skills, such as maintaining proper hygiene; They will have trouble bathing themselves and brushing their teeth without assistive equipment. PT interventions can help minimize and control these limitations. The implementation of balance training and assistive devices will be imperative interventions for an individual to modify and adapt to their gait

However, client demonstrate deficit in narrow BOS balance and tandem standing balance with closed eyes and slight resistance. In addition, client was concerned about her balance during one leg rising with opposite hand raising gym exercise. Client will attend occupational therapy services 3x per week and will be able to stand on balance board for 1 minute with wider BOS while holding side bar to improve her balance. For long term goal, client will attend occupational therapy services 3x per week and will be able to stand independently on balance board for 1 minute with narrow BOS to improve her endurance, strength and balance while standing. Client will get education from an occupational therapist for increasing her BOS while standing, and to hold side rail while walking/exercising to avoid future fall accident. It is also recommended that client will attend outpatient physical therapy service to address her balance

Summary: Alfred Griffin is a 69-year-old male who was referred to MRS by Sterling Hearing Center. A comprehensive orientation was provided in the office on 8/3/17, to Alfred and his wife Robin. During the meeting this counselor reviewed agency services; the employment purpose of MRS programming; that an employment outcome shall be in an integrated setting; eligibility criteria; services available through MRS and the statewide workforce investment system; the individualized nature of the program; the requirement to use other sources of funds before MRS can pay for services; how the applicant will be involved in making informed choices regarding their rehabilitation program; customer contribution; the agency’s order of selection for

MS is a disease that involves that demyelination of the neuromuscular system (cite). This autoimmune disease is characterized by extreme fatigue and limited mobility; this in turn affects his or her balance. In this study done by Dr. Jeffrey Herbert and company, thirty-eight subjects underwent a fourteen-week single-blinded, randomized controlled trial aimed to combat vestibular deficiency using a VR program and exercise protocol for endurance training. The subjects were then randomly allocated into three separate groups: experimental intervention (12), exercise intervention (13), and control (13). Additionally, the following weeks were organized into three phases: 1. Measuring the patient’s baselines (Week 1-4) 2. Performing the interventions in a human performance laboratory (Week 5-10) and 3. Measuring the outcomes (Week 11-14). The experimental group worked on a VR program that has clinical and literature based evidence that includes upright postural control and eye movement exercises (cite). A firm surface, foam cushion, and tiltboard were all used to change the base of support (BOS) during upright postural control, in addition, the investigators also challenged the subjects by closing/opening their eyes, tossing objects for them to catch, and changing their feet placement (shoulder width, heels together, partial heel to toe, and tandem). The eye movement exercises for the protocol

Today’s technology makes it very easy for those from the hearing world and deaf world to communicate. Deaf Rehab doesn’t mean I will only work with deaf or hard of hearing people but also with those that are deaf-blind. So when it came to find a medical breakthrough, I decided to focus on technology that I would be able to use throughout my career. Technology has helped the medical field come so far and because of that new technology there are so many advances in the medical field that help our lives better. Recently videophone technology was invented to help deaf-blind people communicate on their phones and was tested on students ranging from 16 to 20 (Emerson & Bishop, 2012). It was a major breakthrough because the success of this technology could determine whether or not the deaf-blind can effectively communicate with one another with the use of a handheld device or from their computers, rather than having a signer/interpreter with them at all times or having to use bulky, hard to carry devices like the

It involves using a series of body, eye and hand maneuvers. These exercises help retrain and stimulate the vascular system. The American Academy of Neurology has found the Epley Maneuver to the be the most effective form of therapy for BPPV. It involves performing clinician-guided, safe head movements. It only takes a few minutes to perform the Epley Maneuver. The goal of this treatment is to get the crystals to move from the posterior semicircular canal into another inner ear canal. Habitation is another treatment that can be used for BPPV. It involves teaching the patient how to perform Brandt-Daroff exercises, which teach the brain to not stimulate the vertigo response. Home exercises and medications to control the symptoms are also available. In rare cases, surgery is

Balance of the human body is the secret to alleviation of internal and external pain and dysfunction. Understanding the possible underlying causes to a specific issue is the most important concept when beginning the task of “rebalancing” the body (i.e. daily activities, past trauma, congenital defects, sleeping patterns etc.). Once you’ve taken into account the possible and definitive subjective negatives, using an objective process of elimination and assessment will confer the ultimate treatment plan and goals. Certain aspects of actual implementation are majorly intuitive, although the basics can be easily explained. In other words, only through practice and experience using this modality can any one person become highly effective. The Table

When treating patients with Meniere’s disease you will notice that all patients have different levels of balance disturbances and degrees of hearing loss. The degree of symptoms a patient experiences will justify which surgical option the patient will undergo. The non-destructive surgeries aim at reversing endolymphatic hydrops and preserving the patient’s hearing by endolymphatic sac decompression.1 Destructive procedures like chemical or surgical labyrinthectomy, and vestibular nerve section result in vestibular deafferentation of the inner ear. Preserving the patient’s hearing is the goal in vestibular nerve section, and to a certain extent chemical labyrinthectomy. Unfortunately surgical labyrinthectomy will result in definite hearing loss for the patient.1

This approach initially uses patient generated forces in the form of active range of motion (AROM), usually to the end of the available range. If the patient generated forces are successful to improve the patient’s presentation, then there is no need to employ manual therapy techniques. If the patient generated forces are unable to fully resolve the patient’s symptoms, then manual therapy techniques are utilized; however, the initial manual therapy techniques are applied with the least amount of force possible in an attempt to resolve the patient’s symptoms, and are only progressed to a more forceful technique if the patient’s symptoms failed to resolve with the initial technique. In other words, manual therapy is only used when the patient is unable to resolve their symptoms through end range AROM.23(p446) The MDT approach offers an additional safeguard. If manual therapy is needed, the integrity of the structures to be mobilized would have been fully tested by virtue of the patient performing numerous end range AROM exercises prior to the manual therapy, and any potential issues with structures to be mobilized or manipulated would likely have been exposed prior to the manual technique. 23(p446) Being trained and certified as a MDT therapist helps to mitigate the risk associated with treating patients with an acute lumbar

Therefore, when the target was met it served as an automatic performance feedback component of motor learning. This target also served as a visual feedback for symmetry during arm swing when walking. If the pt was able to hit Dr. Morgan’s face on both sides, then that signified that he had a symmetrical reciprocal swing. Weight sifting in half kneeling stance was also performed utilizing the harness. This exercise was done bilaterally. The pt was asked to weight shift from side to side while keeping an upright posture. Dr. Morgan once again used NDT cues to guide the patients posture which seemed to be very effective for this patient. Similarly, the pt also performed tall kneeling exercise where he worked on slouching and then returning to an upright posture while the PT was behind him to help to provide additional truck stability. These exercises being performed with the harness as discussed in class allows the patient to perform the task as much as they possibly can on their own. It allows for progression as you can progressively release more body weight for the pt to hold up on his own. The pt seemed to respond very well to the therapist and her requests and was compliant. He seemed willing to try anything Dr. Morgan wanted him

The parameters which were measured were: total excursion of COP and the velocity of COP excursion. The interventions consisted of a balance exercise program given over four consecutive weeks. During this period, participants had three sessions per week, delivered by a clinical physiotherapist and each session lasted about 25 minutes ( 5 minutes of warm up, 15 minutes of main exercises and a 5 five minutes of cool down). For VR group the Nintendo® Wii Fit with a Balance Board was used and the Ski Slalom game, where the participant had to ski downhill negotiating gates by shifting their body weights from side to side, was selected for participants. This game was chosen as it requires one to move anteroposterior and mediolateral from the center of pressure and this mimics balance exercises. A demonstration and a trial session was provided to the participants. Thereafter, participants performed the games on their own under the supervision of a therapist. For the WB group the number of sessions and length of each session was as the VR group and the participants did a variety of exercises on the Wobble board (standing with the feet parallel with eyes open and closed, rocking the board forward, backward and laterally, single leg standing on both affected and unaffected leg with eyes open and closed, receiving and throwing a

Initial stimulations between 2 and 3 amps induced vestibular responses, which the patient reported that she was “sinking into the bead” or “falling from a height” (Blanke, O., & O. 2002). When increasing the amplitude to 3.5 the patient began to report having an out of body experience (Blanke, O., & O. 2002). This stimulation to the brain’s right angular gyrus also created illusory transformations of the patient’s arm and legs, indicating that out of body experiences may be due to a failure of the brain to integrate complex somatosensory and vestibular information (Blanke, O., & O. 2002, Mobbs, D., & Watt, C. 2011).

head, and this apparatus sends a signal to the brain so that your reflex action