INNER EAR ANATOMY & PHYSIOLOGY
- Anatomy of vestibular system
- Balance systems
- Visual, vestibular and somatosensory
MEDICAL DIAGNOSES & PROGNOSIS: PERIPHERAL & CENTRAL ORIGIN
- Benign Paroxysmal Positional Vertigo (BPPV)
- Vestibular neuronitis, labyrinthitis
- Meniere’s disease, endolymphatic hydrops, acoustic neuroma
- Central vertigo: Cerebrovascular Accident (CVA), multiple sclerosis, migraine-associated vertigo
- Cervicogenic Vertigo
- Post-concussion syndrome
- Sensory integration / Multi-factorial balance dysfunction
DETERMINING A THERAPY DIAGNOSIS
- Patient history
- Onset
- Symptom description, duration, nature
- Patient questionnaires
Exam Lab
- Clearing cervical spine: mVAT, Sharp-Purser test
- Occulomotor exam:
- smooth pursuit
- saccades
- vergence and visual acuity
- Vestibular exam:
- Head Thrust
- Head-Shaking Nystagmus
- Hallpike-Dix
- Roll Test
- Assessing nystagmus: horizontal, vertical, torsional
- Motion Sensitivity Quotient
- Balance assessment:
- mCTSIB
- Dynamic Gait Index
- Gait
VESTIBULAR REHABILITATION: DEVELOPING A PATIENT-SPECIFIC TREATMENT PLAN
- Canalith repositioning maneuvers
- Epley maneuver
- BBQ roll / quick BBQ roll
- Cassani, Appiani
- Brandt-Daroff Exercises
- Gaze stabilization: basic and advancements
- Balance progression
- Sensory integration in balance
Document functional limitations, goals, Medicare fall risk, & FLR g-codes
CASE STUDIES