VESTIBULAR REHABILITATION THERAPY (VRT) - PowerPoint PPT Presentation

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VESTIBULAR REHABILITATION THERAPY (VRT)

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(BPPV should be treated first with a particle repositioning maneouvre) Symptoms of Vestibular Impairment Dizziness on certain head movements Vertigo, ... – PowerPoint PPT presentation

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Title: VESTIBULAR REHABILITATION THERAPY (VRT)


1
VESTIBULAR REHABILITATIONTHERAPY (VRT)
  • GP Study Day 28/01/12
  • Mairead Collins MISCP

2
What is VRT?
  • An exercise-based approach designed to maximise
    CNS compensation for Vestibular pathology
  • Not new!
  • Cawthorne Cooksey 1940s people who moved more
    did better, people should perform provoking
    movements
  • Recent studies advocate customised approach

3
Who is VRT suitable for?
  • Vestibular Neuritis/Labyrinthitis
  • Benign Paroxysmal Positional Vertigo (BPPV)
  • Bilateral Vestibular Hypofunction
  • Menieres Disease
  • Central causes of vertigo brainstem infarct,
    cerebellar infarct, MS etc..
  • (BPPV should be treated first with a particle
    repositioning maneouvre)

4
Symptoms of Vestibular Impairment
  • Dizziness on certain head movements
  • Vertigo, nausea, vomiting
  • General loss of balance often worse in
    darkness/uneven surfaces
  • Increased symptoms in crowded places/with visual
    stimuli
  • Reduced activity due to avoidance of activities
    that provoke symptoms

5
Treatment Approach
  • Three exercise approaches are used to reduce
  • impairments (gaze instability, dizziness and
    postural instability)
  • Use of Vestibular suppressants??
  • Adaptation
  • Habituation
  • Substitution

6
What does Physiotherapy involve?
  • Initial assessment including subjective
    objective outcome measures
  • An individualised home execise programme is drawn
    up for the patient to work on at home is
    progressed as necessary (usually fortnightly)
  • In-house vestibular balance re-education
  • Advice Education
  • Generally expect to see improvement within 2-3
    months

7
Goals of VRT
  • Reduce symptoms of dizziness nausea
  • Improve postural and gait stability
  • Reduce falls risk
  • Improve independence in ADLs
  • Increase cardiovascular conditioning
  • Decrease anxiety, fear social isolation

8
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