Saturday, February 4, 2017

Vestibular Rehabilitation Therapy Works Best When Diagnosis is Known

Vestibular rehabilitation therapy (VRT) is a subspecialty of physical therapy (PT), focusing on treating vestibular system disorders causing dizziness and imbalance. Vestibular therapists (VT) have training beyond what is typically received in PT school and this additional training includes recognizing the symptoms and signs of vestibular system disorders, such as Benign Paroxysmal Positional Vertigo (BPPV), vestibular nerve weakness (unilateral or bilateral), cervicogenic (neck-related) dizziness and central (brain) disorders. It is extremely important to recognize the various vestibular system disorders and have an accurate diagnosis because the type of VRTthat would best benefit the patient is dependent on the diagnosis. The ability for even a trained and experienced VT to diagnose a specific vestibular system disorder is limited. While VTs are trained to perform clinical tests to help determine the cause of a patient’s symptoms, the results of vestibular function testing is an invaluable tool in any VTs ability to design and implement the most optimal treatment for patients suffering from a vestibular system disorder.
Imagine, for example, a patient presenting with chest pain. There are questions and some basic clinical tests that could be performed to determine the cause of the chest pain, but laboratory tests, such as an EKG and blood tests would aid in identifying a heart attack, while a chest X-ray would help determine pneumonia or a broken rib as the source. In the same way, dizziness and imbalance may be caused by a variety of medical conditions and vestibular function testing is the best way to evaluate these symptoms when the cause is not obvious.
Results from vestibular function testing allows the skilled VT to begin the correct treatment sooner and treatment is more efficient and successful when the precise cause of dizziness or imbalance is known. Different VRT exercises are prescribed for vestibular nerve weakness (unilateral or bilateral), cervicogenic (neck-related) and central (brain) disorders. Having this knowledge leads to fewer VRT visits, which saves time and cost for the patient. In the same way, the patient with pneumonia as the cause of their chest pain may not improve as much or as quickly without the appropriate treatment with antibiotics. Unfortunately, we see many patients who have been through VRT elsewhere without significant improvement only because the proper vestibular exercises were not administered due to a lack of the correct diagnosis.
Stephanie Ford, PT, is BalanceMD’s vestibular therapist. She has extensive post-graduation training and many years of experience treating patients with vestibular system disorders. She utilizes the results of vestibular function testing in order to obtain maximal improvement in her patients.

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