WSU AUD 5420 week 10 vestibular rehab

vestibular rehabilitation

treatment techniques to aid in recovery from vestibular weakness or dizziness (interdisciplinary: audiologist, physician, physical therapist)

half of all people in the US

experience some form of balance or dizziness problem in their lifetime

balance/equilibrium system

interaction between vestibular system, visual system, somatosensory system (proprioceptive function)

vestibular system

responsible for sensation of head movement; composed of vestibule and 3 semi-circular canals per ear

vestibule

utricle & saccule

ALP, US, CA

anterior, lateral, posterior canal; utricle & saccule; cupula & ampullae

vestibulocochlear nerve

one nerve - two branches: cochlear & vestibular branch

vestibule (utricle & saccule)

organs responsible for linear acceleration (ie accelerating in a car, moving up in an elevator, etc); closely involved with postural control

semicircular canals

3 canals in each ear, situated at 90-degree angles to on another; they sense angular head movement in all directions

vestibulo-ocular reflex (VOR)

reflexive eye movements that occur in response to head movement; eyes move in opposite direction of head movement; goal is to keep eyes focused on target of interest during movement; occurs when fluid in semicircular canals moves with head movement

vestibular assessment

diagnostic testing performed by audiologists helps to determine whether vestibular pathology plays a role in patient symptoms (videonystagmography (VNG)/electronystagmography (ENG), rotational chair, posturography)

VNG/ENG

both measure eye movements in response to vestibular system stimulation & provide the same info, but measures are obtained differently - VNG uses cameras to record eye movement from pupil, ENG uses electrodes to monitor eye movement by muscle activity

videonystagmography (VNG)

oculomotor tests (eye movement), positioning/positional tests, spontaneous nystagmus tests, caloric testing (warm/cool air or water in ear canal to stimulate vestibular system so pt feels as if they are moving, measuring nystagmus)

nystagmus

a condition where your eyes make rapid, repetitive, uncontrolled movements; eyes may move in different directions: side to side (horizontal), up and down (vertical), in a circle (rotary or torsional)

rotational chair

recording eye movement while chair is moved in various ways; helpful for diagnosis of bilateral hearing loss; helps assess compensation

benign paroxysmal positional vertigo (BPPV)

most common disorder of the inner ear vestibular system, due to the otoconia detaching from the utricle and collecting in one of the semicircular canals; causes brief, but extreme vertigo, esp when turning head

otoconia

small crystals of calcium carbonate derived from the utricle

vertigo

the sensation of spinning or movement while a person is still

vestibular treatment

discontinuing anti-dizziness medication; exercises to stimulate the vestibular system to promote greater function; audiologists & physical therapists collaborate