Intervention for Unilateral Vestibular Hypofunction

goals for Intervention for Unilateral Vestibular Hypofunction?

Improve gaze stability during head mvmt.

Decrease motion sensitivity.

Improve static & dynamic postural stability.

Independent w/ HEP, including a walking program.

what gaze stability exercise involves moving head horizontally (or vertically, if appropriate) as quickly as possible while keeping stable target in focus

Start w/ target an arm’s length away

VOR X1 viewing

recovery/prognosis from Unilateral Vestibular Hypofunction once pt begins tx

acute (<2 wks): 2-3 wks

chronic: 4-6 wks

what is it when image of an object moves off the fovea of retina & leads to visual blurring?

retinal slip

a small retinal slip is what is used by brain to drive

vestibular adaptation (so important to expose pts to this in tx)

what gaze stability exercise has pt move the head & the target in opposite directions?

VOR X2 viewing

what gaze stability exercise where pt should move their head & eyes in the SAME direction?

VOR cancel

what are typical progressions for gaze stability exercises?

Sitting→standing→walking, compliant surfaces, NBOS, distracting background or environment, ↑ distance to target, ↑ speed of mvmt

keys for postural stability/balance exercises for Unilateral Vestibular Hypofunction includes you can improve balance by

encouraging development of balance strategies (challenging)

Incorporate head mvmt (toss ball while walking, identify post its on wall)

what is a reduction in response to a repeatedly performed mvmt?

habituation

Habituation exercises for Unilateral Vestibular Hypofunction are often used when continual complaints of dizziness are reported. Must determine provoking positions 1st then provide HEP based on outcome of that assessment OR use MSQ to find provocative positions. What is the frequency of these interventions?

Frequency: 3-5x /position, 2-3x/day (NPTE)

Education: sxs generally decrease w/in 2 wks

Aerobic exercise/walking program is important for Unilateral Vestibular Hypofunction as

mvmt is important

Encourage daily exercise→ must be moderately challenging