Why Is Vestibular Function Important To Recognize
Pt with protracted recovery often have vestibular dysfunction caused by several factors: post traumatic BPPV or migraine, a co- existing labyrinthine concussion, and central vestibular dysfunction from a brainstem concussion.
Early Symptoms Of Concussion
- 55% Dizziness
- 49% Visual Blurring/double vision/Difficulty in busy visual environment
- 43% Balance Problems
- Neck Pain
- Space/Motion Discomfort(co-exists with Migraine and/or anxiety
How Is PT Involved
Sub-Acute:
- Balance/Vestibular /Neurologic screening
Rehabilitation/Return to Play/acitvity:
- Balance/Vestibular Therapy/Reaction time/Education
- Management of co-existing Cervicogenic issues related to HA/Dizziness or Whiplash Injury
- Return to exertion/Guide graded progression of activity
Balance/Vestibular Assessment
- Self-Report: ABC, FES, DHI
- Computerized Dynamic Posturography/mCTSIB
- Clinical Tests: FGA, Dual Cognitive Task paradigms, FTSTS,BESS
- Infrared Goggle assessment for BPPV/positional nystagmus
- Optional Vestibular Testing: VNG, Audiogram
Ocular Assessment
- Ocular Motor Exam:
- Pursuit
- Saccades
- OPK
- Alignment
- VOR
- Convergence
- Accommodative insufficience
- Cervical Assessment
Cervical Assessment
- Postural exam: head tilt, uneven weight bearing, Thoracic/pelvis
- ROM exam: rotation, passive segmental spinal mobility
- TMJ , Strength , special tests
When To refer to balance institute of indiana?
If no symptoms resolution after 10 days:
Symptom Based Indications
- Headache
- Pressure in the head
- Neck pain
- Dizziness
- Balance impairments
- Numbness/Tingling
- Ringing in Ears
- Presents with > 2/5 of the following: nausea/vomiting, sensitivity to light/sound/noise, difficulty concentrating
Exam Based Indications
- BESS-significant balance deficit at 7+ days post injury
- Abnormal balance exam
- Vestibular screen indicates and complaints of dizziness present
- Any nystagmus present, smooth pursuit deficits or symptoms of blurry vision
- Jaw tenderness, pain, popping, clicking or deviations noted with opening
- Neck pain and limited ROM
Email us
info@balanceinstituteindy.com
Phone:
(317) 577-7333
North Office
7440 N. Shadeland Ave.
Suite 130
Indianapolis, IN 46250
Fax:
(317) 577-7330
South Office
6249 S. East Street
Suite C.
Indianapolis, IN 46227