On Monday 16th Feb at 8pm(GMT) we’ll be discussing vestibular rehabilitation with our co-host Donncha Lane (@DizzyIreland). Here is some information to read before the chat, including links to more resources.
Dizziness
A specialist area of rehabilitation is the management of dizziness. Dizziness is a subjective, non – specific term which can describe the symptoms of vertigo, light-headedness, imbalance or a combination of these. Dizziness is commonly, but not always, due to vestibular system dysfunction. Vestibular dysfunction can be stratified by origin of pathology. Peripheral vestibular disorders involve structures within the bony labyrinth of the inner ear or the vestibular nerve. Common conditions include benign positional paroxysmal vertigo, unilateral or bilateral vestibular hypofunction. Central vestibular disorders occur from the level of the vestibular nuclei and above and can affect any subsequent pathways to the eye muscles, cervical muscles, cerebellum, autonomic system or vestibulospinal tract.
Health professionals, including physiotherapists, with appropriate postgraduate training are optimally placed to provide vestibular rehabilitation to patients with complaints of dizziness. Vestibular rehabilitation consists of specifically prescribed exercise and movements to alleviate symptoms associated with vestibular dysfunction, in addition to general conditioning exercises and patient education. In the era of evidence based practice, the physiotherapy profession is endeavouring to build on an inconsistent evidence base for numerous interventions. Vestibular rehabilitation currently has a strong research base as shown in recent Cochrane reviews (Hillier and McDonnell, 2011; Hilton and Pinder, 2014).
During this chat we’ll discuss the following areas:
- What does vestibular rehabilitation mean to you and do you practice it?
- What are the main clinical areas you feel vestibular rehabilitation is pertinent to?
- What is required to run a vestibular rehabilitation service?
- How do we ensure competence in such a specialist area?
Pre-chat resources
- The Vestibular Rehabilitation Special Interest Group (VR SIG) (extension of the APTA Neurology Section)
- The Epley manoeuvre for benign paroxysmal positional vertigo (BPPV) (Cochrane summary)
- Vestibular rehabilitation to improve dizziness, balance and mobility in patients with unilateral peripheral vestibular dysfunction (Cochrane)
- Clinical practice guideline: Benign paroxysmal positional vertigo
- Vestibular Rehabilitation Therapy: Review of Indications, Mechanisms, and Key Exercises
About our host Donncha Lane
Donncha is a senior physiotherapist in acquired brain injury at the National Rehabilitation Hospital, Dublin. Presently he works between inpatient acquired brain injury rehabilitation and also runs the outpatient Dizziness and Vestibular Rehabilitation Triage (DIVERT) service. He is certified competent in vestibular rehabilitation from Susan Herdmans world-renowned course and has completed numerous CPD courses in the area. He has recently completed his MSc in Advanced Professional Practice (Neurological Rehabilitation) from Plymouth University.
Post chat information
Several resources were shared including:
Controlling your symptoms booklet from Menieres Society
Balance retraining booklet from Menieres Society
Clinical tests including the Motion Sensitivity Quotient
The whole chat transcript can be found here
