One of the leading health concerns for people over the age of 60 is falling. Between 20 and 40% of adults over the age of 65, living at home, fall each year. The consequences of these falls can be disastrous and are a leading cause of hip fractures in the elderly.
Balance Diagnostic & Therapy Center specializes in the diagnosis and treatment of all types of balance disorders. Utilizing the Video ENG, our team of professionals will record and diagnose the cause of the patient's instability and quickly move forward into customizing a treatment program that equips the patient with proven fall prevention techniques and balance retraining. Our goal is to help retrain the patient's body and brain to process balance information effortlessly.
VNG & VBT
Top Five Reasons to Order a VNG
- Determine the presence of a vestibular disorder as cause of symptoms.
- Differentiate between central and peripheral vestibular dysfunction and identify side of lesion.
- Identify the presence of central oculomotor dysfunction, which may mimic vestibular dysfunction.
- Classify the type of vestibular disorder to determine the most effective therapy (e.g., Meniere's disease versus BPPV).
- Create a baseline measure for vestibular function in progressive disease or degeneration.
Vertigo or disequilibrium may persist due to poor central nervous system (CNS) compensation in patients after any acute injury to the vestibular system even if there is no ongoing labyrinthine dysfunction. Some patients will develop maladaptive postural control strategies that are destabilizing or bothersome in certain settings. These patients will benefit from a vestibular and balance rehabilitation program.
The use of exercises in the rehabilitation of patients with vestibular disorders dates back to the 1940's (Cawthorne, 1944). Recent work has refined the techniques and expanded the applicable patient population. The result is a firm documentation of the efficacy of the use of vestibular and balance rehabilitation programs for the management of patients with dizziness and balance disorders.
Vestibular rehabilitation, also known as vestibulation rehabilitation therapy (VRT), is the use of customized exercise activities based on movements of the head and/or eyes, or environmental visual movements that provoke symptoms of disequilibrium or vertigo and functional activities that involve static and dynamic balance and gait. The exercise program may include, but is not limited to:
- Habituation activities focusing on specific planes of motion that provoke symptoms or visual motion that provokes symptoms.
- Canalith repositioning procedures (CRP) which include various methods of specific movements of the head and body designed to reposition the otoconia and/or other material from abnormal location in one of the semicircular canals back into the vestibule region. These techniques are specifically for the treatment of benign paroxysmal positional vertigo (BPPV).
- Vestibulo-ocular reflex (VOR) exercises that promote recovery of normal VOR gain, allowing for gaze stability during head movements.
- Gait and balance exercises, both static and dynamic, on a variety of surfaces under a variety of conditions.
The overall goal of vestibular and balance therapy (VBT) is to promote the central nervous system's natural compensation to reduce and sometimes eliminate symptoms for the patients with chronic dizziness or imbalance. Specific techniques are also useful in the elimination of symptoms for certain types of acute peripheral vestibular patients. The research to date suggests efficacy for a wide variety of lesion sites with symptom presentation proving more critical than site-of-lesion for patient selection.
Each patient has specific goals for their therapy program, but there are general goals that apply to the majority of patients receiving VBT. These include:
- Promote central vestibular system compensation.
- Reduce the patient's sensitivity to head, eye or visual motion that produces vertigo or disequilibrium.
- Reduce the risk of falls by improving static and dynamic balance and gait activities.
- Improve the maintenance of the compensation process via increased activities of daily living that involve head and eye movements.
Frequently Asked Questions
Why should my patient receive VBT even before they receive their VNG results?
The research to date suggests efficacy of VBT for a wide variety of lesion sites with symptom presentation proving more critical than site-of-lesion for patient selection. The vestibular therapist can evaluate your patient's symptoms, identify their functional limitations and immediately begin addressing their symptoms effectively even before a specific site-of-lesion is identified.