Vestibular rehabilitation - acpin

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Adapta$on exercises Aim to increase the gain of the VOR. (Girardi & Konrad 1998) Increase the tolerance to head movement. head movement, eyes focus on object (= x1) Head and object move, whilst focussing on object (= x2) Change distance, speed, direction, background, postural demands. Should train for 1 -‐2 minutes Repeat 3-‐5 times a day Context specific Herdman 2002) Virre & Sitarz 2002 found good results for 2 x 30 minutes sessions for a week subjects looking at moving images on a computer
Mechanisms of recovery Subs$tu$on. Primarily for bilateral disorders Other strategies replace the lost vestibular function (visual and somatosensory) A number of reflexes can be optimised COR which operates at low frequency (under 0.1) can partially compensate by increasing its range-‐ up to 0.3Hz (Herdman 1997) VCR (vestibulo-‐collic reflex) aligns head to gravitational vertical and the CCR (cervico-‐collic reflex) aligns head to the body, can increase their influence in posturally challenging circumstances or in balance problems (Guitton et al 1986)
Page 1 and 2: Anne Rodger ACPIN Conference an
Page 3 and 4: Dynamic systems framework postur
Page 5 and 6: Ves$bular system Website for this
Page 7 and 8: ? How much of a problem is
Page 9 and 10: MS - A central or peripheral
Page 12 and 13: What is Ves$bular Rehabilita$on
Page 14 and 15: Objec$ve assessment Visual: Ob
Page 16 and 17: Outcome measures Subjective: D
Page 18 and 19: Mechanisms of recovery Spontaneo
Page 22 and 23: Subs$tu$on Con$nued Performance
Page 24 and 25: Habitua$on exercises Tailoring
Page 26 and 27: Summary Vestibular dysfunction
Page 28 and 29: References Bhattacharyya, N; Ba
Page 30 and 31: References 3 Karatas, M (2008)

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