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Semin Hear 2002; 23(2): 149-160
DOI: 10.1055/s-2002-33000
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Vestibular Rehabilitation: Critical Decision Analysis

Richard E. Gans
  • The American Institute of Balance, Seminole, Florida
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Publication History

Publication Date:
25 July 2002 (online)

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ABSTRACT

Vestibular Rehabilitation Therapy (VRT) is used by audiologists, physical and occupational therapists, and physicians as an efficacious treatment and management strategy for patients with noncompensated vestibular dysfunction secondary to a vestibular disease or disorder. Although vestibular rehabilitation techniques were first reported over a half-century ago, it has been in the past decade that these techniques have become a widely accepted nonmedical or nonsurgical treatment strategy for patients with chronic and often debilitating symptoms. The use of diagnosis-based strategies or individualized and programmatic therapy protocols and programs has been documented as providing the best treatment outcomes. Critical decision analysis and clinical pathways provide a straightforward method for clinicians in the identification and treatment of this population.

KEYWORDS

Vestibular - vestibulopathy - noncompensated - stabilized - unilateral vestibular dysfunction - vestibular rehabilitation

REFERENCES

  • 1 National Institute on Deafness and Other Communication Disorders, U.S Dept of Health and Human Services, National Institutes of Health. The National Strategic Research Plan . 1995 97-3217: 77-110
    Google Scholar
  • 2 Dizziness: Hope Through Research Pamphlet Office of Scientific and Health Reports, National Institute of Neurological and Communicative Disorders and Stroke. . 1996 86-76: 1-27
    Google Scholar
  • 3 Herdman S J. Therapy: rehabilitation. In: Goebel JA, ed. Practical Management of the Dizzy Patient Philadelphia: Lippincott William & Wilkins 2001 0: 327-344
    Google Scholar
  • 4 Kramer P, Shelhamer M, Zee D S. Short-term vestibulo-ocular adaptation: influence of context.  Otolaryngol Head Neck Surg . 1998;  119 60-64
    PubMedGoogle Scholar
  • 5 Lisberger S. Physiologic basis for motor learning in the vestibulo-ocular reflex.  Otolaryngol Head Neck Surg . 1998;  119 43-48
    PubMedGoogle Scholar
  • 6 Cawthorne T. The Physiological basis for head exercises.  J Chartered Soc Physiother . 1944;  30-106
    PubMedGoogle Scholar
  • 7 Cooksey F S. Rehabilitation and vestibular injuries.  Pro R Soc Med . 1946;  39 273
    PubMedGoogle Scholar
  • 8 Shepard N T, Telian S A, Smith-Wheelock M. Habituation and balance retraining therapy; a retrospective review.  Neurol Clin . 1990;  8 458-475
    PubMedGoogle Scholar
  • 9 Horak F B, Jones-Rycewicz C, Black F O, Shumway-Cook A. Effects of vestibular rehabilitation on dizziness and imbalance.  Otolaryngol Head Neck Surg . 1992;  106 175-180
    PubMedGoogle Scholar
  • 10 Shumway-Cook A, Horak F B. Vestibular Rehabilitation: an exercise approach to managing symptoms of vestibular dysfunction.  Seminars in Hearing . 1989;  10 196-204
    PubMedGoogle Scholar
  • 11 Shumway-Cook A, Horak F B. Rehabilitation strategies for patients with vestibular deficits.  Neurol Clin . 1990;  8 441-457
    PubMedGoogle Scholar
  • 12 Herdman S J. Exercise strategies for vestibular disorders.  Ear Nose Throat J . 1989;  68 961-964
    PubMedGoogle Scholar
  • 13 Nashner L M. Computerized dynamic posturography. In: Jacobson GP, Newman CS, Kartush JM, eds. Handbook of Balance Function Testing San Diego, CA: Singular Publishing Group 1997: 280-307
    Google Scholar
  • 14 Shumway-Cook A, Horak F B. Assessing the influence of sensory interaction on balance: suggestions from the field.  Phys Ther . 1986;  66 1548-1550
    PubMedGoogle Scholar
  • 15 Herdman S J, Blatt P J, Ventuto P, Tusa R J. Quantitative dynamic visual acuity test (DVA): clinical utility in diagnosis (Abst).  Phys Ther . 1998;  78 S23
    PubMedGoogle Scholar
  • 16 O'Leary D P, Davis-O'Leary L L. High frequency autorotation testing of the vestibulo-ocular reflex.  Neurol Clin North Am . 1990;  8 297-312
    PubMedGoogle Scholar
  • 17 Hillman E J, Bloomberg J J, McDonald P V, Cohen H S. Dynamic visual acuity while walking in normals and labyrinthine-deficient patients.  Journal of Vestibular Rehabilitation . 1999;  9 49-57
    PubMedGoogle Scholar
  • 18 Jacobson G P, Newman C W. The development of Dizziness Handicap Inventory.  Arch Otolaryngol . 1990;  116 424-427
    PubMedGoogle Scholar
  • 19 Ware J E. How to Score the Revised MOS Short Form Health Scales (SF-36).  Boston: The Health Institute, New England Medical Center Hospitals; 1988
    Google Scholar
  • 20 Gates G A. Clinimetrics of Meniere's disease.  Laryngoscope . 2000;  110 8-11
    PubMedGoogle Scholar
  • 21 Cohen H S, Kimball K T, Adams A S. Application of vestibular disorders activities of daily living scale.  Laryngoscope . 2000;  110 1204-1209
    PubMedGoogle Scholar
  • 22 Powell L E, Myers A M. The Activities-Specific Balance Confidence Scale.  J Gerontol A Biol Sci Med Sci . 1995;  50 M28-M34
    PubMedGoogle Scholar
  • 23 Gans R E. Vestibular Rehabilitation: Protocols and Programs.  San Diego, CA: Singular Publishing Group; 1996
    Google Scholar
  • 24 Shepard N T, Telian S A. Programmatic vestibular rehabilitation.  Otolaryngol Head Neck Surg . 1995;  112 173-182
    CrossrefPubMedGoogle Scholar
  • 25 Black F O, Angel C R, Pesznecker S C, Gianna C. Outcome analysis of individualized vestibular rehabilitation protocols.  Am J Otol . 2000;  21 543-551
    PubMedGoogle Scholar
  • 26 Cohen H S. Vestibular rehabilitation reduces functional disability.  Otolaryngol Head Neck Surg . 1992;  107 638-643
    PubMedGoogle Scholar
  • 27 Gans R E. Vestibular rehabilitation: producing successful outcomes.  The Hearing Review . 1999;  6(7) 32-36
    PubMedGoogle Scholar
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