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Rehabilitation for Balance Disorders

Rehabilitation for Balance Disorders. Canalith Repositioning Maneuvers Vestibular Rehab. Canalith Repositioning. Posterior Canal (85-95% success) Epley Semont Horizontal Canal (100% success) Barbecue Roll Appiani Casani. Posterior Canal BPPV. The Epley. Epley Issues.

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Rehabilitation for Balance Disorders

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  1. Rehabilitation for Balance Disorders Canalith Repositioning Maneuvers Vestibular Rehab

  2. Canalith Repositioning • Posterior Canal (85-95% success) • Epley • Semont • Horizontal Canal (100% success) • Barbecue Roll • Appiani • Casani

  3. Posterior Canal BPPV

  4. The Epley

  5. Epley Issues • Speed of maneuver: fast isn’t necessarily good. • Is vibration necessary? • Follow up movement restrictions? • Follow up exercises?

  6. The Semont • The “slam dunk” maneuver • Designed with cupulolithiasis in mind • No different in success rate than Epley

  7. Horiz. Canal--Barbecue Roll: • Start supine • Rolls toward unaffected ear • in 90 degree steps • 2 to 3 times around

  8. Appiani: • Start sitting • Lay toward unaffected side w/ head elevated and facing straight ahead. Remain 1 minute after nystagmus disappears • Turn head toward table – 3 min post-nyst • Return to sitting • Lay on affected side to double check.

  9. Casani, et al. (2002) • Start sitting facing foward • Lay to affected side head held straight • Turn head toward affected side • Return to sitting.

  10. Vestibular Rehabilitation • Habituation • Adaptation • Substitution

  11. Brandt-Daroff Exercises

  12. Cawthorne-Cooksey • Exercises scaled • From simple to difficult • From isolated parts (eye movement only, e.g.) • To generalized movement (eye & head, whole body)

  13. Assessing Progress • Symptom amelioration • Scales • Dizziness Handicap Inventory (Jacobson) • Vestibular Disorders Activities of Daily Living Scale • Vestibular Symptom Index (Black) • Tests • Berg Balance Scale • Timed Up and Go Test

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