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Comprehensive Guide to Balance Disorder Rehabilitation and Canalith Repositioning Maneuvers

Explore effective treatment methods for balance disorders like posterior canal BPPV through Canalith Repositioning Maneuvers, including Epley, Semont, and Horizontal Canal maneuvers. Learn about the importance of follow-up exercises and movement restrictions. Dive into vestibular rehabilitation techniques like Habituation, Adaptation, and Substitution, along with Brandt-Daroff and Cawthorne-Cooksey exercises. Assess progress using various scales and tests.

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Comprehensive Guide to Balance Disorder Rehabilitation and Canalith Repositioning Maneuvers

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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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