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Improvements in dizziness and imbalance results from using a multi disciplinary and multi sensory approach to Vestibular Physical Therapy - a case study.

Gottshall KR, Sessoms PH - Front Syst Neurosci (2015)

Bottom Line: After 6 weeks of therapy, twice weekly, improvements in clinical vestibular measures were observed as well as walking speed and patient confidence.This case study provides supportive evidence that multidimensional tasking in a virtual environment provides a safe but demanding form of vestibular therapy for patients needing more challenging tasks than those provided with traditional therapy techniques.Those persons requiring higher levels of performance before returning to full duty (e.g., pilots, special operators, etc.) may find this type of therapy beneficial.

View Article: PubMed Central - PubMed

Affiliation: Physical Therapy Department, Naval Medical Center San Diego, San Diego CA, USA.

ABSTRACT
This paper discusses a case study of a 41-year-old active duty male service member who sustained head trauma from a motorcycle accident and underwent multidisciplinary vestibular physical therapy rehabilitation. He was initially treated with traditional physical therapy applications of treadmill walking and standing balance with some symptom improvements, but was not able to maintain a running speed that would allow him to return to full active duty status. Further treatment utilizing a Computer Assisted Rehabilitation Environment was performed in order to increase level of difficulty and further enhance function. This treatment is able to elicit vestibular deficits seen in the community as it requires subjects to walk and balance while performing tasks within a virtual scenario incorporating platform motion, visual surround and flow, and cognitive processing. After 6 weeks of therapy, twice weekly, improvements in clinical vestibular measures were observed as well as walking speed and patient confidence. The patient was able to return to full duty after treatment. This case study provides supportive evidence that multidimensional tasking in a virtual environment provides a safe but demanding form of vestibular therapy for patients needing more challenging tasks than those provided with traditional therapy techniques. Those persons requiring higher levels of performance before returning to full duty (e.g., pilots, special operators, etc.) may find this type of therapy beneficial.

No MeSH data available.


Related in: MedlinePlus

Four different applications used for treatment of the patient on the Computer Assisted Rehabilitation Environment (CAREN). (A) Endless Road, (B) Forest Road, (C) Mountain Patrol, and (D) Boat.
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Figure 1: Four different applications used for treatment of the patient on the Computer Assisted Rehabilitation Environment (CAREN). (A) Endless Road, (B) Forest Road, (C) Mountain Patrol, and (D) Boat.

Mentions: Treatment sessions on the CAREN lasted 45 min, once per week for a total of six weeks. The sessions included various immersive applications where the patient had to balance on the moving platform or walk while performing different physical or cognitive tasks (Figure 1). This included the “Endless Road” application where the patient walked on a straight path while performing a series of cognitive tasks, which were presented in order of: (1) direction of optotype letter “E”; (2) addition or subtraction of two numbers; and (3) stroop test (name of a color is displayed on the screen (e.g., “blue,” “green,” or “red”) with uncorrelated font color and the patient either says the word or color of the font). These tasks were given to provide a multitasking component to the activity as well as perform side-to-side head turning (scanning), as the images (numbers and words) were presented randomly on the left and right sides of the screen. The subject chose his own walking speed by pressing buttons to increase or decrease speed using a handheld game controller. After an initial “warm-up” round of the three cognitive tasks, the same tasks were performed again but with the addition of platform motion. This included a platform gyration during the optotype testing, left or right tilt when the math equations were presented, and a left or right shift when the stroop word was presented.


Improvements in dizziness and imbalance results from using a multi disciplinary and multi sensory approach to Vestibular Physical Therapy - a case study.

Gottshall KR, Sessoms PH - Front Syst Neurosci (2015)

Four different applications used for treatment of the patient on the Computer Assisted Rehabilitation Environment (CAREN). (A) Endless Road, (B) Forest Road, (C) Mountain Patrol, and (D) Boat.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4526811&req=5

Figure 1: Four different applications used for treatment of the patient on the Computer Assisted Rehabilitation Environment (CAREN). (A) Endless Road, (B) Forest Road, (C) Mountain Patrol, and (D) Boat.
Mentions: Treatment sessions on the CAREN lasted 45 min, once per week for a total of six weeks. The sessions included various immersive applications where the patient had to balance on the moving platform or walk while performing different physical or cognitive tasks (Figure 1). This included the “Endless Road” application where the patient walked on a straight path while performing a series of cognitive tasks, which were presented in order of: (1) direction of optotype letter “E”; (2) addition or subtraction of two numbers; and (3) stroop test (name of a color is displayed on the screen (e.g., “blue,” “green,” or “red”) with uncorrelated font color and the patient either says the word or color of the font). These tasks were given to provide a multitasking component to the activity as well as perform side-to-side head turning (scanning), as the images (numbers and words) were presented randomly on the left and right sides of the screen. The subject chose his own walking speed by pressing buttons to increase or decrease speed using a handheld game controller. After an initial “warm-up” round of the three cognitive tasks, the same tasks were performed again but with the addition of platform motion. This included a platform gyration during the optotype testing, left or right tilt when the math equations were presented, and a left or right shift when the stroop word was presented.

Bottom Line: After 6 weeks of therapy, twice weekly, improvements in clinical vestibular measures were observed as well as walking speed and patient confidence.This case study provides supportive evidence that multidimensional tasking in a virtual environment provides a safe but demanding form of vestibular therapy for patients needing more challenging tasks than those provided with traditional therapy techniques.Those persons requiring higher levels of performance before returning to full duty (e.g., pilots, special operators, etc.) may find this type of therapy beneficial.

View Article: PubMed Central - PubMed

Affiliation: Physical Therapy Department, Naval Medical Center San Diego, San Diego CA, USA.

ABSTRACT
This paper discusses a case study of a 41-year-old active duty male service member who sustained head trauma from a motorcycle accident and underwent multidisciplinary vestibular physical therapy rehabilitation. He was initially treated with traditional physical therapy applications of treadmill walking and standing balance with some symptom improvements, but was not able to maintain a running speed that would allow him to return to full active duty status. Further treatment utilizing a Computer Assisted Rehabilitation Environment was performed in order to increase level of difficulty and further enhance function. This treatment is able to elicit vestibular deficits seen in the community as it requires subjects to walk and balance while performing tasks within a virtual scenario incorporating platform motion, visual surround and flow, and cognitive processing. After 6 weeks of therapy, twice weekly, improvements in clinical vestibular measures were observed as well as walking speed and patient confidence. The patient was able to return to full duty after treatment. This case study provides supportive evidence that multidimensional tasking in a virtual environment provides a safe but demanding form of vestibular therapy for patients needing more challenging tasks than those provided with traditional therapy techniques. Those persons requiring higher levels of performance before returning to full duty (e.g., pilots, special operators, etc.) may find this type of therapy beneficial.

No MeSH data available.


Related in: MedlinePlus