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Individuals with unilateral vestibular damage - Examination and treatment with focus on the musculoskeletal system

Wilhelmsen and Kvåle published a case series on patients with long lasting dizziness. Treatment targeting the musculoskeletal system improved selv-reported symptoms and perception of disability

Dizziness
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Abstract

Background and purpose: Persistent dizziness and balance problems are reported in some patients following unilateral vestibular pathology. The purpose of this case series is to address the examination and treatment of musculoskeletal dysfunction seen in patients with unilateral vestibular hypofunction (UVH).

Case Description: The musculoskeletal system was evaluated with the Global Physiotherapy Examination, dynamic balance was measured during walking using tri-axial accelerometers positioned on the lower and upper trunk, symptoms and functional limitations were assessed with standardized self-report measures. The four patients had symptoms of severe dizziness lasting more than a year after the onset of the vestibular dysfunction with moderate level of perceived disability. Musculoskeletal abnormalities typically included postural misalignment, restricted abdominal respiration, restricted trunk movements and tense muscles of the upper trunk and neck. The patients participated in a modified vestibular rehabilitation program consisting of body awareness exercises addressing posture, movements and respiration.

Outcomes: Following intervention self-reported symptoms and perception of disability improved. Improvements in mobility and positive physical changes were particularly found in the upper trunk and in respiratory movements. The attenuation of medio-lateral accelerations in the upper trunk changed; a relatively more stable upper and concomitantly more flexible lower trunk was identified during walking in three patients.

 

Wilhelmsen K, Kvåle A. Individuals with unilateral vestibular damage - Examination and treatment with focus on the musculoskeletal system - a Case Series. Physical Therapy, 2014; 94 (7): 1024-1033.