Vestibular Rehabilitation
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Questions and Answers

Which direction should the head be turned initially during a LARP exercise

  • Head to the left
  • Head towards the ceiling
  • Head towards the floor
  • Head to the right (correct)

    • What is the direction of the patient's head movement in the Left Anterior (LA) exercise?

  • Up and to the left
  • Down and to the left
  • Down and to the right (correct)
  • Up and to the right

    • What type of viewing involves the thumb and head moving in the same direction?

  • x0 viewing (correct)
  • x2 viewing
  • LARP viewing
  • x1 viewing

    • What is the pattern of head movement in the Diamond gaze yes/yes stability pattern?

    <p>Up and down</p> Signup and view all the answers

    What type of viewing involves the patient looking at a stationary target and moving their head back and forth around 30 degrees?

    <p>x1 viewing</p> Signup and view all the answers

    What type of viewing involves the thumb and head moving in opposite directions?

    <p>x2 viewing</p> Signup and view all the answers

    In the right anterior maneuver, how is the patient's head positioned at the beginning of the procedure?

    <p>Turned to the left 30 degrees in flexion</p> Signup and view all the answers

    Where is the head starting position for Right Horizontal maneuver?

    <p>Right slightly flexed</p> Signup and view all the answers

    What is the purpose of the repositioning maneuvers in vestibular rehabilitation?

    <p>To recalibrate the inner ear</p> Signup and view all the answers

    What is the last position for Left horizontal maneuver?

    <p>Head to the left flexed</p> Signup and view all the answers

    How long do we hold each position in horizontal manuevers

    <p>30 seconds</p> Signup and view all the answers

    What is the first head position for Left Posterior Maneuver?

    <p>Head to the left and extended</p> Signup and view all the answers

    Which step follows after the patient has turned their head to the right in the Right Anterior Maneuver?

    <p>Turn onto their left shoulder</p> Signup and view all the answers

    Which is the proper progression for difficulty of exercises?

    <p>Supine, sitting, standing, foam pad</p> Signup and view all the answers

    What should you do if someone's eyes look choppy during gaze stability

    <p>Slow down</p> Signup and view all the answers

    Which is not a way to make the eye exercise easier for someone?

    <p>Bring the thumb closer so their eyes converge</p> Signup and view all the answers

    If the patient says their head felt heavy during the maneuver what should you do?

    <p>Write it as a note in the chart next to the exercise</p> Signup and view all the answers

    During the Diamond gaze exercise, how far away should the patient be from the paper?

    <p>Arms distance</p> Signup and view all the answers

    If someone can do the eye exercise easily you should ...?

    <p>Upgrade them using the progressions</p> Signup and view all the answers

    What is the target for sinusoidal eye exercise?

    <p>Single dot</p> Signup and view all the answers

    Study Notes

    Repositioning Maneuver

    • Right posterior maneuver: Sit on the table, turn head to the right 30 degrees, lay on back with head off the table, hold for 30 seconds, turn head to the left, hold for 30 seconds, turn onto left shoulder, hold for 30 seconds, and slowly get up.
    • Left posterior maneuver: Same as right posterior but opposite.
    • Right anterior maneuver: Lay on stomach with head off the table, turn head to the left 30 degrees, hold for 30 seconds, turn head to the right, hold for 30 seconds, turn onto left shoulder, hold for 30 seconds, and slowly get up.
    • Left anterior maneuver: Same as right anterior but opposite.
    • Right horizontal maneuver: (no additional details provided)
    • Left horizontal maneuver: Same as right horizontal but opposite.

    Canal Stimulation

    • Right anterior (RA): Patient sits with arm in front, holding thumb at eye level, turns head 45 degrees to the left, moves head downwards while looking at thumb, and repeats.
    • Right posterior (RP): Patient sits with arm in front, holding thumb at eye level, turns head 45 degrees to the right, moves head upwards while looking at thumb, and repeats.
    • Left anterior (LA): Patient sits with arm in front, holding thumb at eye level, turns head 45 degrees to the right, moves head downwards while looking at thumb, and repeats.
    • Left posterior (LP): Patient sits with arm in front, holding thumb at eye level, turns head 45 degrees to the left, moves head upwards while looking at thumb, and repeats.
    • LARP: Patient sits with arm in front, holding thumb at eye level, turns head 45 degrees to the right, moves head upwards and downwards while looking at thumb, and repeats.
    • RALP: Patient sits with arm in front, holding thumb at eye level, turns head 45 degrees to the left, moves head upwards and downwards while looking at thumb, and repeats.

    Viewing Types

    • x0 viewing: Patient looks at arm and moves head and arm in the same direction.
    • x1 viewing: Patient looks at a stationary target (such as thumb or dot) and moves head back and forth around 30 degrees.
    • x2 viewing: Patient looks at arm and moves head and arm in opposite directions.

    Diamond Gaze Exercises

    • No/no stability pattern: Patient looks at middle dot, turns head left and right equally three times, shifts eyes to each dot, and moves head left and right.
    • Yes/yes stability pattern: Same as no/no stability pattern but moving head up and down instead.

    Repositioning Maneuvers

    • Right Posterior Maneuver:

      • Start by sitting and turning head right 30 degrees.
      • Lie back with head off table in extension; hold for ~30 seconds.
      • Turn head to the left and hold for ~30 seconds.
      • Roll onto left shoulder while keeping head turned left; hold for ~30 seconds.
      • Slowly return to sitting position.

    • Left Posterior Maneuver:

      • Similar to the right posterior maneuver but start with head turned left 30 degrees.

    • Right Anterior Maneuver:

      • Lie stomach down with head off table in flexion.
      • Turn head left 30 degrees, holding for ~30 seconds.
      • Turn head right and hold for ~30 seconds.
      • Roll onto left shoulder, head still turned right; hold for ~30 seconds.
      • Slowly rise to sitting.

    • Left Anterior Maneuver:

      • Same as right anterior, but starting with head turned right.

    • Right Horizontal Maneuver:

      • Specific details not provided; similar principles likely apply.

    • Left Horizontal Maneuver:

      • Similar to right horizontal maneuver, but opposite movements.

    Canal Stimulation

    • Right Anterior (RA):

      • Patient sits holding thumb at eye level; turns head left 45 degrees.
      • Moves head down while focusing on thumb; check response (x0, x1, x2).
      • Close eyes and return to starting position; repeat.

    • Right Posterior (RP):

      • Patient sits, turns head right 45 degrees, and moves head upward while tracking thumb.

    • Left Anterior (LA):

      • Patient sits, turns head right 45 degrees, and moves head down while looking at thumb.

    • Left Posterior (LP):

      • Patient sits, turns head left 45 degrees, and moves head upward while tracking thumb.

    • LARP and RALP:

      • Similar protocols as RA and LA but involve moving head both upward and downward.

    Viewing Conditions

    • x0 Viewing:

      • Patient looks at their arm while moving head and arm together in the same direction.

    • x1 Viewing:

      • Patient looks at a stationary target and moves head back and forth ~30 degrees.

    • x2 Viewing:

      • Patient looks at their arm and moves head and arm in opposite directions.

    Stabilization Patterns

    • Diamond Gaze No/No:

      • Patient looks at a central dot in a diamond configuration; turns head left and right three times.
      • Shifts eyes to each dot while keeping head neutral before moving head.

    • Diamond Gaze Yes/Yes:

      • Similar to the no/no pattern, but involves moving head up and down instead.

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    Description

    This quiz covers the steps involved in repositioning maneuvers for vestibular rehabilitation, including right and left posterior maneuvers. Learn the proper techniques for treating vestibular disorders.

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