New Technology Helps Physical Therapists Identify Vestibular Disorders
Dizziness and vertigo are among the most common complaints of individuals seeking medical attention, both in the emergency department and with their primary care providers. Vestibular disorders are responsible for the majority of dizziness/vertigo complaints. The Vestibular System, or inner ear, is a highly sensitive system that helps control our equilibrium, balance, and gaze stabilization (i.e., helps our eyes remain focused on a target when we move our head).
Types of Vestibular Disorders include, but are not limited to:
- Benign Paroxysmal Positional Vertigo (BPPV)
- Vestibular Neuritis, Acute Vestibular Syndrome, Unilateral or Bilateral Hypofunction
- Vestibular Migraines
- Meniere’s Disease
- Persistent Postural Perceptual Dizziness (PPPD), or Chronic Subjective Dizziness
- Concussion/Brain Injury
Vestibular Certified Physical Therapists are highly trained to evaluate and treat dizziness of a vestibular origin. During the initial assessment, your Physical Therapist (PT) will be focused on your eye movements. When a Vestibular Disorder is present, involuntary eye movements called nystagmus may be present. Nystagmus will result in eye movements from side to side, up/down, or in a circular motion, and it may cause blurred vision, room spinning, or general disequilibrium. PTs interpret this nystagmus to identify what and where the problem is within your vestibular system, and therefore, provide interventions to address the issue.
Nystagmus is sometimes challenging to interpret, especially in room light. In-room light, your brain, aka the command center, will compensate for the vestibular disorder by helping your eyes to better focus on a target (visual fixation), resulting in fewer symptoms and decreasing the intensity of nystagmus. When nystagmus is less visible, it becomes more difficult to identify the source of the problem.
Infrared Video Goggles are an innovative piece of technology developed to remove visual fixation, allowing your PT to best view the nystagmus and accurately identify the vestibular problem.
In one study, Infrared goggles were able to identify nystagmus or abnormal eye movements in 100% of individuals with a known vestibular pathology, compared to only 33% without Infrared technology (traditional Frenzel lenses or standard assessment).
Infrared Video Goggles are a new and exciting addition to the Excel–West Chester clinic. Not only have these goggles helped identify important clinical findings that would have otherwise been missed, but they have also been incredibly useful for the education of our patients to better understand their dizziness and vertigo.
Dizziness presents in many forms. If you or a family member are experiencing one of the following, you may have a vestibular problem:
- Vertigo (room-spinning or self-spinning)
- Light-headedness or fogginess
In addition to dizziness disrupting usual activities of daily living and quality of life, dizziness and vestibular disorders significantly increase your risk for falling. One study even identified that individuals with the aforementioned deficits were 12 times more likely to fall, leading to injury and other medical complications.
If you believe you are experiencing a vestibular problem, contact your local physical therapist, as well as your primary care provider or ENT to learn more about how Vestibular Rehabilitation can help.
Sarah Pichini, PT, DPT
- Yuri A, Carey JP, Della Santina CC, et al. Disorders of balance and vestibular function in US adults. Arch Intern Med. 2010; 169(10): 938-944.