<?xml version="1.0" encoding="UTF-8"?><rss version="2.0" xmlns:content="http://purl.org/rss/1.0/modules/content/" xmlns:wfw="http://wellformedweb.org/CommentAPI/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:atom="http://www.w3.org/2005/Atom" xmlns:sy="http://purl.org/rss/1.0/modules/syndication/" xmlns:slash="http://purl.org/rss/1.0/modules/slash/" > <channel> <title>Epley maneuver Archives - WWSPT.Com</title> <atom:link href="https://wwspt.com/category/epley-maneuver/feed/" rel="self" type="application/rss+xml" /> <link>https://wwspt.com/category/epley-maneuver/</link> <description>Healing, Function, Recovery, Health</description> <lastBuildDate>Mon, 10 Jun 2024 18:19:45 +0000</lastBuildDate> <language>en-US</language> <sy:updatePeriod> hourly </sy:updatePeriod> <sy:updateFrequency> 1 </sy:updateFrequency> <generator>https://wordpress.org/?v=6.7.2</generator> <site xmlns="com-wordpress:feed-additions:1">215146180</site> <item> <title>Understanding Vestibular Agnosia: A Comprehensive Overview</title> <link>https://wwspt.com/understanding-vestibular-agnosia-a-comprehensive-overview/</link> <comments>https://wwspt.com/understanding-vestibular-agnosia-a-comprehensive-overview/#respond</comments> <dc:creator><![CDATA[Wendy Webb Schoenewald, PT, OCS]]></dc:creator> <pubDate>Mon, 10 Jun 2024 18:19:45 +0000</pubDate> <category><![CDATA[balance]]></category> <category><![CDATA[Benign Paroxysmal Positional Vertigo]]></category> <category><![CDATA[Blog]]></category> <category><![CDATA[BPPV]]></category> <category><![CDATA[brain]]></category> <category><![CDATA[coordination movement problems]]></category> <category><![CDATA[Dizziness]]></category> <category><![CDATA[Epley maneuver]]></category> <category><![CDATA[inner ear]]></category> <category><![CDATA[motion perception]]></category> <category><![CDATA[Neurological condition]]></category> <category><![CDATA[neurology]]></category> <category><![CDATA[Physical Therapy]]></category> <category><![CDATA[Vertigo]]></category> <category><![CDATA[Vestibular Agnosia (VA)]]></category> <category><![CDATA[vestibular disorders]]></category> <category><![CDATA[Vestibular Rehabilitation]]></category> <category><![CDATA[Vestibular System]]></category> <category><![CDATA[WWS Physical Therapy and Vestibular Rehabilitation]]></category> <category><![CDATA[WWSPT]]></category> <guid isPermaLink="false">https://wwspt.com/?p=4419</guid> <description><![CDATA[<p>Introduction Vestibular agnosia is a rare and intriguing neurological condition that affects the brain’s ability to process vestibular information, which is critical for balance and spatial orientation. Understanding vestibular agnosia is crucial for medical professionals, researchers, and those affected despite its rarity. This blog aims to provide a detailed overview of vestibular agnosia, including its […]</p> <p>The post <a href="https://wwspt.com/understanding-vestibular-agnosia-a-comprehensive-overview/">Understanding Vestibular Agnosia: A Comprehensive Overview</a> appeared first on <a href="https://wwspt.com">WWSPT.Com</a>.</p> ]]></description> <content:encoded><![CDATA[<p><strong>Introduction</strong></p> <p>Vestibular agnosia is a rare and intriguing neurological condition that affects the brain’s ability to process vestibular information, which is critical for balance and spatial orientation. Understanding vestibular agnosia is crucial for medical professionals, researchers, and those affected despite its rarity. This blog aims to provide a detailed overview of vestibular agnosia, including its symptoms, causes, diagnosis, and treatment options.</p> <p><strong>What is Vestibular Agnosia?</strong></p> <p>Vestibular agnosia is a neurological disorder characterized by the inability to recognize or process vestibular stimuli. The vestibular system in the inner ear plays a fundamental role in maintaining balance, spatial orientation, and coordinating movement. Individuals with vestibular agnosia have intact vestibular function but cannot consciously perceive or interpret vestibular information, leading to significant difficulties in everyday life.</p> <p><strong>Symptoms of Vestibular Agnosia</strong></p> <p>The symptoms of vestibular agnosia can vary widely but often include:</p> <ul> <li><strong>Balance Issues</strong>: Difficulty maintaining balance, especially in low-visibility conditions.</li> <li><strong>Spatial Disorientation</strong>: Challenges in navigating through space or identifying one’s body position in relation to the environment.</li> <li><strong>Motion Perception Problems</strong>: Inability to perceive or respond appropriately to movement, such as feeling unstable when walking or turning.</li> <li><strong>Vertigo</strong>: Sensations of spinning or dizziness without an apparent cause.</li> <li><strong>Coordination Problems</strong>: Difficulty coordinating movements, leading to clumsiness or frequent falls.</li> </ul> <p><img fetchpriority="high" decoding="async" class="aligncenter" src="https://wwspt.com/wp/wp-content/uploads/2024/06/Agnosia-Science-Direct.png" alt="" width="800" height="530" /></p> <p><strong>Causes and Risk Factors</strong></p> <p>The precise cause of vestibular agnosia is not fully understood. Still, it is typically associated with damage or dysfunction in the brain areas responsible for processing vestibular information, such as the parietal lobes or the temporoparietal junction. Potential causes and risk factors include:</p> <ul> <li><strong>Brain Injury</strong>: Trauma to the head can disrupt vestibular pathways.</li> <li><strong>Neurological Disorders</strong>: Conditions such as stroke, cerebral small vessel disease, Parkinson’s Disease, Alzheimer’s disease, or brain tumors can affect vestibular processing.</li> <li><strong>Infections</strong>: Certain infections can damage the brain regions involved in vestibular perception.</li> <li><strong>Genetic Factors</strong>: There may be a genetic predisposition to developing vestibular agnosia, although this is still under investigation.</li> </ul> <p><strong>Diagnosis</strong></p> <p>Diagnosing vestibular agnosia involves a comprehensive evaluation by a Neurologist or a Vestibular Physical Therapist specializing in vestibular disorders. The diagnostic process typically includes:</p> <ul> <li><strong>Clinical History</strong>: Detailed assessment of symptoms and medical history.</li> <li><strong>Physical Examination</strong>: Tests to evaluate balance, coordination, and spatial orientation.</li> <li>Positional testing for <strong>Benign paroxysmal positional Vertigo</strong> (BPPV)</li> <li><strong>Vestibular Testing</strong>: Specialized tests such as electronystagmography (ENG) or videonystagmography (VNG) to assess vestibular function, Video head thrust Testing(vHIT)</li> <li><strong>Neuroimaging</strong>: MRI or CT scans to identify any brain lesions or abnormalities.</li> </ul> <p><img decoding="async" class="aligncenter" src="https://wwspt.com/wp/wp-content/uploads/2023/03/Wendy_examining_patient_Micromedical__Infrared_Goggles-copy.png" alt="" width="801" height="556" /></p> <p><strong>Treatment and Management</strong></p> <p>Currently, there is no cure for vestibular agnosia, but several treatment approaches can help manage the symptoms and improve quality of life:</p> <ul> <li><strong>Vestibular Rehabilitation Therapy (VRT)</strong>: A customized exercise program to improve balance and spatial orientation. Provide treatment to resolve BPPV</li> <li><strong>Medications</strong>: Drugs to alleviate symptoms like vertigo and dizziness.</li> <li><strong>Cognitive Behavioral Therapy (CBT)</strong>: Psychological support to help patients cope with the emotional and psychological impact of the condition.</li> <li><strong>Assistive Devices</strong>: Tools such as canes or balance aids to enhance safety and mobility.</li> </ul> <p><strong>Conclusion</strong></p> <p>Vestibular agnosia, while rare, presents significant challenges for those affected. We can enhance our understanding and management of this complex condition through continued research and advancements in diagnostic and therapeutic techniques. Healthcare professionals must remain vigilant in recognizing the signs of vestibular agnosia to provide timely and effective support for their patients.</p> <p>Raising awareness and improving education about vestibular agnosia can contribute to better outcomes and quality of life for individuals living with this condition. Suppose you suspect that you or a loved one may be experiencing symptoms of vestibular agnosia. In that case, seeking professional medical advice for a comprehensive evaluation and appropriate management is essential. Contact <a href="https://wwspt.com">WWSPT</a> for additional information on Vestibular agnosia and/or to schedule an evaluation,</p> <p>Wendy Webb Schoenewald, PT, OCS,<br /> WWS Physical Therapy and Vestibular Rehabilitation<br /> Doylestown, PA.</p> <p>(215) 489-3234</p> <p> </p> <p>The post <a href="https://wwspt.com/understanding-vestibular-agnosia-a-comprehensive-overview/">Understanding Vestibular Agnosia: A Comprehensive Overview</a> appeared first on <a href="https://wwspt.com">WWSPT.Com</a>.</p> ]]></content:encoded> <wfw:commentRss>https://wwspt.com/understanding-vestibular-agnosia-a-comprehensive-overview/feed/</wfw:commentRss> <slash:comments>0</slash:comments> <post-id xmlns="com-wordpress:feed-additions:1">4419</post-id> </item> <item> <title>The 3Ds: Diagnostic Dilemma of Dizziness</title> <link>https://wwspt.com/the-3ds-diagnostic-dilemma-of-dizziness/</link> <comments>https://wwspt.com/the-3ds-diagnostic-dilemma-of-dizziness/#respond</comments> <dc:creator><![CDATA[Wendy Webb Schoenewald, PT, OCS]]></dc:creator> <pubDate>Wed, 13 Apr 2022 18:46:05 +0000</pubDate> <category><![CDATA[balance]]></category> <category><![CDATA[Benign Paroxysmal Positional Vertigo]]></category> <category><![CDATA[Blog]]></category> <category><![CDATA[BPPV]]></category> <category><![CDATA[BPPV treatment]]></category> <category><![CDATA[Bucks County Womens Journal]]></category> <category><![CDATA[Dizziness]]></category> <category><![CDATA[Epley maneuver]]></category> <category><![CDATA[Physical Therapy]]></category> <category><![CDATA[vestibular disorders]]></category> <category><![CDATA[Vestibular Rehabilitation]]></category> <category><![CDATA[Vestibular System]]></category> <category><![CDATA[WWS Physical Therapy and Vestibular Rehabilitation]]></category> <category><![CDATA[WWSPT]]></category> <guid isPermaLink="false">https://wwspt.com/?p=3426</guid> <description><![CDATA[<p>Our latest article in the Bucks County Women’s Journal, BCWJ, April – May Helping people resolve Vertigo and Dizziness symptoms is my passion. For the past 30 years at WWS Physical Therapy and Vestibular Rehabilitation, Doylestown, PA. (WWSPT), I have had the privilege of helping thousands of community members alleviate these symptoms. Over the past […]</p> <p>The post <a href="https://wwspt.com/the-3ds-diagnostic-dilemma-of-dizziness/">The 3Ds: Diagnostic Dilemma of Dizziness</a> appeared first on <a href="https://wwspt.com">WWSPT.Com</a>.</p> ]]></description> <content:encoded><![CDATA[<p>Our latest article in the Bucks County Women’s Journal, BCWJ, April – May</p> <p>Helping people resolve Vertigo and Dizziness symptoms is my passion. For the past 30 years at WWS Physical Therapy and Vestibular Rehabilitation, Doylestown, PA. (WWSPT), I have had the privilege of helping thousands of community members alleviate these symptoms.</p> <p>Over the past few decades, the field of Vestibular Rehabilitation (VR) has dramatically expanded. Many more researchers are brilliantly discovering new and effective treatment advances to help physical therapists diagnose and care for patients suffering from Vestibular Dysfunction. To provide our clients with the best care, I strive to stay current on new studies involving vestibular diagnosis of Benign Paroxysmal Positional Vertigo (BPPV), Vestibular Migraine, Meniere’s disease, and Balance issues. How we evaluate our patients to achieve an accurate vestibular diagnosis is essential to their recovery. My staff shares this passion, and we work together to achieve the best outcomes for our patients.</p> <p>What is the Vestibular System? The inner ear is a tiny but complex neural structure that coordinates with our eyes to create a clear vision, guide our muscles and postural system to help us move about with good balance, and let our brain know our direction. The semicircular canals are like a gyroscope sensing rotation, and the otoliths sense acceleration and tilting. Together, they allow us to walk, run, and play without thinking about it.</p> <p>When Vestibular Dysfunction occurs, patients have symptoms of dizziness, vertigo, lightheadedness, nausea, and falling. They have difficulty moving and feel poorly. Many vestibular system disorders occur together, including the most common problem, BPPV, which often follows an attack of vestibular neuritis. Meniere’s disease and vestibular migraine have similar tinnitus symptoms, headaches, and vertigo attacks lasting 2 to 24 hours. These symptoms cause imbalance and distress for patients.</p> <p>Patients have a variety of symptoms on a given day, making it difficult for healthcare providers to diagnose which type of vestibular disorder is plaguing them. With 30 years of experience in the VR field, I often see patients who have been to 4 to 5 physicians or had several ER visits because of acute vertigo,, which can present as a stroke with sudden onset. The most common disorder, BPPV, is far from benign to these patients suffering from debilitating or even disabling symptoms of spinning, nausea, vomiting, and imbalance.</p> <p>At this point, when physicians refer dizzy patients to WWSPT, patients are frustrated and have begun to limit their lifestyle to avoid activities that they believe have caused an attack in the past. For example, patients avoid sleeping on a particular side because rolling to that side caused a vertigo attack three years ago. Simple avoidances for fear of triggering another episode can shrink their world.</p> <p>Our role as specialists in Vestibular Rehabilitation is to become a detective. Not the type you see on TV that finds the killer or the stolen property, but a medical detective who works with your physicians to gather history and information about the tests performed. We do this by taking a detailed account and listening to a patient’s description of episodes. During the evaluation, we piece together bits of information and have the ability to connect certain things that may impact symptoms, such as stress and sleep. We may also help patients correlate other symptoms that could be related to their dizziness. For example, patients might not realize that their headaches or tinnitus are related to their episodes of vertigo. Connecting the evident and not-so-obvious dots will help determine tests to perform.</p> <p>We have several types of technology to assist us. The first is called a Videonystagmoscope; an infrared video camera placed on the patient’s eyes within goggles. These goggles allow observation of the eyes’ nystagmus patterns during an exam, such as the Hallpike Dix positional test. While wearing the goggles, the patient only sees darkness, which gives us a different view of how the eyes and nervous system work in the dark compared to room light.</p> <p><img decoding="async" class="alignnone" src="https://wwspt.com/wp/wp-content/uploads/2022/04/Wendy-demonstrates-BPPV-Lens.png" alt="" width="1772" height="1228" /></p> <p>Interpretation of nystagmus takes skill and experience since no two patients are the same and vestibular disorders commonly overlap. The video of the nystagmus pattern is crucial in helping us discern one vestibular disorder from another and determine whether the brain is more involved than the inner ear. For BPPV, the infrared goggles diagnose which of the three semicircular canals is causing vertigo. They help therapists accurately perform treatment with maneuvers such as the Epley. The technology allows us to see if our treatment choice is patients referred by other physicians by watching the nystagmus pattern during maneuvers.</p> <p>Another helpful technology is the Video Head Impulse Test (vHIT) which looks at the patient’s eyes in room light and measures the eyes’ reflexive response to quick head movements. It screens for vestibular disorders and can help diagnose inner-ear issues from central pathways of the brain linked to the ear. The information from this testing can help therapists adjust their treatment to allow patients the best recovery.</p> <p><img decoding="async" src="https://wwspt.com/wp/wp-content/uploads/2022/04/do-you-suffer-from-Dizziness-.png" alt="" /></p> <p>My colleagues and I at WWS Physical Therapy and Vestibular Rehabilitation, Doylestown, PA., are specialists in diagnosing and treating all vestibular disorders. The key is a thorough history and clinical exam, coupled with the latest technology to provide an accurate diagnosis and ensure we choose the best options for recovery. Please find more information about WWSPT on our website at <a href="http://www.wwspt.com/">www.wwspt.com.</a></p> <p>Wendy Webb Schoenewald, PT, OCS,<br /> WWS Physical Therapy & Vestibular Rehabilitation<br /> Doylestown, PA.<br /> (215) 489-3242</p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p>The post <a href="https://wwspt.com/the-3ds-diagnostic-dilemma-of-dizziness/">The 3Ds: Diagnostic Dilemma of Dizziness</a> appeared first on <a href="https://wwspt.com">WWSPT.Com</a>.</p> ]]></content:encoded> <wfw:commentRss>https://wwspt.com/the-3ds-diagnostic-dilemma-of-dizziness/feed/</wfw:commentRss> <slash:comments>0</slash:comments> <post-id xmlns="com-wordpress:feed-additions:1">3426</post-id> </item> <item> <title>Dentist Chair Triggers</title> <link>https://wwspt.com/dentist-chair-triggers/</link> <comments>https://wwspt.com/dentist-chair-triggers/#comments</comments> <dc:creator><![CDATA[Wendy Webb Schoenewald, PT, OCS]]></dc:creator> <pubDate>Thu, 03 Feb 2022 19:53:47 +0000</pubDate> <category><![CDATA[balance]]></category> <category><![CDATA[Benign Paroxysmal Positional Vertigo]]></category> <category><![CDATA[Blog]]></category> <category><![CDATA[BPPV]]></category> <category><![CDATA[BPPV treatment]]></category> <category><![CDATA[Dizziness]]></category> <category><![CDATA[Epley maneuver]]></category> <category><![CDATA[Health and Wellness]]></category> <category><![CDATA[Treatments]]></category> <category><![CDATA[Vertigo]]></category> <category><![CDATA[vestibular disorders]]></category> <category><![CDATA[Vestibular Rehabilitation]]></category> <category><![CDATA[Vestibular System]]></category> <category><![CDATA[WWS Physical Therapy and Vestibular Rehabilitation]]></category> <category><![CDATA[WWSPT]]></category> <guid isPermaLink="false">https://wwspt.com/?p=3339</guid> <description><![CDATA[<p>At the WWS Physical Therapy and Vestibular Rehabilitation clinic, Doylestown, PA., we treat many patients with a type of #vertigo, called Benign Positional Paroxysmal Vertigo, or #BPPV. BPPV is a peripheral #vestibular disorder involving the inner ear that causes spells of dizziness typically lasting less than one minute when the head is in certain head […]</p> <p>The post <a href="https://wwspt.com/dentist-chair-triggers/">Dentist Chair Triggers</a> appeared first on <a href="https://wwspt.com">WWSPT.Com</a>.</p> ]]></description> <content:encoded><![CDATA[<p>At the WWS Physical Therapy and Vestibular Rehabilitation clinic, Doylestown, PA., we treat many patients with a type of #vertigo, called Benign Positional Paroxysmal Vertigo, or #BPPV. BPPV is a peripheral #vestibular disorder involving the inner ear that causes spells of dizziness typically lasting less than one minute when the head is in certain head positions. And Vertigo is defined as an illusion of movement or a sense of spinning. In BPPV, vertigo is brief, lasting only a few seconds.</p> <p>So, you ask – <strong>What does BPPV have to do with the Dentist’s chair?</strong> One wouldn’t think that #BPPV has anything to do with going to the dentist, but patients often have #BPPV attacks when laid back in the dentist’s chair. It’s not the dentist or hygienist that causes the attack, but it is the <strong>position</strong> that the patient is put in. Sitting or lying back in the dentist’s chair can trigger #vertigo by allowing the “crystals” in the inner ear to shift.</p> <p> </p> <p><img decoding="async" class="aligncenter" src="https://wwspt.com/wp/wp-content/uploads/2022/02/BPPV-TRIGGERS-DENTIST-CHAIR.jpg" alt="" /></p> <p>The mechanism causing Vertigo involves these displaced #crystals, called #otoconia, which, with treatment, we effectively return to the right chamber of the inner ear. Treatment consists in performing an #Epley maneuver by a Certified Vestibular Physical Therapist for Inner Ear disorders and Balance disorders — we lay the patient on their back while tilting their head back and maneuvering their head and body to shift the otoconia to the correct position. See the video below:</p> <p> </p> <div class="wwspt-content-box"> <div class="wwspt-treat-box"> <h2>Physical Therapy for BPPV Vertigo</h2> </div> </div> <div class="wwspt-content-box" style="text-align: justify;"><div class="su-row"> <div class="su-column su-column-size-1-2"><div class="su-column-inner su-u-clearfix su-u-trim"> Many symptoms can be attributed to the vestibular system, such as Vertigo or spinning, motion-triggered dizziness, feeling off-balance, lightheadedness. A vestibular rehab is an exercise approach provided by a Certified Vestibular Physical Therapist for Inner Ear disorders and Balance disorders that affect people in their daily lives.<br /> </div></div> <div class="su-column su-column-size-1-2"><div class="su-column-inner su-u-clearfix su-u-trim"> <center><iframe loading="lazy" src="https://www.youtube.com/embed/9SLm76jQg3g" width="auto" height="280" frameborder="0" allowfullscreen="allowfullscreen"></iframe></center><br /> </div></div> </div></div> <div class="wwspt-content-box"> <p> </p> <p>After treatment, we educate the patients about what to do and what not to do. The dentist chair and the hairdresser’s shampoo bowl are two activities we stress to avoid for the next 24 hours. The angle of these activities can allow the #otoconia (crystals) to dislodge again.</p> <div class="su-row"> <div class="su-column su-column-size-1-2"><div class="su-column-inner su-u-clearfix su-u-trim"> <p style="text-align: center;"><strong>Download BPPV Brochure:</strong></p> <p><a href="https://wwspt.com/wp/wp-content/uploads/2022/02/BPPV-Brochure-Updated-2021pdf-update.pdf" target="_blank" rel="noopener"><img loading="lazy" decoding="async" class="aligncenter wp-image-844 size-medium" style="border: 1px solid #ececec;" title="BPPV (Benign Paroxysmal Positional Vertigo) Brochure" src="https://wwspt.com/wp/wp-content/uploads/2015/01/bppv-brochure-228x300.jpg" alt="BPPV (Benign Paroxysmal Positional Vertigo) Brochure" width="228" height="300" /></a></div></div> </div> <p><strong> </strong></p> <p><strong> </strong></p> <p>Wendy Webb Schoenewald, PT, OCS,</p> <p>WWS Physical Therapy and Vestibular Rehabilitation,<br /> Doylestown, PA.</p> </div> <p>The post <a href="https://wwspt.com/dentist-chair-triggers/">Dentist Chair Triggers</a> appeared first on <a href="https://wwspt.com">WWSPT.Com</a>.</p> ]]></content:encoded> <wfw:commentRss>https://wwspt.com/dentist-chair-triggers/feed/</wfw:commentRss> <slash:comments>1</slash:comments> <post-id xmlns="com-wordpress:feed-additions:1">3339</post-id> </item> <item> <title>Vestibular Rehabilitation Answers Vertigo Issues</title> <link>https://wwspt.com/vestibular-rehabilitation-answers-vertigo-issues/</link> <comments>https://wwspt.com/vestibular-rehabilitation-answers-vertigo-issues/#respond</comments> <dc:creator><![CDATA[Wendy Webb Schoenewald, PT, OCS]]></dc:creator> <pubDate>Tue, 21 Sep 2021 05:00:23 +0000</pubDate> <category><![CDATA[Blog]]></category> <category><![CDATA[BPPV]]></category> <category><![CDATA[BPPV treatment]]></category> <category><![CDATA[Epley maneuver]]></category> <category><![CDATA[Physical Therapy]]></category> <category><![CDATA[Vertigo]]></category> <category><![CDATA[Vestibular Rehabilitation]]></category> <category><![CDATA[VR]]></category> <category><![CDATA[WWS Physical Therapy and Vestibular Rehabilitation]]></category> <category><![CDATA[WWSPT]]></category> <guid isPermaLink="false">https://wwspt.com/?p=2169</guid> <description><![CDATA[<p>“Vestibular Rehabilitation: An answer for Vertigo” from a previous article in the Bucks County Herald By Wendy Webb Schoenewald PT OCS People who have Vertigo, and are suffering from symptoms of dizziness, nausea, loss of balance and vomiting, may not know that there is a simple treatment that can cure those symptoms and allow them […]</p> <p>The post <a href="https://wwspt.com/vestibular-rehabilitation-answers-vertigo-issues/">Vestibular Rehabilitation Answers Vertigo Issues</a> appeared first on <a href="https://wwspt.com">WWSPT.Com</a>.</p> ]]></description> <content:encoded><![CDATA[<p>“Vestibular Rehabilitation: An answer for Vertigo”<br /> from a previous article in the Bucks County Herald By Wendy Webb Schoenewald PT OCS</p> <p>People who have Vertigo, and are suffering from symptoms of dizziness, nausea, loss of balance and vomiting, may not know that there is a simple treatment that can cure those symptoms and allow them to return to life as normal.</p> <p>Physical therapists expertly trained in vestibular therapy can perform a single maneuver on patients experiencing these symptoms that 80 percent of the time will eliminate vertigo.</p> <p>“It’s a pretty amazing process, that you lay someone down, maneuver their head and body and their symptoms are gone,” said Wendy Webb Schoenewald, physical therapist and owner of WWS Physical Therapy and Vestibular Rehabilitation in Doylestown. Many times when we treat orthopedic conditions, it’s six weeks before they’re better, this it is very quickly resolved with a couple of treatments with no drugs involved.”<br /> The physical therapists at WWSPT are trained certified vestibular therapists who treat patients with vertigo.</p> <p><img loading="lazy" decoding="async" class="aligncenter size-full wp-image-532" src="https://wwspt.com/wp/wp-content/uploads/2015/01/Treating-BPPV-with-Frenzel-Lens-753x358.jpg" alt="" width="753" height="358" srcset="https://wwspt.com/wp/wp-content/uploads/2015/01/Treating-BPPV-with-Frenzel-Lens-753x358.jpg 753w, https://wwspt.com/wp/wp-content/uploads/2015/01/Treating-BPPV-with-Frenzel-Lens-753x358-300x143.jpg 300w, https://wwspt.com/wp/wp-content/uploads/2015/01/Treating-BPPV-with-Frenzel-Lens-753x358-250x119.jpg 250w, https://wwspt.com/wp/wp-content/uploads/2015/01/Treating-BPPV-with-Frenzel-Lens-753x358-750x358.jpg 750w" sizes="auto, (max-width: 753px) 100vw, 753px" /></p> <p>Benign Paroxysmal Positional Vertigo, or BPPV, is a peripheral vestibular disorder involving the inner ear that causes spells of vertigo that typically last less than one minute when the head is in certain positions. It occurs when crystals call otoconia are displaced into the canals.<br /> Vertigo can make common, everyday tasks, like doing sit-ups, reaching for a kitchen cabinet, or bending over to pick something up difficult, inducing nausea and vomiting.</p> <p>This can mean patients avoid doing things they love, like working out. For elderly patients, this can mean a loss of mobility and independence if left untreated because they may be afraid that moving around could cause them to fall. For this reason, it is very important for patients to be treated immediately.</p> <p>A trained therapist can confirm the diagnosis of BPPV.<br /> The treatment for this type of vertigo involves manually moving the crystals out of the canals.</p> <p>The most common treatment, the Epley Maneuver, will correct vertigo in one visit 80 percent of the time when performed by a physical therapist who has been specifically trained in vestibular therapy. A skilled therapist will take the patient and lay them down with their head tilted to get the crystals to move. When dizziness subsides, and the crystals have settled into a new position, the therapist will move the patient a second time, to move the crystals farther along out of the canal. When dizziness subsides, the patient will sit up, and the crystals will have moved back into the correct location. To check and make sure all the crystals were put back correctly, the Epley Maneuver is performed a second time to confirm the patient isn’t still getting dizzy.</p> <p>Even though the treatment is simple and effective, patients may put off contacting a therapist because they don’t want to feel worse before they feel better.</p> <p>“We’re effective at keeping symptoms as minimal as possible to successfully treat BPPV,” Schoenewald said.</p> <p>If you or a family member is suffering from vertigo or dizzy symptoms it is important to see your primary care provider, who can directly refer to a vestibular physical therapist.</p> <p>For more information or to schedule an appointment, Contact WWSPT Staff at 215.489.3234.</p> <p>The post <a href="https://wwspt.com/vestibular-rehabilitation-answers-vertigo-issues/">Vestibular Rehabilitation Answers Vertigo Issues</a> appeared first on <a href="https://wwspt.com">WWSPT.Com</a>.</p> ]]></content:encoded> <wfw:commentRss>https://wwspt.com/vestibular-rehabilitation-answers-vertigo-issues/feed/</wfw:commentRss> <slash:comments>0</slash:comments> <post-id xmlns="com-wordpress:feed-additions:1">2169</post-id> </item> <item> <title>How Do You Know If You Have Vertigo?</title> <link>https://wwspt.com/how-do-you-know-if-you-have-vertigo/</link> <comments>https://wwspt.com/how-do-you-know-if-you-have-vertigo/#respond</comments> <dc:creator><![CDATA[Wendy Webb Schoenewald, PT, OCS]]></dc:creator> <pubDate>Wed, 07 Oct 2020 15:38:05 +0000</pubDate> <category><![CDATA[balance]]></category> <category><![CDATA[Benign Paroxysmal Positional Vertigo]]></category> <category><![CDATA[Blog]]></category> <category><![CDATA[BPPV]]></category> <category><![CDATA[BPPV treatment]]></category> <category><![CDATA[Dizziness]]></category> <category><![CDATA[Epley maneuver]]></category> <category><![CDATA[Fainting]]></category> <category><![CDATA[PT Treatments]]></category> <category><![CDATA[Vertigo]]></category> <category><![CDATA[vestibular disorders]]></category> <category><![CDATA[Vestibular Migraines]]></category> <category><![CDATA[Vestibular Rehabilitation]]></category> <category><![CDATA[VR]]></category> <category><![CDATA[WWS Physical Therapy and Vestibular Rehabilitation]]></category> <category><![CDATA[WWSPT]]></category> <guid isPermaLink="false">https://wwspt.com/?p=2882</guid> <description><![CDATA[<p>People are often referred to my office for treatment with a medical diagnostic code of “dizziness and giddiness.” This is an old term used when we didn’t understand the vestibular system, but it has remained in the medical coding system. I find this diagnosis interesting because giddiness makes me think of someone laughing and happy, […]</p> <p>The post <a href="https://wwspt.com/how-do-you-know-if-you-have-vertigo/">How Do You Know If You Have Vertigo?</a> appeared first on <a href="https://wwspt.com">WWSPT.Com</a>.</p> ]]></description> <content:encoded><![CDATA[<p>People are often referred to my office for treatment with a medical diagnostic code of “dizziness and giddiness.” This is an old term used when we didn’t understand the vestibular system, but it has remained in the medical coding system. I find this diagnosis interesting because giddiness makes me think of someone laughing and happy, but most of my patients with vertigo are not either of those things! They are struggling with dizziness throughout their day and are often frustrated and fearful.</p> <p>People with vertigo describe many symptoms including dizziness, spinning, nausea, vomiting, migraines, loss of balance, difficulty walking, and mental fogginess. The balance center located in our inner ear, called the vestibular system, is essential to our body’s ability to function every day. Although it is small—the size of a peanut M&M’s®—when it doesn’t work properly, it becomes a big problem. It can keep you from walking safely and thinking properly and can cause you to feel disoriented and sick.</p> <p><img decoding="async" class="aligncenter" src="https://wwspt.com/wp/wp-content/uploads/2017/11/BPPVanDizziness.jpg" alt="" /></p> <p>The vestibular system’s job is to coordinate our brain and vision with our postural system. This sounds simple, but anyone who’s had a vestibular event knows that, when this system is disrupted, it makes it very difficult to see clearly or move your head quickly. It can cause disorientation so intense that it can knock you over when trying to get out of bed. Fortunately, the specialty of physical therapy known as vestibular rehabilitation can be effective in restoring balance to this tiny but powerful system. Most people referred to my office say they’ve never heard of vestibular rehabilitation, but two out of three people have had some kind of vestibular dysfunction and are aware that therapies can be helpful. According to the National Institutes of Health, about 15% of American adults, or 33 million people, had balance or dizziness problems in the past year. Often patients aren’t clearly diagnosed, so it is part of my role to look for the signs and symptoms of a vestibular problem. Due to the widespread effect that the vestibular system has on proper functioning and coordination, determining a proper diagnosis can be challenging.</p> <p>The most common vestibular disorder—which accounts for a third of vertigo presentations to dizzy clinics and emergency rooms—is BPPV or Benign Paroxysmal Positional Vertigo. It is more common in adults but also presents in the younger population due to its relationship to migraine and concussion. BPPV affects the inner ear, causing spinning spells that typically last one minute or less and are provoked by a change in body or head positions like looking up to a top shelf or getting out of bed. In the inner ear, there are three structures called Semicircular Canals that sense rotational head movements. Calcium carbonate crystals sometimes get loose, and, when they find their way into these canals, they trigger a spinning sensation associated with nausea, vomiting, imbalance, and discomfort. This condition can be treated with maneuvers designed to put the crystals back into their proper location, such as the Epley maneuver. For more detailed information on BPPV, visit Http:// bit.ly/WWSPTFeb2016.</p> <p><img decoding="async" class="aligncenter" src="https://wwspt.com/wp/wp-content/uploads/2020/10/Do-you-suffer-from-dizziness.jpg" alt="" /></p> <p>Vestibular migraine is the second most common cause of dizziness. Patients with migraine can have associated vertigo occurring with a migraine headache, afterward, or even without a headache at all. About 12% of the population suffers from migraines, with a higher prevalence in women than men. About 10% of children experience migraines, but it is most common between the ages of 25 and 55. Vestibular migraine is often preceded by visual symptoms of aura, or warning, including neurological symptoms like sensitivity to light and sound, as well as nausea and imbalance. Management of vestibular migraine includes being aware of what may trigger your migraine, drinking lots of fluids, and exercising regularly. BPPV can trigger a vestibular migraine but is also a common sequela of a migraine attack. Learn more about vestibular migraine at <a href="http://bit.ly/WWSPTOct2018">http://bit.ly/WWSPTOct2018.</a></p> <p>Ménière’s disease is a well-known disorder that can cause spells of disabling vertigo and is commonly associated with hearing loss. It is thought to be a fluid imbalance problem in the inner ear, causing vertigo symptoms lasting a full day that become more disabling with each attack. The mechanism of Ménière’s is not clear, but the attack can occur frequently without a specific trigger, making it more difficult to manage.</p> <p>Vestibular neuronitis, also called labyrinthitis, is an acute disorder of the inner ear caused by a virus attacking the inner ear and reducing input to your brain, which causes severe and sudden onset of dizziness and imbalance. Some patients also have associated hearing loss. Often these patients cannot get out of bed for 1 to 2 days and have symptoms of nausea, vomiting, and imbalance. In this disorder, there is damage to the vestibular nerve, so recovery can take between 3 and 12 weeks depending on the severity. The research shows that starting vestibular rehabilitation as early as possible facilitates a faster recovery.</p> <p>The impact of vestibular disorders on a person’s lifestyle is considerable. They cause a significant interruption of daily activities and an increased need for medical leave from work. Most vestibular patients see 3 to 4 physicians before being properly diagnosed, affecting patients fiscally as well. Vestibular disorders are shown to impact mood, causing increased depression and anxiety. They affect cognitive status because patients are working harder to function which leads to difficulties in spatial memory and attention or “brain fog.”</p> <p>The team of professionals at WWSPT is committed to the proper evaluation and diagnosis of patients with vestibular dysfunction. This helps us utilize the appropriate strategies and treatment to return you to a more active, healthy lifestyle. If you’re dizzy, please give us a call today so we can help you on the road to recovery.</p> <p><em>Wendy Webb Schoenewald, PT, OCS<br /> WWS Physical Therapy & Vestibular Rehabilitation<br /> 1456 Ferry Road, Suite 601<br /> </em><em>Doylestown, Pennsylvania</em></p> <p><em> </em>215.489.3234</p> <p>The post <a href="https://wwspt.com/how-do-you-know-if-you-have-vertigo/">How Do You Know If You Have Vertigo?</a> appeared first on <a href="https://wwspt.com">WWSPT.Com</a>.</p> ]]></content:encoded> <wfw:commentRss>https://wwspt.com/how-do-you-know-if-you-have-vertigo/feed/</wfw:commentRss> <slash:comments>0</slash:comments> <post-id xmlns="com-wordpress:feed-additions:1">2882</post-id> </item> <item> <title>How Can I Prevent Recurrence of BPPV?</title> <link>https://wwspt.com/how-can-i-prevent-recurrence-of-bppv/</link> <comments>https://wwspt.com/how-can-i-prevent-recurrence-of-bppv/#comments</comments> <dc:creator><![CDATA[Wendy Webb Schoenewald, PT, OCS]]></dc:creator> <pubDate>Mon, 05 Oct 2020 19:16:09 +0000</pubDate> <category><![CDATA[Benign Paroxysmal Positional Vertigo]]></category> <category><![CDATA[Blog]]></category> <category><![CDATA[BPPV]]></category> <category><![CDATA[BPPV treatment]]></category> <category><![CDATA[Epley maneuver]]></category> <guid isPermaLink="false">https://wwspt.com/?p=2874</guid> <description><![CDATA[<p>Do you have symptoms like dizziness, lightheadedness, nausea, or a feeling of being off-balance? These are all symptoms of a very common form of an inner ear disorder called Benign Paroxysmal Positional Vertigo, BPPV. It is the most common disorder of the inner ear affecting about 9% of the population over 60 years old. It is […]</p> <p>The post <a href="https://wwspt.com/how-can-i-prevent-recurrence-of-bppv/">How Can I Prevent Recurrence of BPPV?</a> appeared first on <a href="https://wwspt.com">WWSPT.Com</a>.</p> ]]></description> <content:encoded><![CDATA[<p>Do you have symptoms like dizziness, lightheadedness, nausea, or a feeling of being off-balance? These are all symptoms of a very common form of an inner ear disorder called <strong>Benign Paroxysmal Positional Vertigo, BPPV</strong>. It is the most common disorder of the inner ear affecting about 9% of the population over 60 years old. It is the most common diagnosis treated in my clinic, representing 30 to 40% of the dizzy patients we evaluate. Since it is associated with increased fall risk in adults, it is important to treat them promptly.</p> <p>BPPV is a mechanical disorder of the inner ear that occurs when calcium carbonate crystals, called otoconia, which are normally embedded in the utricle of the inner ear, become dislodged. They migrate into one or more of the three semicircular canals, where they are not supposed to be. When this happens, the otoconia shift and create an abnormal movement of fluid in the canal, causing a false sense of rotational motion. Once the otoconia are loose, if we move our head or body, the fluid moves more quickly because of the weight of the otoconia. This causes the inner ear to send false signals to the brain that the room is spinning. This creates the illusion of motion the patient perceives as vertigo, though physiologically it causes abnormal eye movement called nystagmus, which therapists can observe to diagnose BPPV. <strong>How is it treated? </strong>Since #BPPV is a mechanical disorder of the inner ear, it can be treated quickly without medicine. A specially trained vestibular physical therapist can resolve vertigo by performing an #<strong>Epley maneuver</strong>, also called a canalith repositioning maneuver. The therapist uses a very specific series of head and body movements to guide the otoconia back to the utricle where they belong. Sometimes, the otoconia are found to be in a different canal or are adhered to the cupula. This will then require the use of a different maneuver for treatment, but your therapist will be able to determine this through observations during the exam.</p> <p><img decoding="async" class="aligncenter" src="https://wwspt.com/wp/wp-content/uploads/2015/01/Diadnosing-BPPV-with-Frenzel-Lens.jpg" alt="" /></p> <p>Though patients can commonly be treated effectively with the Epley maneuver, the recurrence rate for BPPV is high. Since its symptoms are not very pleasant, patients who suffer from vertigo do not like to hear that there is a 10 to 18% chance of another attack within the next year. The recurrence can vary greatly; patients might have another attack within 6 months or 6 years.</p> <p><img loading="lazy" decoding="async" class="aligncenter" src="https://wwspt.com/wp/wp-content/uploads/2015/01/photo_24-e1410262077264.jpg" alt="Epley " width="940" height="702" /></p> <p><strong>How can I prevent recurrent attacks?</strong></p> <p>The etiology of BPPV is unclear, but a recent systematic review of research articles from 14 countries looks at risk factors affecting the recurrence of BPPV. The risk factors identified may help us identify fall risk patients and help clinicians educate patients about the importance of follow-up after BPPV diagnosis.</p> <p><strong>Women are more likely to relapse than men</strong>, which may be related to menopause causing changes in hormone levels. Patients <strong>older than </strong><strong>65 years </strong>are more likely than their younger peers to suffer from BPPV. <strong>Osteoporosis </strong>has been found to be common in patients with BPPV. Age-related decline in calcium metabolism may also affect the otoconia, weakening their structure, which causes them to break off and allows them to float freely. Treatment of osteoporosis may have a protective effect against BPPV. This study also suggests that systemic diseases, including <strong>hypertension, hyperlipidemia, and diabetes mellitus</strong>, could increase the incidence of relapse attacks. This may be related to the known effect of vascular disease on the inner ear. These diseases can affect microcirculation, causing ischemia or reduced blood flow to the inner ear. It is important to monitor your glucose, A1C readings, and blood pressure and follow your doctor’s recommendations for the management of these disorders.</p> <p>History of <strong>migraines </strong>is a strong risk factor for relapse of BPPV which can have a vascular factor that can damage the inner ear making recurrent BPPV more prevalent. Common inner ear disorders, such as <strong>otitis media and Meniere’s disease</strong>, increase the incidence of BPPV by disrupting the normal function of the semicircular canals.</p> <p>In <strong>head trauma</strong>, 13% of patients report positional vertigo and have bilateral disease at a higher rate than idiopathic attacks of BPPV. Another risk factor that is a common problem with aging adults is <strong>cervical spondylosis </strong>and limited mobility of the spine, which makes BPPV treatment maneuvers more difficult to perform.</p> <p>These risk factors for the recurrence of BPPV help us measure fall risk in patients and help clinicians educate patients about the importance of follow-up after BPPV diagnosis. Regular aerobic exercise can be helpful in managing all these disorders and in keeping the vestibular system healthy. Medical management from your primary physician is important in managing the systemic conditions. A thorough discussion about your medical history with our clinicians helps us customize a treatment and education program specific to you. Although we love what we do in fixing dizzy patients, we want to teach our patients to have confidence in managing and preventing their own symptoms.</p> <p><em>Wendy Webb Schoenewald, </em><em>PT, OCS </em></p> <p>WWS Physical Therapy & Vestibular Rehabilitation<br /> Doylestown, PA<br /> 215-489-3234</p> <p> </p> <p>The post <a href="https://wwspt.com/how-can-i-prevent-recurrence-of-bppv/">How Can I Prevent Recurrence of BPPV?</a> appeared first on <a href="https://wwspt.com">WWSPT.Com</a>.</p> ]]></content:encoded> <wfw:commentRss>https://wwspt.com/how-can-i-prevent-recurrence-of-bppv/feed/</wfw:commentRss> <slash:comments>1</slash:comments> <post-id xmlns="com-wordpress:feed-additions:1">2874</post-id> </item> <item> <title>Balance and Aging</title> <link>https://wwspt.com/balance-and-aging/</link> <comments>https://wwspt.com/balance-and-aging/#respond</comments> <dc:creator><![CDATA[Wendy Webb Schoenewald, PT, OCS]]></dc:creator> <pubDate>Sat, 19 Sep 2020 16:40:03 +0000</pubDate> <category><![CDATA[balance]]></category> <category><![CDATA[Benign Paroxysmal Positional Vertigo]]></category> <category><![CDATA[Blog]]></category> <category><![CDATA[BPPV]]></category> <category><![CDATA[BPPV treatment]]></category> <category><![CDATA[Dizziness]]></category> <category><![CDATA[Epley maneuver]]></category> <category><![CDATA[Exercise]]></category> <category><![CDATA[Healthy Aging]]></category> <category><![CDATA[Physical Therapy]]></category> <category><![CDATA[PT Treatments]]></category> <category><![CDATA[VeDa]]></category> <category><![CDATA[Vertigo]]></category> <category><![CDATA[vestibular disorders]]></category> <category><![CDATA[Vestibular Migraines]]></category> <category><![CDATA[Vestibular Rehabilitation]]></category> <category><![CDATA[VR]]></category> <category><![CDATA[WWS Physical Therapy and Vestibular Rehabilitation]]></category> <category><![CDATA[WWSPT]]></category> <guid isPermaLink="false">https://wwspt.com/?p=2859</guid> <description><![CDATA[<p>WHY ARE SENIORS AT HIGHER RISK FOR FALLS? Dizziness can happen at any age, but if it results in falling it can be a serious health concern, particularly in older adults. Studies show that you can take action to reduce dizziness and your risk of falling. Begin by talking with your health care providers to […]</p> <p>The post <a href="https://wwspt.com/balance-and-aging/">Balance and Aging</a> appeared first on <a href="https://wwspt.com">WWSPT.Com</a>.</p> ]]></description> <content:encoded><![CDATA[<h2>WHY ARE SENIORS AT HIGHER RISK FOR FALLS?</h2> <p>Dizziness can happen at any age, but if it results in falling it can be a serious health concern, particularly in older adults.</p> <p>Studies show that you can take action to reduce dizziness and your risk of falling. Begin by talking with your health care providers to explore medical issues that may be contributing to your symptoms, and exercise to improve your balance and strength.</p> <h3>How Do We Maintain Balance?</h3> <p>Normal balance is dependent on many factors, including multiple systems of the body, as well as external and environmental factors.</p> <p>The body has three primary sensory systems that work together to create postural stability. With normal brain function, the vestibular system of the inner ear coordinates with the visual system and proprioceptors that sense the position and movement of your body in space. These three systems work together while we perform simple tasks, such as standing and walking, or more complex and dynamic activities, such as yoga or hitting a golf ball accurately.</p> <p><img loading="lazy" decoding="async" class="aligncenter size-full wp-image-2262" src="https://wwspt.com/wp/wp-content/uploads/2019/09/Balance-senior.jpg" alt="" width="900" height="572" srcset="https://wwspt.com/wp/wp-content/uploads/2019/09/Balance-senior.jpg 900w, https://wwspt.com/wp/wp-content/uploads/2019/09/Balance-senior-300x191.jpg 300w, https://wwspt.com/wp/wp-content/uploads/2019/09/Balance-senior-768x488.jpg 768w, https://wwspt.com/wp/wp-content/uploads/2019/09/Balance-senior-250x159.jpg 250w" sizes="auto, (max-width: 900px) 100vw, 900px" /></p> <h3>What Causes Dizziness & Imbalance As We Age?</h3> <ul> <li>Impaired Inner Ear Function</li> <li>Cardiovascular Health</li> <li>Neurological Disease</li> <li>Arthritis</li> <li>Mental Status</li> <li>Nutrition</li> <li>Impaired Vision</li> <li>Lifestyle and Environmental Factors</li> </ul> <h3>How Does the Inner Ear Create Symptoms?</h3> <p>The inner ear is a complex structure of fluid-filled tubes and chambers. Specialized nerve endings inside these structures sense the position and movement of the head and detect the direction of gravity. Signals sent from the nerves of the vestibular system are critically important to the brain’s ability to control balance in standing and walking. They also control movements of the eyes that make it possible to see clearly while moving.</p> <p>Anatomical studies have shown that the number of nerve cells in the vestibular system decreases after about age 55. Blood flow to the inner ear also decreases with age. When the vestibular system is damaged, an individual may experience dizziness and balance problems. However, the gradual, age-related loss of vestibular nerve endings can result in balance problems without any associated dizziness. This type of slow loss of vestibular function may be first noticed as difficulty walking or standing, especially in the dark while on soft or uneven surfaces (such as thick carpet or a forest path).</p> <p>A decline in inner ear function may be caused by a number of conditions, including normal aging, benign paroxysmal positional vertigo (BPPV), infection, Meniere’s disease, or diminished blood flow to specialized nerve cells. Additionally, certain medications such as some antibiotics for severe infections and chemotherapy may damage the inner ear, resulting in temporary or permanent hearing loss, impaired balance, and trouble seeing clearly while in motion. Feelings of dizziness, vertigo, imbalance, and disequilibrium may indicate that the inner ear is not functioning correctly.</p> <p>Benign Paroxysmal Positional Vertigo (BPPV) is the most common vestibular disorder in older adults and causes a sense of true spinning vertigo triggered by a change of position of the head or body. With this condition the spinning can be triggered by things like tipping your head up or down, quickly rotating your head, bending over, rolling over in bed, or getting in and out of bed. BPPV is a mechanical disorder that occurs when debris, called otoconia, loosen and tumble into the semicircular canals of the inner ear. This event causes false signals to the brain triggering a brief sense of vertigo. The spinning lasts less than a minute and can provoke nausea, vomiting, and imbalance. BPPV can be effectively treated by a Vestibular Physical Therapist with specialized training by using proven techniques, such as the Epley maneuver or canal repositioning techniques, which help return the otoconia to their correct position in the inner ear.</p> <p>Labyrinthitis is an infection or inflammation of the inner ear that causes severe vertigo lasting 1-2 days, hearing loss, and severe imbalance that can affect walking. Neuronitis is a similar disorder causing vertigo, but it does not affect hearing. Both can be triggered by an upper respiratory infection, virus or flu, or can occur with no obvious cause.</p> <p>Meniere’s disease causes similar symptoms, including periodic episodes of vertigo, dizziness, and hearing loss. It is thought to be a result of an excess amount of fluid, called endolymph, collecting in the inner ear.</p> <p><img loading="lazy" decoding="async" class="aligncenter size-full wp-image-2741" src="https://wwspt.com/wp/wp-content/uploads/2020/05/Vestibular-System-small.jpg" alt="" width="900" height="706" srcset="https://wwspt.com/wp/wp-content/uploads/2020/05/Vestibular-System-small.jpg 900w, https://wwspt.com/wp/wp-content/uploads/2020/05/Vestibular-System-small-300x235.jpg 300w, https://wwspt.com/wp/wp-content/uploads/2020/05/Vestibular-System-small-768x602.jpg 768w, https://wwspt.com/wp/wp-content/uploads/2020/05/Vestibular-System-small-250x196.jpg 250w" sizes="auto, (max-width: 900px) 100vw, 900px" /></p> <h3>Neurological Diseases – Healthy Brain</h3> <p>Normal orientation also relies on healthy brain function to process, adapt, and interpret changing sensory information from the vestibular system, vision, and body input. The brain must process this information to select appropriate balancing strategies and learn new strategies necessary for changing environments. There are many disorders, such as stroke, Alzheimer’s, Parkinson’s Disease, concussion, and dementia, that interfere with brain function resulting in slower and inaccurate balance reactions. Cognitive deficits are often associated with balance problems, demonstrating the complex nature of performing dynamic balance tasks.</p> <p>As you can see, balance is very complex and there are a variety of conditions that can put a person at risk of falling. See VeDA’s article Balance and Falls in Older Adults for more information.</p> <p>Some people may believe feeling off-balance or having dizziness is an unavoidable consequence of aging. Here’s the good news: with proper diagnosis, many of the causes that result in imbalance, dizziness, or falls can be treated or diminished with lifestyle changes.</p> <p>Start by having a thorough assessment by your primary physician at least once a year. Tell them if you are experiencing dizziness, lightheadedness, vertigo, imbalance, or have suffered a fall. There may be multiple health issues and medication interactions contributing to symptoms of dizziness and imbalance. Making an accurate diagnosis to determine the source of the symptoms may be a complicated task for your physician, and they may refer you to a specialist.</p> <p>The physician should include checking for specific muscle weakness in the legs and feet or a decline in sensation, which can indicate a need for strengthening or specific footwear.<br /> If you are experiencing dizziness with specific head movements or sitting up in bed you should be screened for BPPV. If your physician concludes that your vestibular, visual, or sensory systems are creating a risk of falling, s/he will refer you to a certified vestibular therapist who specializes in Vestibular Rehabilitation Therapy (VRT). Studies have shown that VRT can help improve balance, decrease dizziness, and decrease fall risk. A vestibular therapist is a physical therapist with specific training in the assessment of balance deficits and inner ear disorders. Exercises provided by a vestibular therapist will be based on the functional impairments that are measured in the therapist’s evaluation of the vestibular and balance systems. The exercises are designed to reduce dizziness associated with movement and improve visual clarity, balance reactions, joint mobility, and strength to decrease fall risk. (See VeDA’s article about Vestibular Rehabilitation.)</p> <p><img loading="lazy" decoding="async" class="aligncenter wp-image-1865" src="https://wwspt.com/wp/wp-content/uploads/2017/11/BPPVanDizziness.jpg" alt="" width="752" height="503" srcset="https://wwspt.com/wp/wp-content/uploads/2017/11/BPPVanDizziness.jpg 550w, https://wwspt.com/wp/wp-content/uploads/2017/11/BPPVanDizziness-300x201.jpg 300w, https://wwspt.com/wp/wp-content/uploads/2017/11/BPPVanDizziness-250x167.jpg 250w" sizes="auto, (max-width: 752px) 100vw, 752px" /></p> <p>It’s essential that you see your eye doctor and make sure your glasses are the correct prescription. If you have bifocal or progressive lenses, you may want to get a pair of glasses with only your distance prescription for outdoor activities, such as walking. Sometimes progressive lenses can make things seem closer or farther away than they really are, which is especially risky when walking down steps or slopes.</p> <p>It is also important to be screened for diabetes, cataracts, macular degeneration, or neuropathy.</p> <p>You can also make lifestyle choices that have been shown to improve balance and facilitate good health as we age.</p> <p>First, it is important to have adequate nutrition, which includes a balanced diet of fruits, vegetables, protein, and low sugar foods. You should also include supplements of Vitamin D 880 IU with calcium to strengthen the bone and reduce the risk of fractures (CDC, Shahar 2009).</p> <p>Second, it has been shown that staying active and exercising can reduce fall risk in the elderly (Shubert 2011). In community-dwelling adults, a progressive exercise program with a moderate to a high level of balance exercises and cardiovascular conditioning has been shown to be an effective way to reduce falls. Exercise programs may include standing squats, single-leg standing, toe, and heel raises, tandem stance or walking, hip and knee strengthening, walking tasks, and high-level balance tasks such as reaching, turning, and stair-stepping. Tai chi is a form of exercise involving low impact dynamic movements of the arms and legs with reaching and turning, and movement of the torso in repetitive patterns. It not only benefits the body but also is cognitively challenging.</p> <p>Walking is a beneficial form of exercise, especially when the additional emphasis is placed on increasing stride and speed of steps, which studies have shown to reduce falls in older adults.</p> <p>Another easy step in reducing falls is to make changes to your home creating a safer environment.</p> <p>Authors: By Wendy Webb Schoenewald PT, OCS and Viviann C. Bailey MSPT</p> <p>The post <a href="https://wwspt.com/balance-and-aging/">Balance and Aging</a> appeared first on <a href="https://wwspt.com">WWSPT.Com</a>.</p> ]]></content:encoded> <wfw:commentRss>https://wwspt.com/balance-and-aging/feed/</wfw:commentRss> <slash:comments>0</slash:comments> <post-id xmlns="com-wordpress:feed-additions:1">2859</post-id> </item> <item> <title>BPPV, Spinning, and Vertigo</title> <link>https://wwspt.com/bppv-spinning-vertigo/</link> <comments>https://wwspt.com/bppv-spinning-vertigo/#respond</comments> <dc:creator><![CDATA[Wendy Webb Schoenewald, PT, OCS]]></dc:creator> <pubDate>Thu, 22 Feb 2018 20:37:04 +0000</pubDate> <category><![CDATA[Blog]]></category> <category><![CDATA[BPPV]]></category> <category><![CDATA[BPPV treatment]]></category> <category><![CDATA[Dizziness]]></category> <category><![CDATA[Epley maneuver]]></category> <category><![CDATA[spinning]]></category> <guid isPermaLink="false">https://wwspt.com/?p=1928</guid> <description><![CDATA[<p>BPPV is A disorder of the inner ear that is the most common cause of episodic Vertigo, a false sensation of spinning. It is a mechanical disorder where calcium carbonate crystals (otoconia), that are normally embedded in gel substance in the utricle of the inner ear , become dislodged and migrate into one of the three […]</p> <p>The post <a href="https://wwspt.com/bppv-spinning-vertigo/">BPPV, Spinning, and Vertigo</a> appeared first on <a href="https://wwspt.com">WWSPT.Com</a>.</p> ]]></description> <content:encoded><![CDATA[<p><strong>BPPV</strong> is A disorder of the inner ear that is the most common cause of episodic <strong>Vertigo,</strong> a false sensation of spinning. It is a mechanical disorder where calcium carbonate crystals (otoconia), that are normally embedded in gel substance in the utricle of the inner ear , become dislodged and migrate into one of the three fluid filled semicircular Canal’s. Since these fluid filled canals are designed to sense rotational movement ,the crystals which react to gravitational pull or pull of gravity , cause the nerve endings in the canal to be more excited than normal , resulting in a mismatch of information to the brain creating Nystagmus of the eyes, which create a false sense that the room is <em>spinning.</em></p> <p>The most common symptom is a spinning sensation of vertigo but often patients have complained of feeling like they’re falling even when they’re laying down or describe feeling of walking like they are drunk. Vertigo events frequently occur in the morning when you sit up or turn over in bed but often can also be associated with quick turns of the head or bending over to pick something up. These episodes can last seconds or minutes and are commonly associated with nausea vomiting and dizziness as well as imbalance.The level of symptoms can range from mild annoyance to a highly debilitating condition that can affect function and safety and fall risk.</p> <p>There are several types of BPPV including canalithiasis and cupulolithiasis which need to be recognized because they are treated differently. BPPV can occur in each of the three canals in the right and left ear therefore a proper examination is necessary to allow correct treatment with the patient having minimal symptoms. Other disorders may be misdiagnosed as BPPV or patients are given incorrect diagnosis of a more serious condition instead of BPPV.</p> <p>BPPV is a very common disorder with an incidence of 107 per 100,000/year . it is common in senior adults and appears to increase incidences with each decade of life. It can also be associated with trauma, concussion ,migraine inner ear infections or disorders,diabetes and osteoporosis.</p> <p><strong>Treatment</strong><br /> Treatment of BPPV follows a detailed physical exam by the <strong>vestibular rehabilitation specialist</strong>. Since it is a mechanical disorder ,there are treatment maneuvers which differ depending on which canal or type that is involved, these maneuvers assist the otoconia to float back to their origin in the utricle. The most well-known maneuver is called the <strong>Epley maneuver</strong> but there are many different maneuvers for specific variants of BPPV. The treatment procedure involves tilting the head at several different angles and rolling the body to dump the crystals back into the utricle.(see figure) A Skilled vestibular therapist can resolve BPPV with two to three maneuvers in the first session. Often abnormal balance reactions result from BPPV And they need to be assessed further once the vertigo is effectively treated. it is important to treat both BPPV and the imbalance to prevent future falls.<br /> Examination.</p> <p><img loading="lazy" decoding="async" class="aligncenter wp-image-339" src="https://wwspt.com/wp/wp-content/uploads/2022/04/Treating_BPPV_Frenzel_lens.jpg" alt="Treating BPPV with Frenzel Lens" width="550" height="261" /></p> <p>A proper examination involves an assessment of the eyes for normal movement patterns in room light and assessment of static balance examination then using <strong>Frenzel lenses</strong> ,special tests that involve positional changes are performed. The most common test is called the <strong>Dix-Hallpike test</strong> where the patient is laid down with her head turned 45° to one side allowing the head to hang off the edge of the table. Frenzel lenses ,which are infrared goggles that assist the vestibular therapist in observing nystagmus , are used during the exam to assist with accuracy of diagnosis.<br /> it is common after treatment for the patient to feel mildly dizzy and sometimes nauseous but generally this improves in less than 24 hours. There are some cases that takes several treatments to resolve or patients need several further treatments to return their balance reactions to normal to prevent falls.</p> <p>Unfortunately BPPV is a condition that commonly reoccurs periodically with rates as high as 50% <span class="aBn" tabindex="0" data-term="goog_1882041765"><span class="aQJ">within five years</span></span>. We will educate you about how to perform a specific treatment maneuver on your self and if this does not appear to be effective then we you can follow up in the office for further assessment.</p> <p>All of the therapists at Wendy Webb Schoenewald Physical Therapy and Vestibular Rehabilitation are advanced distributor therapists with extensive training in the proper treatment for BPPV and other vestibular and balance disorders. WWSPT has been involved in clinical research trials to teach other physical therapists which maneuvers are most effective in treating some unusual forms of BPPV.</p> <p><a href="https://WWSPT.com">Contact WWSTP</a> for an appointment evaluation.</p> <p>The post <a href="https://wwspt.com/bppv-spinning-vertigo/">BPPV, Spinning, and Vertigo</a> appeared first on <a href="https://wwspt.com">WWSPT.Com</a>.</p> ]]></content:encoded> <wfw:commentRss>https://wwspt.com/bppv-spinning-vertigo/feed/</wfw:commentRss> <slash:comments>0</slash:comments> <post-id xmlns="com-wordpress:feed-additions:1">1928</post-id> </item> </channel> </rss>