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Vestibular Testing in Patients Lacking Cervical Range

Mike Studer, PT, MHS, NCS, CEEAA, CWT, CSST, FAPTA

October 23, 2013

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Question

What do you do for a geriatric patient who does not have the cervical range in order to do the maneuvers to test for vestibular issues?

Answer

If you are looking at the Epley maneuver, it is not necessary that you take that individual back into a position of cervical extension past 10 degrees.  One of the things that I like to do is actually lift the body up.  It is important that the semicircular canals are inverted or in a Trendelenburg position.  When I lay the patient back, I will usually put one or two pillows underneath the thoracic spine so that their head can be supported on the mat behind them, and they do not have to lie back over the edge.  Remember that what we want to do is line up the vestibular apparatuses, specifically the semicircular canals, such that we can reposition the otoconia.  To do that, we need the whole body back in the Trendelenburg 10 degree position.  

 


mike studer

Mike Studer, PT, MHS, NCS, CEEAA, CWT, CSST, FAPTA

Mike Studer, PT, MHS, NCS, CEEAA, CWT, CSST, FAPTA is the owner and lead therapist at Northwest Rehabilitation Associates, a Chamber member and active presence in the Salem community. He has been a PT since 1991 and a Clinical Specialist in Neurologic Physical Therapy since 1995. Mike is the only therapist in the nation to be awarded the Clinician of the Year by two different national academies of the American Physical Therapy Association, being awarded the Clinical Excellence Award in both Neurology and Geriatrics. He has authored over 30 journal articles, and contributed-to or primary authored 6 book chapters. He is a recognized national and international speaker on topics including aging, stroke, motor learning, motivation in rehabilitation, cognition, balance, dizziness, and Parkinson’s Disease, having presented in 48 states and 9 countries. In 2020, Mike presented a TED talk on neuroplasticity that has been viewed by thousands, and he was awarded the highest honor that can be bestowed on a physical therapist – one of only 250 therapists in the nation to be designated a Fellow of the American Physical Therapy Association for a lifetime and diverse contributions to the profession in clinical, research and educational fields.

 


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