Physical Therapy for Central Vestibular Dysfunction

Dizziness is one of the most common reasons patients seek medical care, and because there are many causes of dizziness, management of these patients requires an interdisciplinary approach. Peripheral vestibular dysfunction is the most common cause of dizziness/vertigo diagnosed in specialty clinics. The purpose of this article is to present an interdisciplinary approach to the management of patients with vestibular dysfunction with a focus on the unique and overlapping contributions of audiology and physical therapy to vestibular assessment and rehabilitation.

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The sensitivity and specificity of the Timed "Up & Go" and the dynamic gait index for self-reported falls in persons with vestibular disorders

Journal of Vestibular Research ◽

10.3233/ves-2004-14506 ◽

2004 ◽

Vol 14 (5) ◽

pp. 397-409 ◽

Cited By ~ 7

Author(s):

Susan L. Whitney ◽

Gregory F. Marchetti ◽

Annika Schade ◽

Diane M. Wrisley

Keyword(s):

Physical Therapy ◽

Sensitivity And Specificity ◽

Fall Risk ◽

Vestibular Dysfunction ◽

Initial Assessment ◽

Vestibular Disorders ◽

Patient Chart ◽

Dynamic Gait Index ◽

Dynamic Gait ◽

Gait Index

The purpose of this study was to determine the sensitivity and specificity of the Timed "Up & Go" (TUG) and Dynamic Gait Index in identifying self-reported fallers among persons with vestibular dysfunction. One hundred three patient charts were included from a tertiary vestibular physical therapy practice. The patients ranged in age from 14–90 years and had vestibular diagnoses, falls reported in the patient chart, and completed the TUG and/or the Dynamic Gait Index (DGI). Thirty-one persons reported falling one or more times in the previous 6 months during their initial assessment. Persons who took longer than 13.5 seconds to perform the TUG test were 3.7 times more likely to have reported a fall in the previous 6 months. Those persons with scores less than or equal to 18 on the DGI were 2.7 times (p = 0.03) more likely to have reported a fall in the previous 6 months. The sensitivity of the DGI at 18 or less was 70% and the specificity was 51%. People who scored greater than 11.1 seconds on the TUG were 5times (p = 0.001) more likely to have reported a fall in the previous 6 months. Sensitivity (80%) and specificity (56%) were calculated for TUG scores of greater than 11.1 seconds. The TUG and the DGI appear to be helpful in identifying fall risk in persons with vestibular dysfunction. Slower scores on the TUG (> 11.1 seconds) and lower scores on the DGI (18) correlated with reports of falls in persons with vestibular dysfunction.

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