Answer:

“It basically depends on what’s going on. I strengthen it based on my assessment. So we go all the way down. So what happens is that you need to assess at the basic level. So you have to assess the longest [inaudible 00:00:00:27]. You have to palpate that and have someone nod to see if they actually have neuromuscular control. So we always assess for precision. And then we assess for endurance. We also assess for the spinal extensors. And then based on that, it’s how I progress.

So if we’re talking to an athlete, it also depends on how acute they are. If they’re severely acute, you have to get everything calmed down for us. But we would generally go if you’re talking about basic progression from either supine or sitting. And then give them some resistance as far as their head weight. If they’re in supine, I may change the position and support their head off the edge of the table and start to give them headway. We can stand them up and use TheraBand and just have them do arm exercises with resistance from all different directions. But that’s also been assessed previously to figure out where is their dysfunction and what do I need to do.”

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RESOURCES & LINKS:

• This Q&A is an excerpt from the Vestibular Health Summit Sessions
• The Vestibular Health Summit Sessions are included with 360NeuroGO Enterprise

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FACULTY:

Angela Rich, PT, OCS, ScD, ATC

Angela Rich was a private practice owner for 16 years, specializing in orthopaedics and sports medicine. In 2015, she turned her focus to teaching as an Assistant Professor in Texas State University’s Doctor of Physical Therapy Program with responsibilities in Orthopaedics and Therapeutic Interventions. In 2017, Dr. Rich was recognized with the Faculty Excellence Award in Teaching for the Department of Physical Therapy and the College of Health Professions. Her research agenda focuses on the identification of movement system dysfunction and impairment-based intervention.

Bridgett Wallace, PT, DPT

Bridgett Wallace, PT, DPT, has a doctorate of physical therapy and holds competency-based certifications in vestibular rehabilitation and concussion management. Dr. Wallace has been treating patients with dizziness and balance disorders for more than 20 years and is the founder and President of 360 Balance & Dizziness – a specialty clinic for the evaluation and treatment of dizziness and balance disorders that includes both audiology and therapy services. She is also the co-founder and Director of Clinical Education for 360 Neuro Health Institute, which provides online, mobile, and live educational offerings for healthcare providers.