Answer:

“The literature shows after a brain injury, using binocular occlusion can help cause a visual frame of reference. And so the patient is still able to utilize their full visual field, but they have small pieces of tape here that are able to anchor their vision, essentially. And so typically with those patients, and this is in concordance with a neuro optometrist or ophthalmologist, those are going to be smaller.

For what we use in outpatient, and again, these aren’t necessarily patients that have an acquired brain injury, these are patients that have peripheral vestibular disorders and also have motion sensitivity, we’ll use the nasal occlusion a little bit thicker almost to impair some of their central vision. And the reason why is because you really want to encourage central peripheral integration. And a lot of our patients with dizziness become very centrally bound. When you feel dizzy, or when you feel fearful of falling, you start focusing on a really small area and you can even see some postural changes. And so by temporarily occluding some of the central vision, of course, you don’t want to cover their whole glasses, you’re kind of encouraging them to use more of that peripheral information for where they are in space, which is also going to habituate them.

And so the way that we, there was a question earlier about how do we know to use that, sometimes we’ll simply put a pair of glasses on the patient and have repeat an exercise that didn’t give them any symptoms and see if it changes. See if it causes more symptoms now that they’re utilizing the peripheral vision.

So hopefully that makes it clear on how the two different things are used. One is used as a visual anchor for acquired brain injury, and that’s when you’re working with a neuro optometrist or a neuro ophthalmologist. And then the other is more of a way to open the patient’s field of vision and utilize peripheral and central integration.”

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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:

Kendal Reddell, PT, DPT, NCS

​Kendal Reddell has a doctorate in physical therapy and is an American Physical Therapy Association Board Certified Clinical Neurologic Specialist. She also holds a certificate of competency in the evaluation and treatment of vestibular disorders from Emory University. Kendal is a Parkinson’s Wellness Recovery (PWR!) and LSVT BIG certified therapist, specializing in treating individuals with Parkinson’s disease. Dr. Reddell is a proud graduate of Tarleton State University where she competed in NCAA Women’s Basketball. She received her Doctorate in Physical Therapy from the University of Texas Southwestern Medical School in 2010, and has worked in a variety of settings specializing in brain injury, stroke, Parkinson’s Disease, and vestibular disorders.

Alex Tarabbia, PT, DPT

Alex Tarabbia has a Doctorate in Physical Therapy. She developed a passion for vestibular therapy when volunteering at a specialty balance clinic in her college years. This passion grew while working with patients with vestibular disorders through graduate level clinical internships, as well as taking advanced coursework in vestibular therapy in graduate school. Prior to joining the 360 Balance & Dizziness team, Dr. Tarabbia worked with patients with a variety of orthopedic injuries and balance and mobility impairments in the outpatient setting. Dr. Tarabbia completed her undergraduate work at Gordon College, in Massachusetts, graduating Summa Cum Laude with a Bachelor’s degree in Kinesiology. She received her Doctorate in Physical Therapy from the University of St. Augustine, in Austin, Texas.