Answer: “So we definitely use VOR, VOR cancellation, ocular motor exercises post head trauma. It’s hard for me to say that would be contra-indicative when there’s a VOR deficit. But I get it. I get the conversation because if I’m looking straight ahead and doing VOR, what is my concern about that exercise? It is […]

Answer: Bridgett Wallace, PT, DPT: “So the bow and lean are what we call differential tests. They’re not the test to say you have horizontal canal, that’s the roll test. But sometimes people are like, which ear is it? I can’t tell which side the nystagmus is stronger. These are differentials. So the bow and […]

Answer: “So the tests that we referred to today is the one where you have your thumbs out and you’re swinging back and forth. And typically with that test, you’re looking for motion sensitivity. With the other version of the test, what I’ll do is I’ll hold the patient’s head. I don’t know if you […]

Answer: “I don’t do saccadic or pursuit training initially by itself. I keep everything, in the beginning, 18 inches and out. What happens is, at 18 inches and in, you begin to stimulate convergence. If you stimulate convergence, that can change how that system works. So, you want to keep that periphery open, whether you’re […]

Answer: Shelly Massingale, PT, MPT: “You had mentioned you didn’t get to see Dr. Padula’s lecture, but it was so good. And he really talked a lot about just focal binding, where we need to move out into the periphery more and not be so centrally fixated with our therapy, really. So this question is, […]

Answer: Amy Alexander, PT: “Because athletes start with such high level of balance, usually above general population studies, they have to be really impaired to show up on a static test. Now on the COBALT test, 100% of healthy athletes can do the test, and they do it with a very low error rate. We […]

Answer: “Box breathing is a sympathetic de-stimulation exercise. And so, basically, we have a sheet of paper and we also have an app that can be on a computer screen that forms a box. So they’ll breathe in for four seconds on this part of the box, hold their breath for four seconds, breathe out […]

Answer: “Great question there. And, the question would be, I can rephrase it to, what if you have both PPPD and vestibular migraine at the same time? So, with PPPD you have constant dizziness. And, PPPD can be triggered by anything that causes vertigo. Vestibular migraine obviously causes vertigo. And, a lot of my vestibular […]

Answer: “So, how do you differentiate ataxia and disequilibrium? Generally ataxia I’m looking for a wide-based gait, a bit more of a shuffling perhaps. Disequilibrium can be maybe a little bit less severe, less exciting. Most of our patients are coming in saying that, “Oh yeah, I have disequilibrium. I have poor balance”, but those […]