Combined VOR Re-adaptation and Sensory Reweighting Vestibular Rehabilitation for Persistent Mal de Debarquement: A Retrospective Case Study

Location

Hall of Governors

Start Date

4-7-2017 4:00 PM

End Date

4-7-2017 6:00 PM

Abstract

Background and Purpose: Persistent Mal de Debarquement (pMdD) is an uncommon condition that occurs after exposure to passive motion. Due to the rarity of the condition, there is little evidence for effective treatment of pMdD. Some evidence has shown benefits to vestibular rehabilitation, specifically using sensory reweighting or VOR re-adaption. The purpose of this case study is to determine the efficacy of combined VOR re-adaption and sensory re-weighting interventions for patients with persistent Mal de Debarquement syndrome.

Case Description: A SS-year-old Caucasian female presenting with of dizziness, unsteadiness, sway, and rocking after disembarking from a cruise 4 months earlier. The patient's symptoms and diagnostic workup were consistent with persistent Mal de Debarquement (pMdD) Syndrome. The patient presented to outpatient physical therapy for vestibular rehabilitation. Current research indicates vestibular rehabilitation in the form of sensory reweighting and VOR re­ adaptation can prove beneficial for patients with pMdD. Treatment interventions included a combination of VOR re­ adaptation and reverse sensory re-weighting to reduced patient symptoms and return quality of life. The method of reverse sensory re-weighting is theorized to begin at high levels of instability with use of cushions, where the patient feels most stable and demonstrates less sway, and slowly progress to more compliant surfaces. The slow progression to more compliant surfaces with concurrent VOR exercises allowed the patient to re-adapt to stable surfaces without perception of symptoms.

Outcomes: 6 treatments occurred once a week over a 7-week period with weekly VOR progressive HEP. The patient demonstrated an increase with both DGI and Tinetti scores, demonstrated reduced sway in sitting, increased stability on compliant surfaces, and reported reduced intensity and frequency of symptoms.

Discussion: The combined use of reverse sensory re-weighting and VOR re-adaptation with a weekly gaze stabilization HEP has shown positive outcomes for pMdD related symptoms and impairments

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Apr 7th, 4:00 PM Apr 7th, 6:00 PM

Combined VOR Re-adaptation and Sensory Reweighting Vestibular Rehabilitation for Persistent Mal de Debarquement: A Retrospective Case Study

Hall of Governors

Background and Purpose: Persistent Mal de Debarquement (pMdD) is an uncommon condition that occurs after exposure to passive motion. Due to the rarity of the condition, there is little evidence for effective treatment of pMdD. Some evidence has shown benefits to vestibular rehabilitation, specifically using sensory reweighting or VOR re-adaption. The purpose of this case study is to determine the efficacy of combined VOR re-adaption and sensory re-weighting interventions for patients with persistent Mal de Debarquement syndrome.

Case Description: A SS-year-old Caucasian female presenting with of dizziness, unsteadiness, sway, and rocking after disembarking from a cruise 4 months earlier. The patient's symptoms and diagnostic workup were consistent with persistent Mal de Debarquement (pMdD) Syndrome. The patient presented to outpatient physical therapy for vestibular rehabilitation. Current research indicates vestibular rehabilitation in the form of sensory reweighting and VOR re­ adaptation can prove beneficial for patients with pMdD. Treatment interventions included a combination of VOR re­ adaptation and reverse sensory re-weighting to reduced patient symptoms and return quality of life. The method of reverse sensory re-weighting is theorized to begin at high levels of instability with use of cushions, where the patient feels most stable and demonstrates less sway, and slowly progress to more compliant surfaces. The slow progression to more compliant surfaces with concurrent VOR exercises allowed the patient to re-adapt to stable surfaces without perception of symptoms.

Outcomes: 6 treatments occurred once a week over a 7-week period with weekly VOR progressive HEP. The patient demonstrated an increase with both DGI and Tinetti scores, demonstrated reduced sway in sitting, increased stability on compliant surfaces, and reported reduced intensity and frequency of symptoms.

Discussion: The combined use of reverse sensory re-weighting and VOR re-adaptation with a weekly gaze stabilization HEP has shown positive outcomes for pMdD related symptoms and impairments