Tables
Information From Medical History and Examinations Before Referral to a Physical Therapist
a Canal paresis was determined by caloric testing; according to norms, abnormal canal paresis was a left-right asymmetry of greater than 25%.
b The posturography path length was determined by static stabilometry, registering of the center of pressure, in millimeters, while the patient stood for 1 minute with eyes closed. The mean path length for people who are healthy is 860 (SD=323) mm.18 For patient D, posturography was undertaken at her second visit after discharge from the hospital.
Self-Report Information Associated With Dizziness and Balance Problems Prior to the Physical Therapist Examination and Completed Modified Vestibular Rehabilitation (MVR) Sessions
a The patients were given written instructions for a home program adapted from that described by Herdman and Whitney.12 Two eye-head coordination exercises (viewing paradigms 1 and 2: moving head back and forth and nodding) were to be performed twice per day, 7 days per week. Walking inside or outside in diverse environments was suggested. Reactions to the exercises were noted in logs given to the physical therapist the following week. Information for patients A and B was not available.
Global Physiotherapy Examination (GPE-52) of and Self-Report Measures for 4 Patients With Persistent Dizziness Before and After the Interventiona
↵a For comparison, measurement errors and scores for people who are healthy are shown.24 Clinically important change (from before the intervention [Pre] to after the intervention [Post]) was defined as change greater than or equal to the measurement error (ie, improvement).
b The GPE-52 has 5 domains and 13 subdomains; each subdomain contains 4 tests.
c Self-reported symptoms and disability were determined with the Vertigo Symptom Scale (VSS) (range=0–60 points; clinically important change, ≥3 VSS points) and the Dizziness Handicap Inventory (DHI) (range=0–100 points; minimal important change, 11 DHI points).
Trunk Acceleration Along the Mediolateral Axis in the Lower and Upper Trunk During Walkinga
↵a Pre=before the intervention, Post=after the intervention, RMS=root-mean-square, g=unit of gravity (m/s2). Calibration of the accelerometers against gravity was carried out on a horizontal surface before each test session. Patients walked at 3 self-administered speeds (slow, preferred, and fast) across an 8.5-m marked path. Time was registered during steady-state walking (middle 4.3 m) by photoelectric cells connected to a computerized stopwatch. A velocity of 1.2 m/s (the mean preferred walking speed) was used to explore RMS g values at the lower and upper trunk and upward attenuation along the mediolateral axis.25,26
Examples of Physical Exercises in the Modified Vestibular Rehabilitation (MVR) Programa
↵a Adapted with permission from Kvåle et al17 and publisher John Wiley & Sons Ltd.
b Examples of reflective questions or instructions from the physical therapist to the patient during walking: Is your walking relaxed? How is your foot-floor encounter? How is your breathing while walking? How is your head positioned? Are your arms moving in a relaxed manner during walking?
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