Improvements in dizziness and imbalance results from using a multi disciplinary and multi sensory approach to Vestibular Physical Therapy – a case study

Kim R. Gottshall, Pinata H. Sessoms

This paper discusses a case study of a 41-year-old active duty male service member who sustained head trauma from a motorcycle accident and underwent multidisciplinary vestibular physical therapy rehabilitation. He was initially treated with traditional physical therapy applications of treadmill walking and standing balance with some symptom improvements, but was not able to maintain a running speed that would allow him to return to full active duty status. Further treatment utilizing a Computer Assisted Rehabilitation Environment was performed in order to increase level of difficulty and further enhance function. This treatment is able to elicit vestibular deficits seen in the community as it requires subjects to walk and balance while performing tasks within a virtual scenario incorporating platform motion, visual surround and flow, and cognitive processing. After 6 weeks of therapy, twice weekly, improvements in clinical vestibular measures were observed as well as walking speed and patient confidence. The patient was able to return to full duty after treatment. This case study provides supportive evidence that multidimensional tasking in a virtual environment provides a safe but demanding form of vestibular therapy for patients needing more challenging tasks than those provided with traditional therapy techniques. Those persons requiring higher levels of performance before returning to full duty (e.g., pilots, special operators, etc.) may find this type of therapy beneficial.