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Assessment of function in a patient with inner ear dysfunction focuses on three major areas: (1) evaluation of the musculoskeletal system; (2) balance and gait assessment, and (3) vertigo assessment.
Musculoskeletal assessment includes general range-of-motion, strength, sensation and coordination.
Balance and gait assessment includes completion of a test that allows comparison of the patient's level of balance function to his or her age group. In addition, static and dynamic balance skills are assessed including balance during gait. A test of sensory interaction in balance is performed in order to assess the patient's ability to use vestibular inputs for orientation when deprived of other sensory inputs. Finally, the patient's use of appropriate movement strategies in balance control is examined.
Vertigo assessment begins with a dizziness questionnaire to determine frequency and severity of dizziness symptoms and to document lifestyle changes resulting from balance and dizziness problems. In addition, the patient is asked to move in and out of 21 different positions requiring head and trunk motion in specific planes of motion. The patient is asked to report the presence and intensity of dizziness symptoms; the duration of dizziness is timed, and a vertigo score is calculated from the intensity and duration measures. Other symptoms such as nausea, sweating and nystagmus are recorded.
After assessment, a list of patient problems is generated; short-and long-term goals are established, and, if appropriate, the patient is begun on a specific exercise program based on his or her individual assessment findings. next
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