Physical Therapy Goals
The patient’s goals included the ability to work a full shift and complete work duty activities, tolerate driving, and grocery shopping without any symptoms. Patient’s goals also included returning to family activities including ice-skating, riding roller coasters, and watching movies without any vestibular symptoms. Physical Therapy goals included the increasing vestibular function to improve quality of life and continuation of responsibilities without exacerbation of symptoms. Physical therapy focused on increasing patient’s static and dynamic balance, gaze stabilization, and activity tolerance to improve vestibular function. The patient’s prognosis was good due to her young age, no significant comorbidities, and level motivation to return to prior level of function without any vestibular symptoms.
The patient’s plan of care (POC) in this case report involved supervised visits 2x a week for eight weeks. The POC included a daily home exercise program (HEP) 3 times a day focusing on gaze stabilization exercises initially as described by the newly established clinical practice guidelines of vestibular rehabilitation for peripheral vestibular hypofunction by the American Physical Therapy Association. The initial POC included gaze stabilization exercises, habituation exercises
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Initially, the subject was unable to complete POC in standing position and tolerate ambulating with horizontal head turns. After two weeks, the patient demonstrated increase tolerance and was able to complete gaze stabilization program standing and include static and dynamic balance exercises with appropriate increase in symptoms. The subject displayed improved gaze stabilization, increased balance, and increased tolerance to activity as evident by ability to complete work activities and tolerate supervised sessions with very little to no
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