What do you do for a geriatric patient who does not have the cervical range in order to do the maneuvers to test for vestibular issues?
Answer
If you are looking at the Epley maneuver, it is not necessary that you take that individual back into a position of cervical extension past 10 degrees. One of the things that I like to do is actually lift the body up. It is important that the semicircular canals are inverted or in a Trendelenburg position. When I lay the patient back, I will usually put one or two pillows underneath the thoracic spine so that their head can be supported on the mat behind them, and they do not have to lie back over the edge. Remember that what we want to do is line up the vestibular apparatuses, specifically the semicircular canals, such that we can reposition the otoconia. To do that, we need the whole body back in the Trendelenburg 10 degree position.
Dr. Studer, a Physical Therapist (PT) since 1991 and a Board-Certified Clinical Specialist in Neurologic Physical Therapy since 1995, co-founded and co-owns Spark Rehabilitation and Wellness in Bend, Oregon. Additionally, he serves as an adjunct professor at Touro University and is an instructor at UNLV. Actively engaged as a practicing clinician, researcher, author, and presenter in DPT programs and continuing education, Mike was honored as the 2011 Clinician of the Year in the Neurologic Academy and, in 2014, in the Geriatric Academy of the APTA.
Dr. Studer has presented invited lectures in all 50 states and 12 countries across four continents. In 2020, he received the highest honor in PT, being distinguished as a Catherine Worthingham Fellow of the APTA. Over his 33-year career, Mike has authored over 35 articles and six book chapters and is a consultant to Major League Baseball.
Related Courses
1https://www.physicaltherapy.com/pt-ceus/course/applications-in-dual-task-rehabilitation-3659Applications in Dual Task Rehabilitation From High Tech to Low: Covering the Range for All Treatment SettingsIn this course, attendees should be prepared to extend their use of dual task repertoire and application from an approach that introduces distractions as a game or challenge, to a more sophisticated delivery of care in an effort to both habituate patients to distractions, and improve their reformatting of procedural memories, through automaticity. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyPhysicalTherapy.comwww.physicaltherapy.comApplications in Dual Task Rehabilitation From High Tech to Low: Covering the Range for All Treatment SettingsIn this course, attendees should be prepared to extend their use of dual task repertoire and application from an approach that introduces distractions as a game or challenge, to a more sophisticated delivery of care in an effort to both habituate patients to distractions, and improve their reformatting of procedural memories, through automaticity. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.3659OnlinePT120M
In this course, attendees should be prepared to extend their use of dual task repertoire and application from an approach that introduces distractions as a game or challenge, to a more sophisticated delivery of care in an effort to both habituate patients to distractions, and improve their reformatting of procedural memories, through automaticity. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.
2https://www.physicaltherapy.com/pt-ceus/course/clinical-applications-in-neurology-parkinson-3933Clinical Applications in Neurology: Parkinson's Disease and Parkinson's PlusThis course intends to help the emerging neurologic-focused therapist move from intermediate to advanced, within the scope of their license. Neurology for the non-neurologist’s PD, PD+, and movement disorder focus aims to improve your clinical acumen, examination, education, and intervention skills, within this complex myriad of conditions…or at least as much as we can cover in 2 hours! This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyPhysicalTherapy.comwww.physicaltherapy.comClinical Applications in Neurology: Parkinson's Disease and Parkinson's PlusThis course intends to help the emerging neurologic-focused therapist move from intermediate to advanced, within the scope of their license. Neurology for the non-neurologist’s PD, PD+, and movement disorder focus aims to improve your clinical acumen, examination, education, and intervention skills, within this complex myriad of conditions…or at least as much as we can cover in 2 hours! This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.3933OnlinePT120M
This course intends to help the emerging neurologic-focused therapist move from intermediate to advanced, within the scope of their license. Neurology for the non-neurologist’s PD, PD+, and movement disorder focus aims to improve your clinical acumen, examination, education, and intervention skills, within this complex myriad of conditions…or at least as much as we can cover in 2 hours! This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.
3https://www.physicaltherapy.com/pt-ceus/course/why-this-test-clinical-decision-3185Why this test? Clinical Decision Making for BalanceWhen faced with limited time, resources, space, or information – how do clinicians decide the most optimal collection of balance tests for each patient? To make the best decision, therapists must consider many factors. Are you using the best decision-making process when examining a patient with imbalance? A short list of what will be covered in this advanced level course includes clinical decision-making for an imbalance examination, including factors such as: diagnosis, prognosis, personality and effect (low self efficacy, depression, agitation), cognitive impairment, reimbursement, fear of falling, and many more, Listen-in and learn how to choose the most optimal screening tools and tests for each patient!auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyPhysicalTherapy.comwww.physicaltherapy.comWhy this test? Clinical Decision Making for BalanceWhen faced with limited time, resources, space, or information – how do clinicians decide the most optimal collection of balance tests for each patient? To make the best decision, therapists must consider many factors. Are you using the best decision-making process when examining a patient with imbalance? A short list of what will be covered in this advanced level course includes clinical decision-making for an imbalance examination, including factors such as: diagnosis, prognosis, personality and effect (low self efficacy, depression, agitation), cognitive impairment, reimbursement, fear of falling, and many more, Listen-in and learn how to choose the most optimal screening tools and tests for each patient!3185OnlinePT120M
When faced with limited time, resources, space, or information – how do clinicians decide the most optimal collection of balance tests for each patient? To make the best decision, therapists must consider many factors. Are you using the best decision-making process when examining a patient with imbalance? A short list of what will be covered in this advanced level course includes clinical decision-making for an imbalance examination, including factors such as: diagnosis, prognosis, personality and effect (low self efficacy, depression, agitation), cognitive impairment, reimbursement, fear of falling, and many more, Listen-in and learn how to choose the most optimal screening tools and tests for each patient!
4https://www.physicaltherapy.com/pt-ceus/course/maximizing-patient-engagement-through-science-4595Maximizing Patient Engagement Through the Science of Behavioral EconomicsLearn the evidence and the application of mastering your soft skills to optimize the patient experience and patient engagement. Be ready to improve in every aspect of patient care from the interview, diagnosis, education, intervention, and home exercise prescription.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyPhysicalTherapy.comwww.physicaltherapy.comMaximizing Patient Engagement Through the Science of Behavioral EconomicsLearn the evidence and the application of mastering your soft skills to optimize the patient experience and patient engagement. Be ready to improve in every aspect of patient care from the interview, diagnosis, education, intervention, and home exercise prescription.4595OnlinePT180M
Learn the evidence and the application of mastering your soft skills to optimize the patient experience and patient engagement. Be ready to improve in every aspect of patient care from the interview, diagnosis, education, intervention, and home exercise prescription.
5https://www.physicaltherapy.com/pt-ceus/course/applications-in-fear-most-pervasive-4596Applications in Fear: The Most Pervasive Complication That You Can Treat and PreventWe all have fear, it is pervasive. In this course, we learn about how to recognize, treat, and prevent the secondary complications of fear – with an evidence-based approach.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyPhysicalTherapy.comwww.physicaltherapy.comApplications in Fear: The Most Pervasive Complication That You Can Treat and PreventWe all have fear, it is pervasive. In this course, we learn about how to recognize, treat, and prevent the secondary complications of fear – with an evidence-based approach.4596OnlinePT120M
We all have fear, it is pervasive. In this course, we learn about how to recognize, treat, and prevent the secondary complications of fear – with an evidence-based approach.
