Karpatkin spring 6

must address the pt's specific problem... so if the pt has VOR findings in horiz & vertical directions and you only train horiz, vert won't improve

long term change of a system in response to its input ... training the pt to build up tolerance - do VOR for a few min, stop, repeat, slowly lengthening the time tolerated before symptoms set in

when you move head or visual target too fast there's vertigo

• use of an alternative strategy to compensate for lost function
• ex: using proprioception, vision, preprogramming, smooth pursuit ... maximizing the use of these other modalities
• but: success depends on how well the subs mimic the lost function

anticipating where the next visual target will be ... close yr eyes, then move them to look at the next target

practicing moving eyes smoothly between targets

• getting used to a stim so you don't have a neg response to it
• -or in better lingo-
• long term reduction in neurologic response to a noxious stimuli thru repeated exposure to that stimuli

• peripheral sensory apparatus (the labyrinth)
• CNS processor
• mechanisms for motor output

• head: angular velocity & linear acceleration
• spine: pos rel to head
• spatial orientation: with respect to gravity
• motion: sense of self motion

• vestibular nuclear complex (pons)
• cerebellum
• plus other sensory info to estimate head & body orientation

monitored by cortical processes (vestibular cortex / right perisylvian area)- it monitors info of the cerebellum and pons, then acts on it

• vestibulo-ocular reflex (VOR) - can eyes stay focused as head moves
• vestibulocolic reflex (VCR) - stabilization of head by neck
• vestibulospinal reflex (VSR) - compensatory spine movements to prevent falls

• otolith organs & semicircular canals
• motion sensors sending info to vestibular nuclei & cerebellum
• then the info combines w visual and proprioceptive input in response to balance tasks