June 25, 2019 at 10:54 am #74026
Elizabeth Dannenbaum PT, MSc is a physiotherapist and clinical researcher. Shas been working in the outpatient vestibular program of the Jewish Rehabilitation Hospital, Centre intégré de santé et de services sociaux de Laval since 2000. She is a faculty lecturer at McGill University School of Physical & Occupational therapy. She has a part time clinical research position were her research focuses on clinical assessment and treatment tools for children and adults with vestibular deficits.
Why did you choose this article or document?
I chose this article because it discusses 2 aspects of vestibular rehabilitation I find very interesting; pediatric vestibular rehabilitation and how a vestibular loss can impact on spatial awareness.
What is the question being asked?
This paper is a review paper. It describes how the vestibular system works with the vision/proprioception system to develop spatial relationship coordinates in healthy people. It then describes the effect of vestibular loss on spatial awareness in children and adults.
What did they conclude?
-the vestibular signal provides important information to the hippocampus during navigation in building up spatial reference frames (knowledge of were the person is in space)
-the absence of vestibular information can lead to reduced cognitive performance in several domains ( i.e pathfinding, mental rotation (ie puzzels) , reduced short term memory concentration)
-there are critical periods in children’s development for vestibular input integration; 2 years old: rudimentary spatial localization, 6-7 years old: place navigation is developed (defined as “ navigation toward a specific location based on its spatial relationship to a constellation of exteroceptive cues”, 11years old: adult performance
Who might we apply this research to in our clinical practice?
This paper explains part of the puzzle of why certain adult patients with a bilateral or unilateral loss (especially right vestibular loss) have difficulty returning to their previous functional level.
It emphasizes the importance of screening for vestibular loss in children especially in those with SNHL and psychomotor developmental delay.
How do the results relate to current practice or influence future practice?
Each time I read this article, I come away with new information I want to see how I can apply to my vestibular rehabilitation therapy sessions. Many concepts are very new.
The following are some ideas I am trying to integrate into the vestibular rehabilitation in some of my patients:
-navigating eyes closed to a known target in the clients house or the department
-walk toward a target eyes open, then turn around and walk back with eyes closed.
In summary this paper has helped me further my understanding on how we navigate through space and how it may be impacted in children and adults with vestibular hypofunction.