190: Why All Of Your Neuro Clients Need Vestibular Therapy And How To Address It With Christina Garrity, PT, DPT, NCS
Dec 4, 2023
auto_awesome
Physical therapist Christina Garrity discusses the importance of integrating vestibular therapy into neuro client treatment plans. She emphasizes the need for screenings for BPPV in all balance clients and shares easy ways to reduce client falls. Garrity highlights the pillars of visual stabilization, sensory integration, and habituation in treatment plans, and encourages mentorship for problem-solving through cases.
Vestibular therapy is essential in neurology for addressing balance issues beyond dizziness, improving patient outcomes.
Simple screening tests like the modified side lying test can reveal undiagnosed BPPV in patients, reducing fall risks.
Educating healthcare professionals about vestibular dysfunction is crucial for enhancing patient care outcomes and reducing unnecessary tests.
Deep dives
Introduction to Vestibular Therapy and Career Background
Christina Garrity, a board-certified neurologic clinical specialist and a vestibular therapist, shares her journey of starting as an inpatient rehab PT at a level one trauma center and transitioning to outpatient neuro clinic, including vestibular therapy. Forced into vestibular therapy due to clinic specialization, she emphasizes the importance of mentorship and how vestibular therapy can transform patient outcomes.
Importance of Vestibular Rehab in Neurology
Vestibular therapy is crucial in neurology as it addresses the central role of the vestibular system in balance. Even patients without dizziness can have undiagnosed vestibular dysfunction affecting their stability. Simple screens like the modified sideline test can reveal BPPV prevalence and significantly impact patient outcomes, reducing fall risks and improving balance.
Addressing Vestibular Dysfunction in Aging Population
The aging population often underestimates vestibular issues due to desensitization or movement avoidance. Christina stresses the necessity to screen for vestibular dysfunction, highlighting the impact of BPPV on fall risks and advocating for greater education on vestibular systems in healthcare to improve patient care and reduce unnecessary tests like MRI scans.
Overcoming Barriers to Vestibular Training and Mentorship
Christina aims to bridge the gap between general practitioners and vestibular specialists by offering concise courses that empower therapists to integrate basic vestibular assessment and treatment into everyday practice effectively. She emphasizes the need for ongoing mentorship to facilitate better understanding and application of vestibular knowledge.
Promoting Vestibular Education and Accessibility
There is a pressing need to educate healthcare professionals about vestibular dysfunction, move towards standardized vestibular screening in emergency settings, and enhance general awareness of the vestibular system's impact on various conditions. Christina's efforts through courses and mentorship aim to make vestibular education more accessible and integral to patient care.
Connecting Through Education and Platforms
Christina advocates for improving vestibular education not only for specialists but also for general practitioners to optimize patient care outcomes. She emphasizes the need for ongoing dialogue, accessibility to mentorship, and practical tools that streamline vestibular screening and treatment across healthcare settings, making vestibular care more inclusive and impactful for diverse patient populations.
Vestibular screening and treatment doesn’t have to be only for vestibular specialists! On today’s show we interviewed Dr. Christina Garrity, PT, DPT, NCS about the gaps that exist in vestibular care. All humans have vestibular systems and they can be negatively impacted by neurologic diagnoses, but how do you know if they aren’t reporting dizziness? How do you build treatments into your plan of care when you have so many other things to focus on for “non-vestibular patients” or when you don’t have goggles? We tackle these issues and more to help the neurologic therapist understand why and how to implement easy ways to reduce client falls.
The other issue in working with people with vestibular conditions is that they are all so different and after you take the course you may not know how to problem solve through the case. Where can you get mentorship and what could it look like?
Christina believes therapists should integrate these pillars into any neuro client treatment plan of care: 1) Visual stabilization, 2) sensory integration, 3) habituation. Additionally, research shows that 25% of people could have BPPV even without the classic symptoms, so you should be screening for BPPV in anyone at a fall risk! Screening doesn’t have to be complicated because you can do the modified side lying test vs the Dix-Hallpike.
Her go to screening tests for all balance clients are: HIT, modified side lying test, dynamic visual acuity, modified CTSIB, FGA.