Your initial vestibular rehabilitation assessment will be about 1 hour long. You will be emailed a COVID 19 questionnaire to be filled out prior to your appointment and you will be required to wait in your car until your physiotherapist is ready to take you in. They will come out to get you and you will be brought into our clinic, on the ground floor, where we will take your temperature before we proceed with the appointment.
Taking your history
Lee Chambers is our specialist Vestibular Rehabilitation Physiotherapist. The assessment will begin with Lee taking a thorough history. You can expect to be asked about the type of symptoms you have been experiencing, how long they last for and how severe they are. You will also be asked about what sort of things bring on or aggravate your symptoms, as well as what you are able to do to make yourself feel better (if anything). You will be asked about how long you have been experiencing your symptoms and if there is anything that you feel may have brought on your symptoms in the first place.
Lee will ask how your symptoms affect your day-to-day life and they are interfering with your work or doing the things you love to do. This part of the assessment is important to help to identify the goals of rehabilitation.
Relevant medical history will be noted and along with any medications that you are taking. There are also a few questions that everybody is asked to help to identify any more sinister causes of your symptoms. If anything is flagged here, it will be discussed with you and you may be referred back to your GP for this to be investigated further.
This part of the assessment usually takes at least 15 minutes but for some people this can take closer to 30 minutes… occasionally even more! But it is a really important part of the assessment as it gives us a good idea of what is going on. At this stage, Lee will give you a brief explanation of what she thinks may be causing your symptoms and explain what will be happening in the next part of the assessment- the physical exam.
The physical exam
This will largely be tailored by what you tell us when we are taking your history. In this part of the exam, tests will be performed to investigate the causes of your symptoms and how they are affecting your ability to balance. They include tests that look at how well you can co-ordinate the movement of your eyes while your head is still and while your head is moving, tests that look at your ability to balance standing and while walking, and if relevant, tests that will involve manoeuvres to investigate if BPPV is the cause of your symptoms. If there has been a specific movement that you have identified as triggering your symptoms, you may be asked to perform this movement.
The tests involved in the physical exam have the potential to provoke your symptoms. This is similar to if you were going to physiotherapy for lower back pain, we would ask you to move your back in different directions to see what movement you are having difficulty with or causes your pain. This is one of the reasons that we allow an hour for the initial assessment, as you may need time to recover from some of the tests.
The tests included in your physical exam will be guided by what you tell us when we are asking you about your symptoms. So if you tend to get very severe symptoms that take a long time to recover from, we may do only the really important tests that day or the tests may be done in an order so that the ones that are most likely to provoke your symptoms are kept until the end of the exam. On the other hand, if your symptoms are mild and don’t take long to subside, we may be able to push you more within the exam. You will not be asked to do anything that you are not comfortable doing and you will not be asked to do another test until you feel you have recovered from the previous test. You can stop the examination at any point if you want to.
It is extremely rare for the assessment to aggravate your symptoms. Most people just feel tired afterwards. I commonly get people telling me they felt a bit “yuck” afterwards. For this reason, I would try and time your appointment so that you don’t have anything too taxing to do afterwards or schedule the appointment when you have the possibility of getting a lift home if needs be. Again, it is extremely rare for this to occur but it is better to be prepared!
Once we have collected all the information from you in your history and in your physical exam, we will discuss the findings with you and come up with a treatment plan. This will be started the same day as the assessment. Your treatment will either involve an exercise programme to address anything we have found in the examination or a manoeuvre to treat your symptoms, if you are found to be suffering from BPPV (see previous blog for more details on this). Your physiotherapist will discuss what to expect from the treatment and how long you might need to attend for treatment. If you have any questions at all either during or after the appointment, don’t hesitate to ask. Don’t worry if you think it is a stupid question, it is likely we have heard it before!
PMC Physiotherapy Dunboyne recommendation
If you you are experiencing any of the symptoms described and think you may benefit from vestibular rehabilitation contact us at PMC Physiotherapy Dunboyne and get it checked out.
PMC Physiotherapy Clinic, Unit 36, Dunboyne Business Park, Dunboyne, Co Meath
01 8253 997