CVT CVT Fall Prevention & Balance Rehabilitation 2 — Questions and Answers
Question 1: Which gait characteristic is most strongly associated with increased fall risk in patients with vestibular dysfunction?
- Increased cadence
- Reduced gait speed (Correct answer)
- Isolated increase in step width
- Longer-than-normal stride length
Correct answer: Reduced gait speed
Slower gait speed is one of the most robust predictors of fall risk, frailty, and adverse outcomes across multiple patient populations including those with vestibular disorders.
Question 2: Dual-task training in vestibular rehabilitation is designed to:
- Train two therapists to treat one patient simultaneously
- Improve performance of balance tasks while simultaneously completing a cognitive or secondary motor task (Correct answer)
- Apply two different repositioning maneuvers in sequence
- Train in two different clinic environments per session
Correct answer: Improve performance of balance tasks while simultaneously completing a cognitive or secondary motor task
Dual-task training mimics real-world demands where patients must maintain balance while performing cognitive tasks like conversation or carrying objects.
Question 3: Sequential Romberg testing (firm surface, foam surface, eyes open, eyes closed) is used to assess:
- Central versus peripheral hearing loss
- BPPV versus labyrinthitis
- The relative contributions of visual, somatosensory, and vestibular systems to balance (Correct answer)
- Dynamic vestibulo-ocular reflex gain under perturbation
Correct answer: The relative contributions of visual, somatosensory, and vestibular systems to balance
By systematically manipulating surface stability and visual availability, Romberg conditions reveal which sensory inputs a patient relies on and which are impaired.
Question 4: Tai Chi-based programs are beneficial for fall prevention in vestibular patients primarily because they:
- Eliminate the need for formal vestibular rehabilitation
- Focus exclusively on cardiovascular endurance
- Correct BPPV without canalith repositioning
- Simultaneously improve lower extremity strength, flexibility, and postural control (Correct answer)
Correct answer: Simultaneously improve lower extremity strength, flexibility, and postural control
Tai Chi's slow, controlled weight-shifting movements train multiple fall-prevention components simultaneously, with strong evidence for reducing fall frequency in older adults.
Question 5: The Four Square Step Test (FSST) assesses a patient's ability to:
- Quantify nystagmus during direction-changing movements
- Step quickly and safely over a cane in four cardinal directions (Correct answer)
- Measure caloric response asymmetry between ears
- Assess head thrust reflex gain bilaterally
Correct answer: Step quickly and safely over a cane in four cardinal directions
The FSST requires rapid stepping over obstacles in four directions, challenging multi-directional balance, stepping accuracy, and dynamic postural control.
Question 6: When progressing a vestibular patient through balance exercises, the therapist should advance difficulty:
- Immediately to the most challenging task to maximize gains quickly
- Randomly to prevent motor adaptation
- Systematically from stable surfaces and controlled tasks toward increasingly demanding conditions (Correct answer)
- Only when the patient reports absolutely zero dizziness with all exercises
Correct answer: Systematically from stable surfaces and controlled tasks toward increasingly demanding conditions
Systematic progression from firm to compliant surfaces and eyes-open to eyes-closed conditions ensures each step is challenging but achievable, building compensatory strategies safely.
CVT CVT Fall Prevention & Balance Rehabilitation 2
Which gait characteristic is most strongly associated with increased fall risk in patients with vestibular dysfunction?