CVT Vestibular Rehabilitation Techniques 2 — Questions and Answers
Question 1: Which technique involves moving the patient from sitting to side-lying and is used to treat posterior semicircular canal BPPV?
- Semont maneuver (Correct answer)
- Epley maneuver
- Lempert roll
- Brandt-Daroff exercise
Correct answer: Semont maneuver
The Semont (liberatory) maneuver moves the patient rapidly from sitting to side-lying to dislodge debris from the posterior semicircular canal.
Question 2: During gaze stabilization exercises, a patient tracks a target while moving the head. What is the primary goal of this VOR x1 exercise?
- Improve smooth pursuit eye movements
- Enhance VOR gain to maintain stable gaze during head movement (Correct answer)
- Strengthen extraocular muscles
- Reduce saccadic eye movement latency
Correct answer: Enhance VOR gain to maintain stable gaze during head movement
VOR x1 exercises aim to increase VOR gain so the eyes move equally and opposite to head movement, stabilizing the visual image.
Question 3: A patient with bilateral vestibular hypofunction is BEST served by which rehabilitation approach?
- Canalith repositioning maneuvers
- Substitution and habituation strategies using visual and somatosensory cues (Correct answer)
- Surgical semicircular canal plugging
- Repeated Dix-Hallpike testing to provoke adaptation
Correct answer: Substitution and habituation strategies using visual and somatosensory cues
Bilateral vestibular hypofunction cannot be restored via repositioning; therapy focuses on substitution with alternative sensory systems and habituation.
Question 4: Which outcome measure assesses dynamic balance by requiring patients to walk while turning their head horizontally?
- Romberg test
- Dynamic Gait Index (DGI) (Correct answer)
- Dizziness Handicap Inventory (DHI)
- Head Impulse Test (HIT)
Correct answer: Dynamic Gait Index (DGI)
The Dynamic Gait Index includes a task of walking with horizontal head turns, directly challenging vestibulo-spinal reflexes during locomotion.
Question 5: What is the primary mechanism behind habituation exercises for vestibular disorders?
- Strengthening the peripheral vestibular end organ
- Repeated exposure to provocative movements to reduce CNS sensitivity to the stimulus (Correct answer)
- Improving labyrinthine blood flow
- Increasing otolith membrane density
Correct answer: Repeated exposure to provocative movements to reduce CNS sensitivity to the stimulus
Habituation relies on neuroplasticity: repeated exposure to a provocative stimulus gradually reduces the symptomatic response over time.
Question 6: In the Lempert (BBQ) roll maneuver, the patient rolls through which sequence of positions to treat horizontal canal BPPV?
- Supine → affected side → prone → unaffected side → sitting (Correct answer)
- Sitting → supine → affected side → sitting
- Affected side-lying → sitting → unaffected side-lying
- Supine → head turned 45° toward affected side → sitting
Correct answer: Supine → affected side → prone → unaffected side → sitting
The Lempert roll uses sequential 90° rolls from supine through affected side, prone, and unaffected side to move canalith debris out of the horizontal canal.
Question 7: Which sensory condition on the Sensory Organization Test (SOT) isolates somatosensory input by removing visual and accurate vestibular cues?
- Condition 2
- Condition 3 (Correct answer)
- Condition 4
- Condition 5
Correct answer: Condition 3
SOT Condition 3 removes vision (eyes closed) and sways the support surface, leaving somatosensory as the primary reliable input for balance.
CVT Vestibular Rehabilitation Techniques 2
Which technique involves moving the patient from sitting to side-lying and is used to treat posterior semicircular canal BPPV?