Affiliations: Director of Vestibular Assessment and Rehabilitation, 34520 Bob Wilson Drive, San Diego, CA, USA. Tel.: +1 619 532 7450; Fax: +1 619 532 5032; E-mail: Kim.gottshall@med.navy.mil | [x] Department of Otolaryngology, Spatial Orientation Center, Naval Medical Center San Diego, San Diego, CA, USA | [y] Departments of Otolaryngology, Neurobiology, Communication Sciences and Disorders, and Bioengineering, University of Pittsburgh 107 Eye and Ear Institute 203 Lothrop Street Pittsburgh, PA, USA
Abstract: Vestibular complaints are the most frequent sequelae of mTBI. Vestibular physical therapy has been established as the most important treatment modality for this group of patients. Nevertheless there is little work objectively documenting the impact of vestibular physical therapy on this group of patients. Studies have been completed in the past examining clinical measures like the GCS on overall recovery pattern after TBI. But outcomes measures specifically aimed at examining the adequacy of vestibular tests to track vestibular recoveryhave remained lacking. Scherer and Schubert reinforced the need for best practice vestibular assessment for formulation of appropriate vestibular physical therapy treatment strategies. Now the application of vestibular testing and rehabilitation in this patient population is needed to provide information on objective outcome measures. Vestibular physical therapy is most effective when applied in a customized fashion. While we and others have developed vestibular physical therapy procedures that are applied in best practices for mTBI vestibular patients, these therapies must be customized for the patient entry level of function and expectation level of recovery. Knowledge of the patient's disability and diagnosis is critical to build the foundation for return to activity, work, or sport.
