Dizziness is a common and nonspecific complaint leading to a growing number of emergency department visits and hospital admissions following trauma associated with a fall. Otovestibular conditions constitute a significant proportion of dizziness cases. Common treatable peripheral vestibular disorders, including benign paroxysmal positional vertigo (BPPV), that may go unrecognized may be diagnosed using inexpensive bedside tests.
Two patients were consulted to have a vestibular rehabilitation therapy evaluation performed by physical therapy in the acute care department as both subjectively described BPPV. The first patient was treated using conventional techniques and application of evidence-based guidelines for BPPV intervention. However, orthopedic/pain limitations restricted traditional examination techniques for the second patient allowing consideration of a novel approach to carrying out the examination.
The first patient was treated successfully for BPPV remission using emerging clinical practice guidelines. The clinical evaluation of the second patient was nonsignificant; however, the presentation illustrates how traditional vestibular assessment techniques can be modified in a novel way in the acute care setting based on recent biophysical scientific evidence.
This case study found that evidence-based practice guidelines as well as application of a biophysical scientific knowledge base can be applied into the acute care vestibular rehabilitation examination using primarily different configurations of a hospital bed only. Positive outcomes hold the unique potential of physical therapist consultation services throughout acute and inpatient environments, as well as setting a clinical precedent for future patients presenting with previously unrecognized BPPV.