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Pediatric Vestibular Rehabilitation

A Case Study

Alves, Camilla Cavassin PT; Silva, André Luis Santos PT, DSc

doi: 10.1097/PEP.0000000000000654

Background: A 9-year-old child with a 9-month history of complaints of dizziness, headache, and motion sensitivity came to physical therapy. The child complained of difficulties playing on a playground, running, riding in a car, watching “action movies,” sitting under fluorescent lights, and making quick head movements.

Methods: An initial evaluation included a clinical oculomotor examination, vergence testing, static and dynamic visual acuity testing, head impulse testing, subjective visual vertical, balance testing, the pediatric vestibular symptom questionnaire, the Dizziness Handicap Inventory—child caregivers version (DHI-PC) and a visual vertigo analog scale. Physical therapy included virtual reality with Xbox games plus adaptation, habituation, and balance exercises. She was seen once per week and given a home program of exercises 2 to 3 times a day.

Results: After 10 treatment sessions, she reported that playing was easier, headaches had reduced, she could travel as a passenger in a car for long distances without complaints, and that she could watch 3-dimensional action movies without symptoms. Her pediatric vestibular symptom questionnaire scores had reduced from 0.7 to 0.1. The DHI-PC had decreased from 22 to 12 points and her visual vertigo analog scale scores were improved.

Conclusions: Vestibular rehabilitation improved this child's quality of life. She was able to return to her daily living activities with fewer symptoms.

A 9-year-old child with a 9-month history of complaints of dizziness, headache, and motion sensitivity had a successful outcome after physical therapy.

Brazilian Institute of Vestibular Physical Therapy and Balance (IBRAFIVE), São Paulo, São Paulo, Brazil.

Correspondence: Camilla Cavassin Alves, PT, IBRAFIVE Instituto Brasileiro de Fisioterapia Vestibular, Rua Pirapitingui 80, Sala 708, Bairro Liberdade, São Paulo, São Paulo, Brazil, 01508-020 (

The authors declare no conflicts of interest.

Copyright © 2019 Academy of Pediatric Physical Therapy of the American Physical Therapy Association