Vestibular Physical Therapy in Individuals With Cognitive Impairment: A Theoretical Framework

被引:12
作者
Klatt, Brooke N. [1 ]
Ries, Julie D. [2 ]
Dunlap, Pamela M. [3 ]
Whitney, Susan L. [3 ]
Agrawal, Yuri [1 ]
机构
[1] Johns Hopkins Univ, Dept Otolaryngol Head & Neck Surg, Baltimore, MD USA
[2] Marymount Univ, Dept Phys Therapy, Arlington, VA USA
[3] Univ Pittsburgh, Dept Phys Therapy, Pittsburgh, PA 15260 USA
来源
JOURNAL OF NEUROLOGIC PHYSICAL THERAPY | 2019年 / 43卷
关键词
Alzheimer disease; cognitive impairment; dementia; vestibular rehabilitation; ALZHEIMERS-DISEASE; EXERCISE PROGRAM; CHALLENGE POINT; DEMENTIA; PEOPLE; REHABILITATION; BALANCE; CARE; COMMUNICATION; STRATEGIES;
D O I
10.1097/NPT.0000000000000266
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Falls are a major health care concern in individuals with Alzheimer disease (AD) and their caregivers. Vestibular impairment is a known risk factor for falls, and individuals with AD have been shown to have an increased prevalence of vestibular loss compared with age-matched controls. Vestibular physical therapy (VPT) is effective in improving balance and reducing fall risk in cognitively-intact persons with vestibular impairment. However, the effectiveness of VPT in improving balance and reducing falls in individuals with AD who have vestibular loss has never been explored. Summary of Key Points: In this article, we apply prevailing ideas about rehabilitation and motor learning in individuals with cognitive impairment (IwCI) to VPT. Recommendations for Clinical Practice: We propose a modification of current evidence-based VPT protocols for IwCI using the strength-based theoretical framework that emphasizes the motor learning abilities of IwCI. In addition, we highlight the importance of establishing an excellent rapport with IwCI, and present key strategies for optimizing the therapeutic relationship. In ongoing work, we are assessing the efficacy of this modified VPT protocol in IwCI to improve balance and reduce falls.
引用
收藏
页码:S14 / S19
页数:6
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