Case Studies

Finding An Effective Treatment

Five Years Post Stroke

A 70 year-old male with a five-year history of left medullary stroke was referred to the balance center by his family practitioner because of increased complaints of difficulty walking and further restriction of his daily life activities. These new complaints followed a brief hospitalization for a gastrointestinal problem.

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Return to Work Determination

Acuity & Steadiness During Active Movement

A 47 year-old construction worker complains of a six month history of intermittent dizziness and mild unsteadiness accompanied by visual blurring. He is a self-referral, concerned about his ability to perform his job safely, particularly in elevated locations.

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Fall Risk Reduction in the Elderly

Disequilibrium of Aging

A 70 year-old woman is referred to physical therapy by her primary care physician. She reports a seven month history of dizziness during movement and disequilibrium. She has fallen once in the yard while walking at dusk. She is unable to work in her garden without great care.

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Simplifying Treatment Dilemmas

Impairments Drive Specialized Treatment Plan

Patients A and B are elderly individuals referred from family practice presenting with mild dizziness, increasing imbalance and decreased activity levels over the last several months. Patient A reports multiple ‘near fall’ events, whereas Patient B reports a single fall without injury. Both have known diabetic neuropathy that has been evaluated and confirmed by their neurologists.

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Data Drives Effective Care in Chronic Conditions

Chronic Low Back Pain

A 66 year-old female complains of a 10+ year history of chronic low back and lower extremity pain with frequent recurrence. Her pain is significantly increased with activities of daily living to an 8/10 rating (10=severe pain), particularly with walking and standing activities. Management to date has included multiple episodes of rehabilitation care, medical management with injections, and corrective shoe orthotics—all with limited relief. Her goal is to live life without severe pain.

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Differentiating Functional Impairments

BPPV With Disequilibrium

A 70 year-old librarian assistant was referred to an ENT by his primary care physician. He complains of positional vertigo, confirmed on clinical examination as BPPV or canalithiasis of the right posterior semicircular canal. He underwent a canalith repositioning procedure (CRP) that day.

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