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As vestibular therapists, we often focus on assessing the function of the semicircular canals in the inner ear. However, the otolithic organs—the utricle and saccule—play a crucial role in maintaining balance and spatial orientation and are not routinely assessed. Two electrophysiological tests, Cervical Vestibular Evoked Myogenic Potentials (cVEMPs) and Ocular Vestibular Evoked Myogenic Potentials (oVEMPs), provide valuable insights into otolithic function. I often forget the difference between the two VEMPs tests, so hopefully writing this blog will make it stick. If not, at least I have a quick resource to refer back to!

If you are like me, these tests may not be...

This fall, Guardian Caps are appearing more frequently in football, including on professional fields. As someone with experience with rugby and wakeboarding, I immediately noticed how these caps resembled scrum caps used in rugby or impact vests for wakeboarding.

Guardian Caps are soft-shell helmet covers designed to reduce the force of impacts during collisions. With concussions continuing to be a significant issue in contact sports, especially football and hockey, these caps offer a fresh approach to an old problem. Let's face it, over the past few decades, helmet designs have not changed much while concussions have remained a persistent issue.

How Do Guardian Caps Work?

The...

Maintaining mobility and activity levels in patients with balance issues is essential for their overall well-being. Falls are a leading cause of losing independence in older adults, making fall prevention a key priority. As healthcare providers, we must balance the need to reduce fall risks with keeping patients active. This is where ambulatory aids like walking, Nordic, and trekking poles can make a significant difference. In this post, we’ll review the benefits, differences, and sizing of these poles, and how to determine which is the best option for your patients.

1) Walking Poles: Stability and Confidence on the Go

Designed to provide stability, they can help patients maintain...

In the field of vestibular therapy, taking a thorough vestibular history is crucial. Accurate diagnosis of vestibular conditions (i.e. vestibular migraines) often depends solely on the patient’s history. When I first entered this field years ago, I was advised to focus on three primary elements during vestibular history-taking: symptoms, tempo, and circumstance. Over time, this approach has proven invaluable in my practice.

In this post we'll cover these three elements along with a useful acronym that will help gather all of the pertinent information.

Key Components of a Vestibular History

1. Symptoms

To begin, determining the nature of the patient’s symptoms is essential. Is...

As healthcare providers, we occasionally encounter patients with dizziness that does not fit the usual patterns of vestibular disorders. One such condition is Third Window Syndrome (TWS), which most commonly presents as Superior Semicircular Canal Dehiscence (SSCD). There are other presentations of TWS aside from SSCD and TWS itself was first described by Minor in 1998. 

In this blog, we will cover what TWS is, its causes, symptoms, triggers, diagnosis, and treatment options.

What is Third Window Syndrome?

Third Window Syndrome (TWS) encompasses a group of inner ear disorders characterized by an abnormal opening or thinning in the bony structures of the inner ear. The most...

We’re excited to share an assessment technique that has significantly enhanced our ability to evaluate patients with vestibular hypofunction: the Skull Vibration Induced Nystagmus Test (SVINT). After hearing about it a few times over the past few years, we decided to investigate further and are glad we did. Given our access to infrared goggles, implementing SVINT was quite affordable since portable handheld massage devices can be picked up at places like Walmart.

Clinically, the test has helped us pick up vestibular hypofunctions when our other battery of tests such as looking for gaze evoked nystagmus, head impulse test, head shaking nystagmus test, and dynamic visual acuity tests...

At North 49, the three common questions we get asked about infrared goggles are:

1. Can we get a discount rate on goggles through North 49?
2. Do I really need goggles?
3. Which goggles do you recommend?

Can we get a discount rate on goggles through North 49?

The answer to the first question is, unfortunately no. That being said, we would really appreciate that if you end up buying a pair of goggles from Vestibular First that you use: https://vestibularfirst.com/?referredby=507 as it allows us to collect points that we redeem to purchase anatomical models that we give out as draws at our weekend courses. From time to time we also have give-away draws for our monthly newsletter subscribers....

As a healthcare provider, seeing patients with various medical conditions is part and parcel of our daily routine. However, there are certain conditions that are relatively rare, but require keen attention and understanding for effective management should they occur. One such condition is an acoustic neuroma, also known as vestibular schwannoma. In this blog, I will provide insights into what an acoustic neuroma is, its prevalence, clinical presentation, conservative treatment principles, and indications for surgery. Then, if you want to take a deeper dive, I'll provide some of my favourite resources at the end of the this blog. 

Understanding Acoustic Neuroma:

Acoustic neuroma is...

How Blogs Help SEO

In today's digital age, a strong online presence is crucial for the success of any medical practice, including physiotherapy clinics. A few years ago, we recognized the importance of being easily found on the web to attract new clients and when we did a search our clinic ranked high, being easily found if someone searched "physical therapy". However, with the search word "physiotherapy" we showed up on the fourth page.

Given that, we had to make some changes and one tool that has boosted our search engine optimization (SEO) or ability to be found on the web is by posting blogs using keywords such as "physiotherapy". The general experience from us and...

Do you ever struggle distinguishing between different types of nystagmus, such as end point nystagmus (EPN) and gaze evoked nystagmus (GEN)? If so, you're not alone. Working closely with therapists in vestibular therapy over the years we've found this to be a common issue. Given such, let's review three practical tips when assessing patients that we have found helpful.

Actually, before we get too far, we need to remember that end point nystagmus is a normal physiological response, while a true positive gaze evoked nystagmus finding is indicative of a central or peripheral vestibular disorder.

As we will see in this blog, end point nystagmus is a bit of a misnomer as it can be...