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What Is The 5 Minute Cover Test?

May 07, 2022

Did you know that dizziness, headaches, and pain in the sinus region can be due to a binocular vision dysfunction (BVD)? There are several tests we can use to assess for this, but let's review one of the simplest being the 5 Minute Cover Test. Before we do this though, let's do a quick review of what a BVD is.

What is a binocular vision dysfunction (BVD)?

Binocular vision dysfunction is a condition where the eyes are not looking in the same direction. When looking straight ahead, to the side, up, down, as well as near and far the eyes should be aligned and move together as a pair. Causes of BVD are usually due to poor functioning of a nerve or nerves that control eye movement, or of the...

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Our Secret Sauce For Getting More Than 100 New Vestibular Referrals a Month

Apr 08, 2022

Are you a health care provider who enjoys the challenge of assessing and treating individuals with dizziness?

Would you like to help more patients who are dealing with dizziness?

Or, are you simply looking for a niche market?

If this is you, good call as there is so much need to provide vestibular therapy services.

Learn from others who have travelled before you

Over the years we have been intentional in marketing our services which has been key in seeing well over 100 new vestibular referrals a month. At North 49 we actually see more people with dizziness than we do with all MSK conditions combined and hope to share what we have learned with you so you can have the same success in less...

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BPPV Treatment: 3 Reasons Why It's Not Working

Feb 26, 2022

BPPV is the most common cause of dizziness across the lifespan. Fortunately with treatment it typically resolves within 1-3 sessions. Untreated, BPPV also has a 50% chance that it will resolve spontaneously within 3 months. (Bhattacharyya 2017)

So, what happens if the history of someone’s dizziness is consistent with BPPV, but it is not responding to treatment? It happens and we’ve been there. From our experience this could be due to several reasons, so let’s review the three most common reasons why.

Reason #1: You’re not using the correct technique to treat BPPV.

With any form of treatment, technique is vital. So, with BPPV let’s review some of the common...

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What is a Perilymphatic Fistula?

Feb 03, 2022

Do you or a patient of yours experience dizziness with coughing, loud sounds, or with sudden altitude changes? If so, the symptoms maybe due to a perilymphatic fistula.

Let’s cover the 5 W’s of what a perilymphatic fistula is. That way we will have a better understanding of what it is, what causes it, and treatment options.

What is a Perilymphatic Fistula?

A perilymphatic fistula is a hole or defect in one of the two thin membranes of the inner ear, being the round and oval window.

Function of the round and oval window

These two membranes allow for pressure changes in the inner ear. Specifically, the oval window allows for the vibration from the stapes (smallest bone in your...

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Vestibular Hypofunction Treatment Guidelines - Update

Jan 04, 2022

As health care providers we like to say that we provide evidence based treatment, but what is the evidence for the vestibular therapy we provide? Specifically, how about the treatment we provide for vestibular hypofunction?

With being a busy clinician it can be a bit daunting trying to keep up with the latest research. We also have to realize that for every good piece of research there is research that is, well, not so good. So, how do we filter out the clinically relevant and strong evidence based research?

Fortunately, from time to time clinical practice guidelines come out and provide direction. Over the past few years there have been clinical practice guidelines developed for...

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Vestibular Therapy Marketing Strategies - part 3 (wrap up)

Dec 27, 2021

In our previous two posts we reviewed vestibular therapy marketing strategies that have been key for North 49 in consistently seeing well over 100 new vestibular patients a month. The two key strategies include educating ourselves as well as educating other health care providers.

In this post we will conclude this series by covering the steps we have taken to educate the general public regarding our services, along with two X factors.

Marketing 101

Before we get too far, when it comes to vestibular therapy marketing can you relate to any of the following:

  • Feeling like you would rather not market your services as you do want to come across as being “salesy”?
  • Promoting what you...
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Vestibular Therapy Marketing Strategies Part 2 - educating our customers

Nov 09, 2021

What effect would an additional 20 new vestibular patients a month have on your clinic? How about 50, 75, 100, or thinking big how about over 100? It is totally achievable. We have been there and we want to share our journey with you so you can have the same, if not better results in less time. In order to get there let's review some marketing strategies for your vestibular therapy practice.

Brief Recap:

Part 1 of this series reviewed how we have grown from a start-up clinic with no patients to consistently seeing well over 100 new vestibular referrals a month. We also reviewed:

Developing niche marketing streams to use our clinical skills to address common problems that face the public,...

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Vestibular Therapy Marketing Strategies - Part 1

Oct 14, 2021

What effect would an additional 20 new patients a month have on your clinic? How about 50, 75, 100, or thinking big how about over 100?

Does the hard work and time you take attending courses to improve your skills and patient outcomes automatically result in increased referrals?

Does your community have a good understanding of how you can impact their health and well-being?

If you have ever wondered about these things, you are not alone. We have wondered these things as well and would like you to be a part of our journey as we share how North 49 has been able to grow to consistently see over 100 new patterns each month with dizziness and balance issues. Over the next few months we will...

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Vertebral Artery Dissection - Is This Something We Still Need To Worry About?

Sep 04, 2021

Do you ever wonder what would happen if one of your patients had a vertebral artery dissection?

Do you ever wonder if you would be able to screen if your patient has a vertebral artery dissection?

We recently had a patient come through our clinic with a vertebral artery dissection and his history was alarming. Before we review this case let’s review some of the common questions about this condition:

  • What is vertebral artery dissection?
  • What causes vertebral artery dissection?
  • How common is vertebral artery dissection?
  • What are the symptoms of a vertebral artery dissection?
  • How is vertebral artery dissection diagnosed?
  • What is the treatment for vertebral artery dissection?

What is...

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Let’s Consider Taking a Step Backwards When Assessing Balance

Aug 05, 2021

A few months ago we reviewed how gait speed is not only a great test to measure mobility, but why it should also be considered a vital sign (link). But have you ever wondered about assessing your patient’s ability to walk backwards? This is a more complex task needed for tasks such as backing up to a chair, opening a door, or avoiding a sudden obstacle. Or,  have you ever wondered if there was a standardized testing protocol for backwards walking with normative data? 

The study by Carter in 2017, called “The 3m Backwards Walk & Retrospective Falls: Diagnostic Accuracy of a Novel Clinical Measure” looked at walking backwards and falls. The study reviews:

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