Document Detail

Acrophobia and pathological height vertigo: indications for vestibular physical therapy?
MedLine Citation:
PMID:  15842192     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: Acrophobia (fear of heights) may be related to a high degree of height vertigo caused by visual dependence in the maintenance of standing balance. The purpose of this case report is to describe the use of vestibular physical therapy intervention following behavioral therapy to reduce a patient's visual dependence and height vertigo. CASE DESCRIPTION: Mr N was a 37-year-old man with agoraphobia (fear of open spaces) that included symptoms of height phobia. Exposure to heights triggered symptoms of dizziness. Intervention. Mr N underwent 8 sessions of behavioral therapy that involved exposure to heights using a head-mounted virtual reality device. Subsequently, he underwent 8 weeks of physical therapy for an individualized vestibular physical therapy exercise program. OUTCOMES: After behavioral therapy, the patient demonstrated improvements on the behavioral avoidance test and the Illness Intrusiveness Rating Scale, but dizziness and body sway responses to moving visual scenes did not decrease. After physical therapy, his dizziness and sway responses decreased and his balance confidence increased. DISCUSSION: Symptoms of acrophobia and sway responses to full-field visual motion appeared to respond to vestibular physical therapy administered after completion of a course of behavioral therapy. Vestibular physical therapy may have a role in the management of height phobia related to excessive height vertigo.
Susan L Whitney; Rolf G Jacob; Patrick J Sparto; Ellen F Olshansky; Gail Detweiler-Shostak; Emily L Brown; Joseph M Furman
Publication Detail:
Type:  Case Reports; Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Physical therapy     Volume:  85     ISSN:  0031-9023     ISO Abbreviation:  Phys Ther     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-04-21     Completed Date:  2005-06-30     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0022623     Medline TA:  Phys Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  443-58     Citation Subset:  AIM; IM    
Department of Physical Therapy, University of Pittsburgh, 6035 Forbes Tower, Pittsburgh, PA 15260, USA.
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MeSH Terms
Phobic Disorders / physiopathology,  rehabilitation*
Physical Therapy Modalities*
Vertigo / physiopathology,  rehabilitation*
Vestibular Diseases / physiopathology,  rehabilitation*
Vestibular Function Tests
Grant Support

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