Sky Lakes Medical Center | Live Smart | Summer 2021
6 LIVE smart | Summer 2021 By Alek Angeli, PT, DPT, Certified Vestibular Specialist Sky Lakes Outpatient Rehabilitation Persistent postural-perceptual dizziness (PPPD) is a chronic inner-ear disorder that includes on-and-off symptoms of dizziness, unsteadiness, anxiety or non- spinning vertigo. PPPD symptoms typically last at least three months or more and are triggered by positional changes, movement, and exposure to environments with complex or moving visual objects. Symptoms include: ▸ Increased sensitivity to walking in crowded environments, like grocery store aisles; ▸ Hypersensitivity to viewing heavily patterned carpet, scrolling on a mobile phone, or watching a loud and suspenseful movie; ▸ The sensation of constant swaying or feeling as if you’re standing on a boat in the middle of a lake; ▸ Difficulty remembering recent events or just not feeling like your normal self; and ▸ Difficulty walking on uneven surfaces, walking in the dark, and walking down slopes or stairs. Treating PPPD Physical therapy is an effective treatment option for PPPD. Physical therapists provide a variety of treatment methods, including vestibular training and balance, walking and habituation exercises. Treatment also includes training the eyes while the head and body are in motion. Habituation exercises are repetitive movements similar to activities that typically trigger PPPD symptoms. Both vestibular and habituation exercises will seem to increase symptoms—but only slightly. They are designed to help strengthen the vestibular system to better tolerate activities that are movement-based and have increased visual stimulation. These types of treatments are also tailored specifically to each person and require close monitoring by a skilled vestibular physical therapist. GET YOUR LIFE BACK IN BALANCE Outpatient rehabilitation can help restore your equilibrium. See our full range of therapy options at SkyLakes.org/Balance-Falls . Dizziness, anxiety, vertigo: Could it be PPPD? Managing symptoms It is important to recognize which activities provoke PPPD symptoms. Gradual exposure to those activities can help improve your symptom response. Examples of things you can do include: ▸ Visiting grocery stores that are familiar, during times that are not busy; ▸ Avoiding patterned floors or clothing; ▸ When walking in crowds, trying to walk along the side so that traffic is less stimulating; ▸ When riding in a car as a passenger, pretending as if you are driving; and ▸ Walking outside every day for at least 30 minutes. PPPD can be described as a series of “misunderstandings” between your ears, spinal cord, eyes and brain. The condition is often reversible. Once recognized, PPPD can be managed with tailored treatment strategies, including specialized physical therapy.