what are the mTBI classifications
Grade 1: no loss of consciousness, sx last hours to minutes or days after injury (post traumatic amnesia, headache, cog fog, mild confusion)
Grade 2: Loss of consciousness <5min (PTA 7-24hours, sx consistent w grade 1 but also tinnitus, loss of balance, confusion)
Grade 3: loss of consciousness >5min (PTA>24hrs, visual disturbances, altered arousal, significant impaired motor coordination)
What is due to stroke of the labyrinthe A. Supplying the peripheral vestibular organ
- micro vascular disease
- trauma to CNVIII
- vestibular neuritis
- Ototoxicity from use of antibiotics (bilateral imps)
- vestibular Schwannoma
Peripheral Vestibular Organ Hypofunction or loss
what is Canalithiasis treatment for posterior and horizontal canal?
Posterior canal canalithiasis- epley or semont maneuver
Horizontal canal canalithiasis- BBQ roll or Gufoni maneuver
What are the most common SCI sites ?
C5-7
T12-L2
Which orthoses ?

Lumbosacral orthosis LSO
what is the Buffalo concussion treadmill test
Initiated 5-7 days after acute injury
Similar concepts to the symptom limited activity test
baseline vitals and symptoms recorded
treadmill set to 3.2 or 3.6mph (based on height)
Walk at 0% grade for 3min then increase by 1% for each min after until 15min
This is pt presentation for ?
- low frequency hearing loss and episodic vertigo
- 2 or more bouts of vertiginous dizziness (spinning) lasting mins to hours
- additional reports of tinnitus and aural fullness
- spontaneous improvement in symptoms only
- nothing helps reduce symptoms during an episode
Ménière's Disease
What is the positional assessment of Left posterior canalithiasis and what direction is the nystagmus?
Positional assessment: left dix hallpike, loaded dix hallpike
up beating left torsional nystagmus
What is damage at or peripheral to the ventral horn cell
Flaccid paralysis
- decreased one with weak/paralyzed muscles
- spinal reflex arc impaired
which cervical collar?
aspen collar
wear 6-8 weeks
more restrictive
This is which step of return to play progression ?
Walking, low intensity cycling, light jogging
light aerobic activity
This is pt presentation of ?
- recurrent attacks of instability in response o changes in middle ear pressures, loud noises (including speaking) & increased bone conductions (vibrations)
- may demonstrate peripheral hypo function and or signs of BPPV
Superior canal dehiscence
How does the cerebellum adjust errors?
Mossy fibers: transmit cortical motor signals and sensory feedback
Parallel fibers: relay signals from mossy g=fibers to purkinje cells
Purkinje cells: cerebllar output, regulate and fine tune motor signals
Deep cerebellar nuclei: Receive information from mossy fibers and relay to the inferior olive
Inferior olive: the error detector, direct synapse w purkinje cells via climbing fibers, modulate purkinje cell activity
This is which respiratory function ?
- weakness of trunk muscles
Lateral breathers (incomplete SCI)
which cervical collar?
miami J collar
cleanliness
wear 6-8 weeks
what is post concussion syndome?
mTBI symptoms lasting weeks to months post injury ?
- risk factors: gender, age, psychiatric history, or a history of chronic pain syndromes
- ICD 10 diagnosistics
- rooted in Autonomic Nervous System Dysfunction
This is unilateral impairment pt presentation of ?
- sudden onset of dizziness, and instability
- may report sensations of turning or vertiginous dizziness (spinning)
- nausea and vomitting
- symptoms persist however reduce while th CNS compensates for asymmetrical vestibular signals
Acute phase of Peripheral vestibular hypo function/loss
What does the MVST and LVST innervate?
MVST- cervical spinal cord
bilateral innervation of cervical muscles- head stabilization
LVST- lower spinal cord
ipsilateral innervation of axial muscles- extensor muscle activation
What are signs and symptoms of AD?
- high BP (hypertension) pounding/severe headace
- bradychardia
- cardiac arrhythmia
- sweating above level of injury
- flushing of face/neck above level of injury
- piloerection or goosebumps above or below level of injury
- pillow below level of injury
- blurred vision or spots in field of vision
- nasal congestion
which orthosis?
Cervical thoracic lumbosacral orthosis
stabilize spine while out of bed
This is assessment for which mTBI impairment ?
- vital sign changes with position and in response to activity
- Buffalo concussion treadmill (or bike) test
Autonomic dysfunction & external tolerance impairment
What is inflammation of CN VIII after addditional infection (flu)
Vestibular neuritis
What is cupulolithiasis?
Otoconia are stuck to the cupula
Cupula becomes directly sensitive to gravity
No latency
Symptoms last >60 sec
Direction of nystagmus changes and beats opposite of the gravity dependent canal
This is PT for ?
- weight bearing / stretching program
- neuromuscular re-education
- FES
- positioning / splinting / serial casting
- vibration
Spasticity
Criteria for KAFO bracing?
no contracture in hip flex, knee flxrs, or ankle PFs
- SLR 0-110 deg
- independent in all transfers including wheelchair to floor
- Max VO2 is > 20
- 50 continuous full tricep dips in parallel bars