Medical Evaluation, Diagnostic Testing, Rehabilitation
Our comprehensive patient case management protocol is designed for physicians who have patients with generalized dizziness or balance problems and would like NDBC to diagnose and treat their patients per NDBC protocols. The recommended treatment plan for a patient will depend on the results of the initial comprehensive medical evaluation and the diagnosis.
1. Comprehensive Medical Evaluation
AAAAa. Patient is required to complete NDBC's detailed medical history form
AAAAb. Patient is required to complete a dizziness & balance handicap assessment
AAAAc. One of our medical physician's provides a comprehensive evaluation
AAAAd. Patient treatment plan is established
Based upon initial findings of the medical evaluation, the patient will either be scheduled for diagnostic testing or scheduled to have a physical therapy evaluation by a physical therapist. The patients that are not appropriate for our services will be referred back to the referring physician.
* A report will be mailed to the referring physician indicating the initial findings, the patient's dizziness handicap, and the patient's treatment plan within one week of the patients appointment.*
2. Computerized Diagnostic Testing in Balance Lab
AAAAa. Video Electronystagmography (VENG)
AAAAb. Computerized Dynamic Posturography (CDP)
AAAAc. Audiometry testing (hearing)
AAAAd. Evoked Potential Testing (nerve pathways, vestibular function)
Patients that are referred to our balance lab for diagnostic testing may have these Electrophysiologic studies performed: Videonystagmography (VNG), Computerized Dynamic Posturography (CDP), Audiometry testing (hearing), or Evoked Potential Testing (nerve pathways). The studies that are performed will based upon their initial medical evaluation orders, current symptoms, and the results of studies performed during the actual examination.
Diagnostic testing in our Balance Lab is conducted by our Audiologist Mark Cheple, who has over 20 years of audiometric and vestibular testing experience.
* A report will be mailed to referring physician after the patient has reviewed their Electrophysiologic results from the balance lab, and their physical therapy evaluation that indicates the significant findings and the continued treatment plan for the patient. *
3. Physical Therapy Evaluation
AAAAa. Physical therapy evaluation
AAAAb. Positional nystagmus evaluation using VNG technologies
AAAAc. Spontaneous nystagmus evaluation using VNG technologies
AAAAd. Gaze evoked nystagmus evaluation using VNG technologies
AAAAe. Computerized Dynamic Posturography (CDP)
AAAAAAAi. Establish a starting point for the patients rehabilitation program
AAAAAAAii. Sensory Organization Test (SOT)
AAAAAAAiii. Motor Control Test (MCT)
The physical therapist will perform a thorough analysis of the patient's symptoms and conduct a variety of tests to evaluate their strength, joint motion, balance, sensory systems and mobility. The patient will also be tested with our Computerized Dynamic Posturography (CDP) to assess how well the patients balance systems are working together. From this detailed evaluation, a personalized treatment plan will be designed for the patient if physical therapy is appropriate for their condition.
4. Report of Findings with NDBC Physician
AAAAa. Physician will review the diagnostic tests from the balance lab
AAAAb. Physician will review the physical therapy evaluation
AAAAc. Physician will review patient's treatment plan and course of treatment
*A report will be faxed to referring physician after the patient has reviewed their Electrophysiologic results and physical therapy evaluation indicating the significant findings and the continued treatment plan for the patient. If the referring physican wants the actual test data, please indicate, and we will mail the results to you.*
5. Physical Therapy Treatment sessions
AAAAa. 8 to 12 week rehabilitation program
AAAAb. 2 visits week for the first month, one visit week for the following month
AAAAc. Monthly re-testing on CDP to document patient progress
AAAAd. Physical therapy modalities available:
AAAAAAAi. Vestibular Rehabilitation
AAAAAAAii. Neuro Rehabilitation
AAAAAAAiii. General conditioning
AAAAAAAiv. Gait Training
Physical therapy treatment sessions typically last 1 hour in length and are scheduled 2 times a week for the first month, and once week for the following month. As part of the NDBC rehabilitation program, patients are given home exercise programs to complete on a daily basis outside of the physical therapy done in NDBC clinics. The duration of a patients rehabilitation program will depend on the commitment of the patient in completing their home exercises, and the diagnosis of the patients condition.
After 8 therapy appointments, the patient will see a NDBC physician to discuss the patients progress, any new developments, and the continued treatment plan.
* A report will be faxed to referring physician indicating the patient's progress, CDP re-test results, and the continued treatment plan. *
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