Seattle Dizzy Group

Adjusting to Visual Environment

by Morgan Kriz, DPT

Vestibular Physical Therapist

 (Presented to Seattle Dizzy Group on 10/10/20)

This presentation discusses the challenges of adapting to the virtual world with a chronic vestibular disorder. For example, computer screens and blue light from electronic devices may cause or exacerbate symptoms such as visual issues, dizziness, migraine/headache, nausea, sensory overload, etc.

Morgan Kriz, PT gives suggestions for how to adjust to and overcome the challenges of visual environment so that those with vestibular disorders may better utilize technology and connect virtually with others.

The Brain Can Adapt and Change

The Brain is Like a Computer

Neuroplasticity

“What Fires Together, Wires Together”

The ability of the brain to form and reorganize synaptic connections, especially in response to learning or experience or following injury.

Learning a New Skill

• Can be accomplished (Robertson at el 2004)
  • Explicit learning = intentionally, with an individual’s awareness
  • Implicit learning = unintentionally, with little awareness

• Make change = Little awareness with sleep
• Minimal change = Aware of learning and no sleep

Compensation = Adjustment

• Compensation
  • 1883 Bechterew first described
  • EWALD (1892), MAGNUS (1922, 1924) and others recognized the importance of optic, somato-sensory, cortical, and spinal influences on the compensation of labyrinthine lesions

• • Patients rely on somatosensory cues from the lower extremities during the acute stage, and on visual cues during the chronic stage (Herdman 1998)

• • The visual inputs that arise from peripheral visual motion cues are more powerful than those from central (foveal) visual motion (Horak 2014)
• Decompensation
  • Overactivity leads to fatigue resulting in increased symptoms for 24-36 hours
  • Decompensation can occur: This may be triggered by a period of inactivity, extreme fatigue, a change in medications, or an intercurrent illness

** A relapse of vestibular symptoms in this setting does not necessarily imply ongoing or progressive labyrinthine dysfunction **

Set Yourself Up For Success

• Life is a learning experience, there are no set backs

• Set a Schedule = 60 every 60
  • Every 60 minutes, stand up/stretch/move/close your eyes for 60 seconds
  • SLEEP
  • Food/hydrate
  • Movement
  • Highlight: 1 thing to look forward to day/week/month/year

• Proper attire & equipment

• Design your happy & SAFE space
  • Desk, couch, bedroom, office

Video Viewer Tips

Postural Control

Balance Stance

• Finding your center of gravity is key for balance, aka “sweet spot”
• Think about a tripod – sturdy base of support – on both of your feet.
• Keep the balls of your feet down, especially your big toe.

Embrace Change

• Change your position often
• Do not tunnel for too long
• Move and appreciate your world

Good Job Brain

• Treat yourself
• Celebrate the milestones = get creative!
• Create

• Guided meditation
  • Self compassion
  • Guided meditation
  • Headspace
  • Sleep

Acceptance

• What coping strategies do you use to help you manage unexpected life changes?
• Do you fall back into old patterns of addictive behaviors or do you practice acceptance and other positive recovery coping behaviors?
• Acceptance involves action through positive coping strategies such as affirmations, visualization, journaling and mindfulness practice.
• Another positive approach to change involves reaching out to a supportive network of fellows, a counselor, family and friends.
• Remember that changes are a normal part of life,
  It is also amazing how we each have our own resiliency and ability to recover from, or adjust easily to, change. Practice living life with an attitude of gratitude and embrace change as an opportunity for continuous renewal and growth.

Watch Video of Presentation

Morgan Kriz, DPT

Vestibular Physical Therapist