In many patients with chronic balance problems, the cause cannot be localized with traditional tools. If the underlying impairments are not identified, providing a one size fits all approach is too often ineffective. In fact, Fife and Baloh et al. estimated this to be true for 50 percent of patients with chronic disequilibrium. Resulting in patients being undiagnosed and untreated. And a study by Stewart et al. in 1999, CDP testing was proved to be the most cost-effective test of balance because of its unique ability to quantify impairments and to differentiate between age-related normal versus abnormal and aphysiologic sway patterns.
When incorporating CDP technology into managing patients with dizziness and/or balance impairments, it’s very important to note that these assessments add tremendous value, but only when paired with a comprehensive intake and a targeted clinical exam. CDP technology provides objective measures that affect and improve your ability to treat the patient.
But you as the clinician, are the missing link necessary to incorporate that information into the holistic view of the patient. Remember, on its own, technology cannot diagnose or provide a treatment plan. Balance assessments are complementary to and not in place of sight of lesion testing or determining a medical diagnosis. What CDP technology can do as a part of a comprehensive assessment is to identify contributing impairments, which helps the clinician develop a treatment plan to address those impairments and to prioritize which impairment to work on first.
Having objective data also helps the clinician set benchmarks for future comparison in order to monitor progress and to determine the optimal time for discharge by setting performance goals using objective data and striving to reach them. The objective data can also help and continuity of care with other staff members involved in the patient’s care. In fact, having objective data improves communication on many levels with the patient, the referring providers, as well as the payers and the patient families.
In addition, in the world of rehab, where self-report surveys and rating scales can sometimes be referred to as objective data. CDP provides performance data measured against age-based norms to improve efficacy, patient motivation, and functional improvement. CDP Technology provides objective information to identify causes of the patient’s functional limitations and disabilities, but it does not identify the contributing disease or pathological causes. For example, the CDP can identify balance impairments when relying on somatosensory or vestibular cues, but it will not identify if the impairment is due to peripheral neuropathy or a bilateral vestibular loss or if you think there could be a psychological overlay component.
We need to be listening to our patients and adding all the data points together in order to see the full picture and create a functional, meaningful change. CDP technology is incredibly beneficial and it’s also important to keep in mind the limitations of technology and where you fit in as the crucial link to providing holistic, skilled care for your patients.
Which of your patients do you think would benefit from testing using CDP technology? In my view, every patient that comes into your clinic would benefit from CDP testing. Certainly, we would all believe that someone who comes in with a balance impairment or a diagnosis of dizziness would benefit, but try to think about each patient uniquely. Whatever their diagnosis might be, it is important to do testing to determine that the sensory and motor balance systems are intact.
I have tested patients with shoulder injuries, neurological injuries, and even healthy athletes doing pre-participation physicals. Whether it’s an orthopedic diagnosis, a neurological diagnosis, or a healthy individual, CDP testing can help to rule in or out an underlying balance impairment that can be resolved with a targeted treatment approach. This technology will change your practice and change the way you approach treatment with your patients.
Watch the full video here: https://youtu.be/g_ZBkIAo6lk
About the Author
Shelly Massingale is Service Line Administrative Director of Banner Sports Medicine. She graduated from Pepperdine University in 1992 and from University of Southern California in 1996 with a Masters Degree in Physical Therapy. Shelly has been treating clients with vestibular and balance disorders for the past 18 years and is a certified and advanced certified vestibular therapist through Emory University. She has been working with clients and athletes with concussions her entire career.
