Rehabkurser

Hem
Sverige
Sturefors
Rehabkurser

Rehabkurser är ett utbildningsföretag & drivs av leg. sjukgymnast Daniel Petersson. Ej patientkontakt

06/02/2026

New Evidence on Acute Vertigo Triage — Key Takeaways
🔍 What They Tested
A new integrated algorithm combining TiTrATE + STANDING + HINTS Plus — the first attempt to merge all three into one ED‑friendly tool.

📊 Bottom Line
The algorithm is very good at catching stroke (90% sensitivity)…
…but not good at ruling it out (57.9% specificity).
➡️ Nearly half of all non‑stroke patients were misclassified as stroke.

⚡ The Big Problem: Vestibular Migraine
Vestibular migraine was the most common false positive.
The authors argue that migraine features must be added to future versions to avoid unnecessary stroke activations.

🎯 Other Findings
Excellent specificity for BPPV and PVD

Moderate sensitivity for both

No management guidance for migraine, PVD, or chronic vascular causes

Stroke pathway triggered too often due to “continuous symptoms” rule

🧠 What Needs to Change
The authors recommend:

Adding vestibular migraine criteria (history, triggers, motion sickness, photophobia/phonophobia)

Clearer Rule Out Stroke pathways

Management guidance for all diagnostic categories

Ongoing validation in real ED settings

📌 Final Verdict
A promising step toward safer acute vertigo triage — but not ready for clinical use.
High sensitivity protects patients, but the false‑positive rate is too high, especially for migraine.
More refinement is essential before this can guide real‑world ED decisions.

30/01/2026

❗️❗This post focuses on general dizziness experiences. It does not cover other medical conditions, such as migraine, vestibular migraine, anxiety disorders, or neurological conditions, that can make dizziness more intense or more frequent. Everyone’s body is different, and individual factors can change how dizziness is felt.

Dizziness isn’t a threshold; it’s an experience.”
People often say things like “I have a high pain threshold” as if it’s a fixed, measurable fact. But here’s the thing: most of us have no way of actually knowing our “threshold.” What we do know is how we’ve reacted in the past, and we turn those reactions into a story about who we are.

I think it is the same thing that happens when you experience dizziness.

Some patients say they’re “super sensitive to dizziness,” while others proudly claim they “don’t get dizzy easily.” It sounds like a stable trait, but dizziness doesn’t work like that. There’s no built‑in “dizziness meter” in the brain.

Dizziness is shaped by a mix of many things for example:
✅ Past experiences
✅ Attention and focus
✅ Stress and body awareness
✅ Expectations (“this movement always makes me dizzy.”)
✅ How safe or unsafe a situation feels

So when someone says, “I’m very sensitive to dizziness,” they’re not always describing a biological fact; they’re describing a personal interpretation of their experiences.

And that interpretation matters.

If you expect dizziness, you’re more likely to notice it. If you fear it, it often feels stronger. If you feel safe and in control, the same sensation might barely register.

This self‑perception can have clinical consequences. It could influence how patients move, how they interpret symptoms, how they approach examinations, and what they expect to feel after treatment. During procedures such as the Epley maneuver, a patient who sees themselves as “sensitive” may become more tense, more vigilant, and more likely to interrupt movements, while someone who believes they are “tolerant” may push too far or overlook important signals. In other words, it is the self‑image that drives the behavior, not the actual vestibular function.

27/01/2026

TRV Chair, luxury gadget or real clinical value?
This post applies to all mechanical repositioning chairs, but since I’ve worked with the TRV chair since 2018, that’s the one I’ll refer to.

I was one of the first clinicians in Sweden to purchase the chair and to this day, I’m still among those with the most hands‑on experience in both diagnostics and treatment using it.

So… what does all that experience tell me?
Is the chair actually needed, or is it just an expensive bragging tool?

After thousands of assessments and treatments, here’s some of what I’ve learned.

✨ The Upsides
✔ Standardized examinations
Regardless of a patient’s anatomy or mobility, I can almost always examine and treat them in the chair. Very few patients fall outside its range.

✔ Less symptom provocation
The chair allows me to follow a specific algorithm that minimizes symptoms during testing. This creates a calmer experience for both me and the patient.

✔ Continuous nystagmus monitoring
Videofrenzel goggles can stay on in every position without disturbing the patient, making it easier to observe nystagmus even during treatment.

⚠ The Downsides
✖ It’s expensive
And it requires a room that can handle significant weight and movement.

✖ Not ideal for severe claustrophobia
A small number of patients simply can’t tolerate the setup.

✖ Not plug‑and‑play
No matter how “fancy” these chairs look, they require experience and deep vestibular knowledge. You’ll see more nystagmus, not because of pathology, but because of videofrenzel + extreme positioning, and you need to know how to interpret that.

So… who should invest in a repositioning chair?
Right now, most chairs in Sweden are found in hospitals and ENT departments.
But honestly? I see even greater value in primary care.

Not because everyone needs chair‑based diagnostics; most BPPV cases can be handled perfectly well on a regular treatment table with the right skills and equipment. But looking ahead, with an aging population and increasing mobility limitations, the chair is fantastic for older patients. That’s where it truly shines.

26/01/2026

Today I met a patient who reminded me why dizziness is one of the most fascinating (and frustrating) areas in medicine.

👉 50+ years old
👉 Previous BPPV (fully recovered 1 year ago)
👉 Migraine
👉 Significant anxiety and fear of movement

She described 4 weeks of “my crystals are back” but the symptoms didn’t match at all:

❌ no clear positional vertigo
❌ unsteady walking
❌ discomfort in supermarkets
❌ a “weird” feeling in the head
❌ symptoms mainly when upright

Everything pointed toward:
🔹 PPPD?
🔹 Migraine‑related dizziness?
🔹 Anxiety‑driven hypervigilance?
🔹 Visual motion sensitivity?

But then comes the twist…

👇
👇
👇

🔍 On examination: a textbook BPPV.
This is exactly why the history of dizziness can be so misleading.
When migraine, anxiety, and fear of movement mix together, the patient’s experience becomes completely “colored” and even classic BPPV can sound like something entirely different.

This is also why we ALWAYS perform positional tests.
Even when the history points in a completely different direction.

💬 QUESTIONS FOR YOU
🔸 Have you ever had a patient where the history and the findings didn’t match at all?
🔸 How often do you “accidentally” find BPPV in patients with anxiety/migraine/PPPD‑like symptoms?
🔸 What’s your strategy when the story points one way but the body points another?

Share your experiences in the comments; the dizziness world needs more conversations about these grey zones.

22/01/2026

🧠 Dizziness in the Emergency Department: Key Findings
A recent BMJ Open study examined 1,535 patients presenting to the emergency department with dizziness. The results highlight how challenging these cases are to diagnose accurately.

📊 What the Study Found
• Patients showed a wide range of vestibular syndromes — acute, episodic, chronic, imbalance-related, or unclear.
• Episodic dizziness was most common, but nearly half of all patients didn’t fit neatly into any diagnostic category.
• The most frequent diagnoses were stroke/minor stroke, BPPV, and acute unilateral vestibulopathy.
• Stroke occurred in about 10% of all dizzy patients, a higher rate than previously reported.

⚠️ Diagnostic Challenges
• 45% left the ED without a clear diagnosis.
• Among those who had a follow‑up visit, more than 30% received a different diagnosis.
• 18% had been misdiagnosed initially.
• Some dangerous conditions (stroke/TIA) were missed at the first visit.

🧲 Imaging Use
• About 70% of all patients underwent MRI or CT.
• High imaging rates reflect diagnostic uncertainty rather than clear clinical necessity.

💡 Takeaway
Dizziness is complex and often multifactorial. Initial assessments frequently miss or misclassify vestibular disorders, but structured follow‑up significantly improves diagnostic accuracy.

21/01/2026

Tack OMT-sektionen för inbjudan och tack till det stora sällskapet som ville hänga med mig på dagens lunchföreläsning.

Allt gott och var rädda om er!

20/01/2026

📌 Rebalancing the Inner Ear: What the New Study Shows
✨ New research confirms it: The Epley maneuver doesn’t just feel effective; it creates objective improvements in utricular function, measured through Subjective Visual Vertical (SVV).

🌀 Study highlights (143 patients, prospective design):

Significant improvement in all SVV parameters after the Epley maneuver
Symptom relief in just ~14 days on average
Extremely low recurrence rate: 2.1%
Longer symptom duration = greater pre‑treatment SVV deviation

19/01/2026

Idag är det upprop för den fristående 7,5 kursen på Linköpings universitet som jag är ansvarig för.

Det har varit ett högt söktryck och kursen är utvärderad av tidigare studenter med toppbetyg.

Kursen består av både kliniker och studenter och magister/masterstudenter.

18/01/2026

I samarbete med OMT-sektionen erbjuds en kostnadsfri lunchföreläsning nu på onsdag 21 januari 12.00-12.30 med möjlighet till frågor efteråt.

Temat är: "Yrsel är din hemmaplan även om du inte tror det" och handlar bland annat om varför fysioterapeuter är högst lämpliga att både diagnostisera och behandla många yrseldiagnoser och vilka fördelar vi som profession har med vår bakgrund/utbildning.

Länk till föreläsningen hittar ni på sociala medier.

Varmt välkomna!

10/01/2026

Stort grattis till alla nya kollegor (f.d studenter fysioterapiprogrammet Linköpings universitet) och tack för att jag fick närvara på er avslutning i kyrkan.
Stort lycka till, vi syns ute i arbetslivet 🤜🤛.

09/01/2026

📌 Background
Benign Paroxysmal Positional Vertigo (BPPV) is a common vestibular disorder causing short episodes of dizziness with head movements. Despite being “benign,” it often leads to:

➡️ Functional limitations
➡️ Psychological stress
➡️ Fear of recurrence

🎯 Purpose
To understand patients’ lived experiences of BPPV using a phenomenological approach.

🛠 Method
✔️ Design: Descriptive phenomenology (Giorgi)
✔️ Participants: 7 individuals with prior BPPV diagnosis
✔️ Data: In-depth interviews (Feb–July 2025)
✔️ Analysis: 6 main themes

🔍 Key Findings
Central theme: “Reconstructing meaning in the face of an unpredictable illness” a journey from shock and confusion to adaptation and self-awareness.

Six themes:
1️⃣ 😨 Shock & confusion from unexpected illness
2️⃣ 🤢 Unbearable symptoms disrupting daily life
3️⃣ 😰 Persistent anxiety about recurrence → emotional fatigue
4️⃣ 💪 Heightened health awareness & lifestyle changes
5️⃣ 😔 Disappointment with treatment → self-management attempts
6️⃣ ❤️ Empathy & family support as emotional anchors

✅ Conclusion
BPPV affects not only physical health but also emotional and social well-being. Fear of recurrence drives lifestyle changes, self-treatment, and the need for support. Though considered “mild,” BPPV has a major impact on quality of life.

💡 Clinical takeaway, care should include:
✔️ Physical treatment
✔️ Psychosocial support
✔️ Patient education to reduce anxiety & reliance on unreliable sources

📖 Source: Lee SJ, Hur Y. Living With the Fear of Recurrence in Benign Paroxysmal Positional Vertigo. Health Expect. 2026 Feb;29(1):e70551. doi: 10.1111/hex.70551. PMID: 41489048; PMCID: PMC12766396.

29/12/2025

✨ Vilket år – och vilken resa! ✨

När jag ser tillbaka på året som gått blir jag både stolt och tacksam 🙏.

Vilket fantastiskt år det har varit för Rehabkurser! Intresset har varit enormt, och att så många av våra utbildningar om yrsel och balansrubbningar blivit fullbokade är något jag aldrig tar för givet. Det visar att kunskap inom detta område verkligen behövs och att vi tillsammans gör skillnad 💪.

🌍 Jag är oerhört tacksam för att få möjligheten att resa runt i hela Sverige och även utomlands ✈️ för att prata om det som är mitt stora intresse: yrsel och balansrubbningar.

Att möta så många engagerade deltagare , höra era frågor och se hur ni tar med er kunskapen hem till er kliniska vardag är en ynnest ❤️.

📈 Och era ord i utvärderingarna… wow! Jag blir både rörd och stolt när jag läser dem. De höga omdömena ⭐ ni ger våra kurser är mer än jag kunnat drömma om. Det ger mig energi och motivation att fortsätta utveckla utbildningarna.

🚀 Men vi stannar inte här! Nästa år kommer webshopen att ta fart igen 🛒, och jag är extra peppad på att lansera version 2.0 av våra anatomiska modeller av båggångar med rörliga kristaller, ännu mera premium!

💙 Från hjärtat: TACK för att ni är med på den här resan. Nu tar vi steget in i 2026 utan att tappa balansen! Gott nytt år, vänner! 🎉

Vi ses där ute, eller online!

Med vänlig hälsning, / Daniel

Adress

Hjortronvägen 7
Sturefors
58961

Telefon

+46736754786

Webbplats

http://www.rehabkurser.se/

Aviseringar

Var den första att veta och låt oss skicka ett mail när Rehabkurser postar nyheter och kampanjer. Din e-postadress kommer inte att användas för något annat ändamål, och du kan när som helst avbryta prenumerationen.

Vill du placera din praktik längst upp i Klinik-listan i Sturefors?

Dela

Om Rehabkurser

Rehabkurser drivs av leg. sjukgymnast Daniel Petersson. Fröet till Rehabkurser sattes omkring 2012. Jag behövde dock ett par år på mig att skriva och bearbeta det material som jag nu stolt kan erbjuda er. Rehabkurser vänder sig framför allt till vårdpersonal och organisationer som vill lära sig mer om undersökning, differentialdiagnostik och behandling inom områdena yrsel och balansrubbningar. Yrsel och balansrubbningar är, i mina ögon, områden där patienter allt för ofta riskerar falla mellan stolarna inom vården. En anledning till detta kan vara att personalen inte har tillräckligt fördjupad kunskap inom dessa områden vilket medför att det blir svårt att få rätsida på både anamnes och att kunna prioritera vilka undersöknings- och behandlingsmetoder som är relevanta för patienten.Jag vill att fler patienter ska få möjlighet till rätt diagnos inom en rimlig tid utan att patienten skall behöva handläggas på specialistklinik. Jag hoppas att jag snart får chansen att träffa just dig och berätta vad jag kan inom dessa områden.

Vänliga hälsningar

Daniel Petersson

leg.sjukgymnast och yrselnörd