Be the First & Last Stop for Vestibular Patients Seeking Help
Dizziness is one of the most common complaints heard by primary physicians, but the reasons contributing to dizziness are numerous and often difficult to diagnose, ranging from age and medication side effects to trauma and infection. These vertigo symptoms can, at times, be the limiting factor for mobility, keeping patients from freely and safely walking around their homes or going out into the community. Vestibular Rehabilitation is highly effective in the reduction and elimination of balance disorders and vertigo. It is the most successful treatment of the most common cause of vertigo over medication or surgery. The ultimate goal of treatment is to eliminate a person's risk for falling.

In this course, you will learn differential diagnostic techniques that identify the contributor of a patient's dizziness. Participants will understand the pathophysiology of the dizziness and treat the condition accordingly. In addition, laboratory components which analyze patients' compensatory functional movement patterns and balance strategies will be reviewed. The lecture and lab components presented will be helpful for treating a variety of disorders, including Benign Paroxysmal Positional Vertigo (BPPV) and chronic vertigo, as well as balance and proprioceptive disorders. Upon completion of this course, you will be confident in applying the best interventions to improve your patients' balance regardless of the demographic or work environment.

Course Content

INTRODUCTION TO VESTIBULAR REHABILITATION

• Epidemiology of dizziness and falling

• Role of the vestibular system and its contribution to daily activity

ANATOMY & PHYSIOLOGY OF THE VESTIBULAR SYSTEM

• Vestibular complex

  • Peripheral and central components

• Balance systems

  • Proprioceptive, visual, and vestibular

  • Motor control and strategies

PATHOPHYSIOLOGY & CLINICAL PRESENTATION OF VESTIBULAR DISORDERS

• Unilateral/bilateral vestibular loss

• Benign paroxysmal positional vertigo (BPPV)

• Perilymphatic fistula

• Superior semicircular canal dehiscence

• Meniere’s disease and migraines

• Concussion

• Transient ischemic attack (TIA)/cerebrovascular accident (CVA)

• Cervical vertigo

• Orthostatic hypotension

DIAGNOSTIC TESTS & EVALUATION PROCEDURES

• Differentiate central vs. peripheral vestibular pathology

• Oculomotor exam

  • Spontaneous and gaze-holding nystagmus

  • Smooth pursuit and saccades

  • Visual acuity

  • VOR cancellation

• Vertical and horizontal nystagmus

• Torsional nystagmus

• Positional testing

  • Roll test

• Vestibular function testing

  • ENG and VNG

  • Cervical and ocular VEMPs

  • Subjective visual vertical

  • Caloric and rotary chair testing

• Balance testing

  • Berg and DGI

  • TUG (standard, manual, cognitive)

  • Gait assessment

  TREATMENT PROGRESSION LAB 

  • Gaze stabilization

    • X1 and X2 viewing

    • Vestibular adaptation and habituation

    • Canalith repositioning techniques

      • Anterior, posterior, and horizontal canals

      • Apiani and Cassani maneuvers

      • Liberatory and Brandt-Daroff maneuvers

    • Cervical exercises

    • Static and dynamic balance exercises

    • Functional retraining

    • Self-treatment and HEP

    CASE STUDIES