presented by Jeff Walter, DPT, NCS
This course is a recording of a previously hosted live webinar event. Polling and question submission features are not available for this recording. Format and structure may differ from standard MedBridge courses. This evidence-based webinar will train clinicians in the practical management of vestibular-related dizziness in the geriatric population and include instruction in anatomy and physiology, identification of abnormal eye movements, examination and treatment procedures, and indications for further medical management of dizziness. The webinar is intended to enhance the clinician's ability to evaluate the appropriateness and effectiveness of vestibular rehabilitation therapy (VRT) for common vestibular disorders in the geriatric population. The identification and management of BPPV variants and vestibular hypofunction will be emphasized.
Jeff Walter, DPT, NCS
Jeff Walter, DPT, NCS, is the director of the Otolaryngology Vestibular and Balance Center at Geisinger Medical Center in Danville, Pennsylvania. His clinical practice focuses on vestibular diagnostic testing and vestibular rehabilitation. He is an adjunct faculty member at Misericordia University's Department of Physical Therapy and a graduate of the University of Wisconsin with a…Read full bio
1. Introduction/Anatomy and Physiology of the Vestibular System
This chapter will focus on the semicircular canal and otolithic structure and function, including the vestibular system’s role in gaze stability and postural control. The content of this chapter will include a review of age-related changes in vestibular function, knowledge of vestibular system anatomy, and showcase why a knowledge of physiology is essential to patient management.
2. Critical Elements of History
A detailed history is a major determinant in discerning if vestibular rehabilitation is appropriate. This chapter will discuss essential dizziness-related questions to review during a patient interview. Common provocative factors and associated symptoms with various vestibular system disorder will be reviewed.
3. Nystagmus Identification
Reliable identification of abnormal eye movements is essential to the differential diagnosis process and guiding intervention. This chapter will review common abnormal eye movements demonstrated by individuals with dizziness and discuss clinical significance.
4. Benign Paroxysmal Positional Vertigo (BPPV): Etiology, Testing, and Differential Diagnosis
BPPV is the most common cause of vestibular-related dizziness in the elderly. This chapter will review risk factors and etiology of BPPV, as well as modified positioning tests for individuals with mobility limitations.
5. Canalith Repositioning Maneuvers: Posterior and Horizontal Canal
There is a strong evidence base supporting the use of maneuvers to address BPPV. This chapter will demonstrate modified canalith repositioning maneuvers for individuals with mobility limitations.
6. Identification of Vestibular Hypofunction
Proper identification of vestibular hypofunction is essential to determine the appropriateness of vestibular rehabilitation. This chapter will review helpful bedside and office examination tests to investigate for peripheral loss.
7. Vestibular Rehabilitative Treatment of Vestibular Hypofunction
This chapter will demonstrate suggested gaze stabilization exercises to reduce head-motion-induced oscillopsia. It will also review balance exercises to promote improvement in postural control.
8. Indications for Medical/Surgical Management
This chapter will focus on recognition of disorders that affect the vestibular system but are not appropriate for vestibular rehabilitative therapy, as well as review various medical and surgical interventions that may reduce vestibular-related symptoms.
9. Question and Answer Session
This chapter is a question and answer session of viewer submitted questions. The question and answer session is facilitated by Jeff Walter.
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