You are now viewing our public site. Back to Dashboard

Vestibular Examination: Postural Control Testing

presented by Jeff Walter, DPT, NCS

Accrediting Body:

Target Audience:

Levels:
Disclosure Statement:

Financial: Jeff Walter receives compensation from MedBridge for this course and Education Resources, Inc. There is no financial interest beyond the production of this course.

Nonfinancial: Jeff Walter has no competing nonfinancial interests or relationships with regard to the content presented in this course.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

MedBridge is committed to accessibility for all of our subscribers. If you are in need of a disability-related accommodation, please contact [email protected]. We will process requests for reasonable accommodation and will provide reasonable accommodations where appropriate, in a prompt and efficient manner.

Accreditation Check:
Video Runtime: 36 Minutes; Learning Assessment Time: 28 Minutes

Balance testing provides valuable insight into the functional impact of a vestibular disorder. Postural control testing can offer information into how efficiently vestibular cues are being utilized for balance. Instruction will emphasize common postural control tests utilized in individuals with vestibular disorders. Content will focus on proper selection, administration, and interpretation of balance testing. Bedside postural control testing will be discussed, including the Modified Clinical Test of Sensory Interaction in Balance. Use of performance-based measures will be reviewed, including the Timed Up and Go Test, Four-Square Step Test, 5-Times Sit-to-Stand Test, and the Dynamic Gait Index. Indications of high fall risk will be discussed, along with traits of a “functional” balance disorder. Video examples will be provided to reinforce content. The course is appropriate for audiologists and occupational/physical therapists and assistants.

Meet Your Instructor

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

Chapters & Learning Objectives

Download Learning Objectives

1. Postural Control Testing

Bedside postural control testing will be discussed, including the Modified Clinical Test of Sensory Interaction in Balance. Testing provides valuable insight into the functional impact of a vestibular disorder. Postural control testing can enhance investigation into how efficiently vestibular cues are being utilized for balance.

2. Performance-Based Outcome Measures

Performance-based postural control tests will be reviewed, including the Timed Up and Go Test, Four-Square Step Test, 5-Times Sit-to-Stand Test, and the Dynamic Gait Index. Indications of high fall risk will be discussed, providing valuable insight into the functional impact of a vestibular disorder.

More Courses in this Series

Vestibular Anatomy and Physiology

Presented by Jeff Walter, DPT, NCS

Vestibular Anatomy and Physiology

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
Video Runtime: 58 Minutes; Learning Assessment Time: 19 Minutes

This course will include instruction in anatomy and physiology of the vestibular system. Completion of this course is highly recommended prior to completion of other MedBridge vestibular course offerings. The course content promotes improved understanding of common complaints associated with vestibular disorders, along with enhanced understanding of the rationales for vestibular examination and treatment procedures. The course will review detailed sensory functions of the semicircular canals and otolithic organs. Dark cell and otoconia structure and function will be reviewed, which is essential to understanding benign paroxysmal positional vertigo (BPPV). Motor functions of the vestibular system will also be reviewed, including their critical contribution to gaze stabilization and postural control. The course is appropriate for audiologists and occupational/physical therapists and assistants.

View full course details

Identification and Management of Unilateral Vestibular Disorders

Presented by Jeff Walter, DPT, NCS

Identification and Management of Unilateral Vestibular Disorders

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
Video Runtime: 101 Minutes; Learning Assessment Time: 36 Minutes

The course will review the features of unilateral vestibular dysfunction (excluding BPPV, which is reviewed in detail in other courses). Common pharmacologic agents utilized in the management of vestibular-related symptoms and associated rehabilitative implications will be discussed. Stable and unstable/progressive unilateral disorders will be reviewed along with appropriateness of vestibular rehabilitation. Content will include a detailed discussion of vestibular neuritis, anterior vestibular artery ischemia, labyrinthitis, Ménière's disease, vestibular schwannoma, and superior canal dehiscence. The course will also include a question-and-answer session with Michael Teixido, MD. Indications for further medical management/diagnostic investigation will be reviewed. The course is appropriate for audiologists and occupational/physical therapists and assistants.

View full course details

Bilateral Vestibular Disorders and PPPD

Presented by Jeff Walter, DPT, NCS

Bilateral Vestibular Disorders and PPPD

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
Video Runtime: 46 Minutes; Learning Assessment Time: 28 Minutes

This course will review the specific features and management options for bilateral vestibular disorders (BVD) and persistent postural perceptual dizziness (PPPD). Etiologic factors for BVD, including aminoglycosides, will be discussed, and the common circumstances that lead to PPPD will be reviewed. Treatment guidelines will be reviewed for both BVD and PPPD, including the role of vestibular rehabilitation. An interview with an individual with bilateral vestibular loss will be shared. The course will include a PPPD-related question-and-answer session with Neil Shepard, PhD, professor emeritus, Mayo Clinic College of Medicine. The course is appropriate for audiologists and occupational/physical therapists and assistants.

View full course details

Central Vestibular Disorders and HINTS Testing

Presented by Jeff Walter, DPT, NCS

Central Vestibular Disorders and HINTS Testing

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
Video Runtime: 54 Minutes; Learning Assessment Time: 32 Minutes

The course will review the features of central nervous system disorders that may present with vestibular-related issues. Content will include a detailed discussion of vertebrobasilar insufficiency, cerebellar-origin dizziness (including Chiari malformation), multiple sclerosis, and white matter disease. To enhance the clinician’s ability to recognize concerning examination findings, a series of video-based examples of CNS-origin ocular impairments will be reviewed. Indications, application, and interpretation of bedside HINTS will be reviewed to increase recognition of potentially sinister causes of vestibular symptoms. Video examples of the components of HINTS testing will be shared. The course is appropriate for audiologists and occupational/physical therapists and assistants.

View full course details

Vestibular Examination: Oculomotor Testing

Presented by Jeff Walter, DPT, NCS

Vestibular Examination: Oculomotor Testing

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
Video Runtime: 77 Minutes; Learning Assessment Time: 24 Minutes

This course will focus on instruction to enhance a clinician’s ability to select, administer, and interpret oculomotor testing in individuals presenting with vestibular-related complaints. Content will include training on findings suggestive of unilateral vs. bilateral vs. central vestibular involvement. An emphasis will be placed on testing of the vestibulo-ocular reflex. Recognizing a deficiency in the vestibulo-ocular reflex can be an indication for the use of vestibular rehabilitation. Testing will include oculomotor screening, dynamic visual acuity, head impulse, head shake, hyperventilation, and mastoid vibration testing. Video case examples will be reviewed to facilitate application of content. This course will also include a question-and-answer session with Neil Shepard, PhD, regarding laboratory-based vestibular function testing. The course is appropriate for audiologists and occupational/physical therapists and assistants.

View full course details

Vestibular Compensation Exercises and Clinical Resources

Presented by Jeff Walter, DPT, NCS

Vestibular Compensation Exercises and Clinical Resources

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
Video Runtime: 64 Minutes; Learning Assessment Time: 7 Minutes

Course instruction will emphasize suggested exercises to address modifiable impairments related to vestibular hypofunction. Mechanisms involved in the resolution of head-motion-induced oscillopsia and postural instability following vestibular loss will be discussed. Exercise suggestions will focus on head-motion-induced oscillopsia and postural instability. Instruction will focus on proper treatment administration and progression. Improvements in dynamic vestibular-related impairments can facilitate improvements in activities of daily living. The course will also include a question-and-answer session with Danielle Tate, DPT, regarding suggested vestibular-related testing and treatment equipment. Additionally, the course will discuss recommended resources to promote professional growth in vestibular rehabilitation. The course is appropriate for audiologists and occupational/physical therapists and assistants.

View full course details

BPPV Pathophysiology, and Differential Diagnosis of Positional Vertigo

Presented by Jeff Walter, DPT, NCS

BPPV Pathophysiology, and Differential Diagnosis of Positional Vertigo

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
Video Runtime: 83 Minutes; Learning Assessment Time: 36 Minutes

BPPV is the most common cause of peripheral vestibular dysfunction and is typically identified and treated with positioning maneuvers. The pathophysiology of BPPV will be reviewed in detail, as will demographic features, predisposing factors, and estimated prevalence of BPPV. This course will include a thorough discussion of canalithiasis and cupulolithiasis, including specific clinical implications. Nystagmus characteristics of BPPV variants will be discussed, and subjective and secondary BPPV will be reviewed. Additionally, differentiating features of alternative (non-BPPV) causes of positional vertigo will be discussed. Video-based cases and decision-making algorithms will be shared to reinforce content. This course will also include a question-and-answer session with Michael Teixido, MD. The course is appropriate for audiologists and occupational/physical therapists and assistants.

View full course details

Diagnostic Maneuvers for BPPV

Presented by Jeff Walter, DPT, NCS

Diagnostic Maneuvers for BPPV

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
Video Runtime: 46 Minutes; Learning Assessment Time: 34 Minutes

This course will review positioning tests utilized in the differential diagnosis of positional dizziness and will include testing for posterior and horizontal canal canalithiasis and cupulolithiasis. Instruction will emphasize proper performance and interpretation of diagnostic maneuvers. Training in the following diagnostic maneuvers will be included: loaded Dix–Hallpike test, sidelying test, half Dix–Hallpike, reverse Dix–Hallpike, supine roll test, and bow and lean test. Testing-related management guidelines will be reviewed. Modification of testing for individuals with mobility restrictions will be discussed. Demonstration of maneuvers and case-based videos will be utilized to reinforce teaching objectives. The course is appropriate for audiologists and occupational/physical therapists and assistants.

View full course details

Treatment Maneuvers for BPPV

Presented by Jeff Walter, DPT, NCS

Treatment Maneuvers for BPPV

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
Video Runtime: 73 Minutes; Learning Assessment Time: 33 Minutes

The course will review canalith repositioning maneuvers utilized to treat horizontal and posterior canal BPPV. Instruction will emphasize proper performance of the treatment maneuvers. Treatment-related management guidelines will be reviewed. Training in the following treatment maneuvers will be included: modified Epley maneuver, liberatory (Semont) maneuver, Gufoni maneuver, and cupulolith repositioning maneuver. Demonstration of maneuvers and case-based videos will be utilized to reinforce teaching objectives. The course will include a BPPV treatment-related question-and-answer session with neurotologist Michael Teixido, MD. The course is appropriate for audiologists and occupational/physical therapists and assistants.

View full course details

Sign up to receive exclusive content from industry leading instructors.