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Vestibular Rehabilitation: Office Examination of the Vestibular System

presented by Jeff Walter

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

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Accreditation Check:
This evidence-based course by Jeff Walter, PT, DPT, NCS, will address the clinician’s ability to evaluate the patient with dizziness for vestibular dysfunction. The course will include instruction in relevant anatomy and physiology review, pathophysiology, and bedside/office examination techniques. The material will be presented in a lecture/lab format with video case studies. The course is intended to enhance the clinician’s capability to recognize unilateral vs. bilateral vestibular loss, BPPV and central etiology dizziness. Practical application to a variety of practice settings (outpatient, acute care, SNF, ER) will be discussed.

Meet Your Instructor

Jeff Walter, PT, DPT, NCS

Jeff Walter, PT, DPT, NCS, is the Director of the Otolaryngology Vestibular and Balance Center, at Geisinger Medical Center in Danville, PA. His clinical practice focused on vestibular diagnostic testing and vestibular rehabilitation. He is an adjunct faculty member at Misericordia University, Department of Physical Therapy and a graduate of the University of Wisconsin, with…

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Chapters & Learning Objectives

1. Introduction, Anatomy and Physiology

Recognize proper orientation of the vestibular organ within the skull. Identify relevant structure and function of the following: semicircular canals, otolithic organs. Identify canal-specific eye movements related to the vestibular ocular reflex. Recognize CNS related oculomotility/stability systems.

2. Systems Review and Introduction to Lab Testing

Recognize indications for lab based labyrinthine function testing. Describe the following tests and recognize the implications of the following: audiogram, videonystagmography, vestibular evoked myogenic potential testing, sensory organization test.

3. History of the Dizzy Patient

Recognize key features to discern regarding the patient’s symptoms. Identify “red flags” from a patient’s history which may indicate CNS related dizziness.

4. Oculomotor Examination

Perform appropriate history intake. Identify necessary testing equipment including tools that promote fixation block. Appropriately perform and interpret the following tests: oculomotility/stability battery, head thrust, head heave, post-head shake induced nystagmus, hyperventilation induced nystagmus, dynamic visual acuity. Identify features of peripheral vs central nervous system related nystagmus.

5. Balance/ Postural Control Testing

Appropriately perform and interpret the following tests: CTSIB testing, Fukuda Step Test, gait assessment.

6. BPPV Related Testing

Appropriately perform and interpret the following tests for identification of Benign Paroxysmal Positional Vertigo (BPPV): Dix-Hallpike, sidelying tests, roll test.

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