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Vestibular Rehabilitation: Office Examination of the Vestibular System

presented by Jeff Walter

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

    Director of the Otolaryngology Vestibular and Balance Center at Geisinger Medical Center in Danville, PA. Clinical practice focused on vestibular diagnostic testing and vestibular rehabilitation. Adjunct faculty at Misericordia University, Department of Physical Therapy. Graduate of the University of Wisconsin, Bachelors of Science in Physical Therapy 1996. Attained competency certification in “Vestibular Rehabilitation” and “Vestibular Function Test Interpretation”. Graduate of the University of Scranton, Doctorate in Physical Therapy 2009. Since 1999, Jeff has lectured at professional conferences, universities and continuing education courses for audiologists, physicians and therapists involved in managing patients with dizziness and imbalance. Developed a teaching website “www.vestibularseminars.com” designed to provide information to assist clinicians in the management of dizziness and imbalance.

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Chapters & Learning Objectives

  1. Introduction, Anatomy and Physiology

    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

    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

    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

    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

    5. Balance/ Postural Control Testing

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

  6. BPPV Related Testing

    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.