Vestibular Rehabilitation: Identification and Management of BPPV -- Jeff Walter

Accreditation Check:

This evidence-based course will train clinicians in the practical management of benign paroxysmal positional vertigo (BPPV). The course will include instruction in relevant anatomy and physiology, pathophysiology, examination techniques, canalith repositioning maneuvers and management guidelines. The material will be presented in a lecture/lab format with video case studies. The course is intended to enhance the clinician’s ability to evaluate the appropriateness and effectiveness of canalith repositioning maneuvers. 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 a Bachelors of Science in Physical Therapy (1996). Jeff Walter attained competency certification in “Vestibular Rehabilitation” and “Vestibular Function Test Interpretation"" and has a Doctorate in Physical Therapy (2009) from the University of Scranton. 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. He 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

Become familiar with various sources of information regarding BPPV management. Identify common terminology utilized to describe vestibular related symptoms. Recognize demographic/ prevalence data regarding BPPV.
2. Anatomy and Physiology

Recognize proper orientation of the vestibular organ within the skull. Identify relevant structure and function of the following: semicircular canals, otolothic Organs. Discuss age-related changes in otoconia.
3. Pathophysiology

Recognize and discuss risk factors. Describe the following BPPV subtypes: canalithiasis, cupulolithiasis. Recognize typical characteristics of: BPPV, central nervous system related positional dizziness.
4. Examination

Identify patterns of nystagmus commonly related to BPPV. Appropriately perform head positioning tests: Dix-Hallpike, sidelying test, roll test, bow and lean test. Recognize modifications to examination based on patient-related movement / position limitations. Recognize alternative causes of positional dizziness.
5. Treatment Maneuvers/Management Guidelines

Appropriately perform canalith repositioning maneuvers: modified Epley’s Maneuver, Liberatory (Semont’s) Maneuver, Gufoni’s Maneuver. Recognize modifications to treatment based on patient related movement / position limitations. Recognize positive prognostic indicators of an effective maneuver.
6. Management Guidelines/Efficiency

Recognize post-treatment guidelines. Identify special considerations for testing and treatment modification. Identify prevention strategies. Instruct patient in appropriate self-treatment guidelines.