• MEDBRIDGE Vestibular Courses

    Below is a course list with links for excellent vestibular related content for clinicians presented by Jeff Walter, PT, DPT, NCS

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    Presented by Jeff Walter, PT, DPT, NCS

    This certificate program is intended to enhance the clinician's ability to provide vestibular rehabilitation and identify indications for further medical/diagnostic consultation. This series of evidence-based courses uses a video case-based approach. Course content includes a review of detailed anatomy and physiology of the vestibular system, features of peripheral and central disorders, an overview of bedside vestibular testing, and treatment concepts to address vestibular loss and management of BPPV. Practical application to a variety of practice settings (outpatient, acute care, SNF, ER) will be discussed.
    Accredited for 14 hours of continuing education

    Presented by Jeff Walter, PT, DPT, NCS

    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.
    Chapters: 1) Semicircular Canals, 2) Otolithic Organs, Otoconia, and Dark Cells, 3) Motor Functions of the Vestibular System

    Presented by Jeff Walter, PT, DPT, NCS

    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.

    Chapters: 1) Vestibular-Related Pharmacologic Agents, 2) Stable Unilateral Vestibular Disorders, 3) Unstable/Progressive Unilateral Vestibular Disorders, Part 1, 4) 4. Unstable/Progressive Unilateral Vestibular Disorders, Part 2, 5) Q&A

    Presented by Jeff Walter, PT, DPT, NCS

    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.

    Chapters: 1) Bilateral Vestibular Disorders 2) PPPD

    Presented by Jeff Walter, PT, DPT, NCS

    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.

    Chapters: 1) Central Vestibular Disorders 2) Traits of Central-Origin Oculomotor Findings 3) HINTS Testing

    Presented by Jeff Walter, PT, DPT, NCS

    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.
    Chapters: 1) Oculomotor Examination 2) Vestibular-Ocular Reflex Testing: Part 1, 3) Vestibular-Ocular Reflex Testing: Part 2, 4) Vestibular Function Tests

    Presented by Jeff Walter, PT, DPT, NCS

    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.
    Chapters: 1) Postural Control Testing 2) Performance-Based Outcome Measures

    Presented by Jeff Walter, PT, DPT, NCS

    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.

    Chapters: 1) Introduction 2) Gaze Stabilization Exercises 3) Balance Exercises 4) Clinical Resources

    Presented by Jeff Walter, PT, DPT, NCS

    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.
    Chapters: 1) Demographic Features, Predisposing Factors, and Pathophysiology, 2) BPPV Subtypes, 3) Alternative Causes of Positional-Type Dizziness

    Presented by Jeff Walter, PT, DPT, NCS

    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.

    Chapters: 1) Testing for Posterior Canal Canalithiasis, 2) Testing for Posterior Canal Cupulolithiasis, 3) Testing for Horizontal Canal Canalithiasis and Cupulolithiasis

    Presented by Jeff Walter, PT, DPT, NCS

    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.

    Chapters: 1) Canalith Repositioning Maneuvers for Posterior Canal BPPV, 2) Canalith Repositioning Maneuvers for Horizontal Canal BPPV, 3) BPPV Management Guidelines

    Presented by Jeff Walter, PT, 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.