DAY 1: VESTIBULAR REHABILITATION ESSENTIALS
ANATOMY & PHYSIOLOGY OF PERIPHERAL & CENTRAL VESTIBULAR SYSTEMS
CATEGORIES OF VERTIGO (INCLUDES MECHANISM, REPORT OF SYMPTOMS, PRESENTATION, PATIENT EDUCATION, & TREATMENT OF CHOICE)
- Benign paroxysmal positional vertigo
- Vestibular hypofunction
- Vestibular neuronitis
- Labyrinthitis
- Meniere’s disease
- Endolymphatic hydrops
- Acoustic neuroma
- Cervicogenic dizziness
- Central vertigo
- Vestibular migraine
- Post-concussion syndrome
- Multiple sclerosis
- TIA/CVA
- Orthostatic hypotension
- Postprandial hypotension
OCULOMOTOR EXAM TO ASSESS FOR CENTRAL FINDINGS
NYSTAGMUS
- Definition of nystagmus
- Documentation of findings
- How to recognize and name nystagmus
BPPV ASSESSMENT & PROPER DOCUMENTATION
- Lab: Clearing cervical spine for safety
- Vestibular positional assessments
- Modified vertebral artery test
- Sharpe-Purser test
- Recognizing peripheral vestibular dysfunction
- Recognizing vestibular imbalance
- Head thrust test
- Head-shaking nystagmus tests
- Positional assessment for BPPV in anterior, posterior and horizontal canals
- Hallpike-Dix test
- Modified Hallpike-Dix test
- Roll test
- Bow and lean test
- Multiple canal BPPV assessment, findings and treatment approach
BPPV TREATMENT: PURPOSE & TECHNIQUE
- Epley maneuver
- Semont/Liberatory maneuver
- BBQ roll
- Quick BBQ roll
- Appiani
- Cassani
- Gufoni
- Post-treatment movement restrictions -discussion of research
- Half somersault
- Brandt-Daroff exercises
ATYPICAL FINDINGS FOR BPPV
CLINICAL DECISION-MAKING
- Sample exam findings
- Determining diagnosis and treatment
- Demonstration of assessment and treatments
VIDEO DEMONSTRATION: NYSTAGMUS
DAY 2: VESTIBULAR REHABILITATION IN ACTION
CERVICOGENIC VERTIGO
- Findings from examination
- Treatment approach
POST-CONCUSSION SYNDROME
- Findings from examination
- Treatment approach
CENTRAL VERTIGO
- Findings from examination
- Video assessments
VESTIBULAR HYPOFUNCTION
- Findings from examination
- Treatment approach
- Clinical practice guidelines
VESTIBULAR REHABILITATION, SENSORY INTEGRATION, & BALANCE STRATEGIES
VESTIBULAR FUNCTIONAL ASSESSMENTS & DOCUMENTATION
- Habituation: motion sensitivity quotient
- Dynamic visual acuity
- Balance: modified clinical test of sensory integration in balance, dynamic gait index
- Gait speed: preferred and fast
- Five time sit to stand
- Musculoskeletal considerations
BILLING, MEDICARE FUNCTIONAL LIMITATION REPORTING, MEDICARE FALL RISK, & FLR G-CODES
DEVELOPING A TREATMENT PLAN BASED ON FINDINGS FROM FUNCTIONAL ASSESSMENTS & WRITING GOALS
CASE STUDIES
- Cervicogenic vertigo
- Post-concussion syndrome
- Central vertigo
- Vestibular hypofunction