Vestibular
According to the Vestibular Disorders Association, nearly 100 million Americans have experienced a vestibular problem at some point in their lives. There are numerous causes of vestibular dysfunction and the symptoms are many. Head trauma, cervical dysfunction, soft tissue, and bony malalignment, as well as bacterial and viral infections are just some of the causative factors relating to headache, dizziness and vertigo related syndromes. This course series is designed to enhance participantsâ awareness of the various indicators relating to headaches, dizziness, and vertigo, as well as the gait and balance dysfunctions that accompany them.
What this certification series will address:
Practicing healthcare professionals will leave this course series with a clear understanding of normal functioning of the inner ear's vestibular system, the pathophysiology of BPPV and its variants, and application of a simple clinical algorithm to help make differential diagnoses of BPPV. It is designed to give therapists and clinicians essential information needed to assess and treat uncomplicated vestibular dysfunction as well as providing insight on incidence, diagnosis, and treatment of balance-related disorders. A review of current clinical practice guidelines will be included to strengthen the differential diagnosis process and clinical application of treatment of both typical and atypical BPPV. Participants will learn to combine practical assessment techniques with effective treatment options including different manual therapy approaches to calming the variety of symptoms relating to patients suffering from multiple diagnoses.
What courses are included
"Assessment and Treatment of Benign Paroxysmal Positional Vertigo"
Taught by Naseem Chatiwala, PT, DPT, MS, NCS
Practicing healthcare professionals will leave this workshop with a clear understanding of the normal functioning of the inner ear's vestibular system, pathophysiology of BPPV and its variants, and application ofa simple clinical algorithm to help make differential diagnosis of BPPV. A review of current clinical practice guidelines will be included to strengthen the differential diagnosis processand clinical application of treatment of both typical and atypical BPPV. A case study in the end will include participant's participation to recognize signs and symptoms of typical and atypical BPPV, make a diagnosis, and then prepare a treatment plan. In addition, participants will learn torecognize when a patient is not presenting with BPPV and when to refer to a neurologist or another medical specialist. Multiple videos will be used to demonstrate clinical assessment and treatment maneuvers of BPPV and itsvariants.
Available as:
2-Hour Online Video
Highlights
- Immediately improve your client's functional limitations by choosing appropriate maneuvers to treat their positional vertigo
- Improve your knowledge in understanding the physiology of BPPV and accurately diagnose the canal involved by accurately using differential diagnostic algorithm
- Practical assessment and simple breakdown of positive and negative results of each test used
- Effective treatment strategies to successfullytreat BPPV
- Classify when BPPV has atypical presentation and be able to successfully assess and treat it
Naseem Chatiwala, PT, DPT, MS, NCS, is a board- certified neuro clinical specialist and a certified vestibular clinical specialist who has 20+ years of experience as physical therapist treating a variety of complex neuro diagnoses. Naseem has been instrumental in developing a neuro and concussion program at The Clough Family Center for Rehabilitative and Sports Therapies and has helped develop guidelines for balance clinics, vestibular screening, baseline testing, return to play and graded exs protocols. Naseem also developed and runs a brace clinic with an orthotist where they do comprehensive gait evaluations and make custom orthosis for patients with neurologic deficits. She is also an adjunct faculty at MGH-IHP and UMass Lowell PT program and a course developer and instructor through Summit Education where she teaches live workshops on Stroke Rehab and Vestibular Rehab.
DISCLOSURES
FINANCIAL: Naseem Chatiwala is compensated by Summit as an instructor. She serves as adjunct faculty at MGH Institute of Health Professions and at the University of Massachusetts, Lowell DPT program. She is also employed as a Clinical Specialist at Emerson Hospital Center for Rehabilitation and Specialty Services.
NONFINANCIAL: Naseem Chatiwala has no non-financial relationships to disclose.
- BPPV Physiology and Assessment
- Anatomy vestibular system
- Physiology of canals
- Physiology of BPPV
- Assessments of BPPV
- DHI
- Dix Hallpike Test
- Roll test
- Deep extension test
- Differential diagnosis
- Clinical algorithm
- BPPV Treatment
- Clinical practice guidelines
- Canalith repositioning maneuvers
- Posterior canal BPPV
- Canalithiasis
- Cupulolithiasis
- Lateral canal BPPV
- Canalithiasis
- Cupulolithiasis
- Anterior canal BPPV
- Posterior canal BPPV
- Atypical BPPV
- Physiology
- Assessment
- Treatment
- Analyze the normal and abnormal anatomy and physiology of the vestibular system.
- Recognize the signs and symptoms of BPPV andconfidently identify variants of BPPV.
- Explain the physiologic rationale of test procedures and results of various tests for BPPV.
- Utilize the results of clinical examinations to develop treatment plans.
- Identify the treatment procedures for typical and atypical BPPV affecting various canals.
- Summarize the evidence-based treatments and protocols using current clinical practice guidelines for BPPV.
"Evaluation and Treatment of Vestibular Disorders"
Taught by Jean McConnell, MS, PT, ATC
This workshop will identify the broad based aspects relating to the complicated dizzy/vertigo/headache/balance compromised patient. There will be an overview of the multiple diagnoses and many syndromes associated with complicated patients who exhibit potential vestibular dysfunction. Participants will learn to combine practical assessment techniques with effective treatment options including different manual therapy approaches to calming thevariety of symptoms relating to patients suffering from multiple diagnoses.
Available as:
6-Hour Online Video
6-Hour Live Session
Highlights
- Confidently assess the source of vestibular problems and develop a treatment plan that works
- Techniques to efficiently identify and treat BPPV in one session and treatment modifications that can be adapted to any setting
- Functional balance testing: Turning Rombergs into rehab
- Trigger point release techniques to rule out myofascial pain and correct postural malalignments
- Effectively differentiate vestibular disorders from pain syndromes including headaches, and central vs. peripheral nervous system dysfunctions
Jean A. McConnell, PT, MS, ATC, is the owner of Pinnacle Health Concepts Physical Therapy and is a skilled physical therapist with over 28 years of clinical experience in acute care, nursing home, home health, sports medicine and outpatient rehab settings. Ms. McConnell specializes in the treatment of vestibular disorders, vertigo/dizziness, headaches, balance disturbances, pelvic floor dysfunctions as well as cervical, thoracic and lumbar-sacral dysfunctions. She graduated from Howard University, with a degree in Physical Therapy and received her BS degree in Health & Physical Education and received her Master's Degree in Physiology & Sports Science from Indiana University. Ms. McConnell also received an Athletic Training certification from West Chester University.
DISCLOSURES
FINANCIAL: Jean McConnell is compensated as the owner of Pinnacle Health Concepts and by Summit as an instructor
NONFINANCIAL: Jean McConnell has no nonfinancial relationships to disclose.
- How to Identify Vestibular Dysfunction
- Working anatomy of the vestibular mechanisms
- Ruling out other causes of dizziness
- Headache/migraine - Viral and post-concussion TBI
- Central nervous system dysfunctions
- Differentiating common vestibular disorders including:
- Menieres
- Labyrinthitis
- BPPV
- Neuritis
- Oscillopsia
- Unilateral vs. bi-lateral disorders
- Assessing and Treating Dizziness from Pain Syndromes
- Postural malalignments
- Cervicogenic vertigo
- The lower spine, sacral iliac dysfunction
- Neurological pathway considerations
- Eliminating pain syndromes - Jones Strain- Counterstrain
- Hands-On Lab
- Properly Performing Functional Vestibular Assessment Techniques
- Interpreting test results for the most effective treatment recommendations
- Fall Prevention - Romberg exercise progressions that assess and improve balance
- Saccades
- Smooth pursuit
- Head-thrust tests
- Hands-On Lab
- Comprehensive and Effective Treatment Plans for Vestibular Disorders
- Effects on activities of daily living
- Manual therapy techniques
- Maitland technique
- Modified Mulligan technique
- Modified Rocabado exercise
- Hands-On Lab
- Modalities That Improve Vestibular Function
- Treatment pathways
- When to use neuromuscular re-education vs. therapeutic exercise
- Outcome measurement tools
- Visceral mobilization technique
- Treating BPPV
- Traditional approach
- Technique modifications for non-traditional applications(emergency room, acute care, home health care setting)
- Dix-Hallpike
- Epley maneuver for anterior-posterior canal dysfunction
- Roll test
- Gufoni Maneuver for horizontal canal dysfunction
- Habituation exercises for BPPV Disorders
- Differentiate the incidence and etiology of at leastthree vestibular dysfunctions.
- Discuss the reasons many patients experience multiple vestibular-related diagnoses.
- Utilize all available assessment tools for testing balance and vestibular dysfunction.
- Describe the relationship of postural deformities as related to soft tissue and bony malalignment and trigger point irritationto vestibular dysfunction.
- Demonstrate techniques, modalities, activities, manual therapy techniques, and balance exercises for treating individuals suffering multiple diagnoses involving the vestibular system.
- Utilize BPPV testing and treatment techniques to resolvevertigo symptoms efficiently.
"Vestibular Rehab & Balance Training"
Taught by Karen Hogan-Curran, PT, DPT
This interactive workshop will cover the anatomy, physiology and function of the vestibular system and the vestibular system's important role in balance and mobility. It isdesigned to give therapists and clinicians basic essential information needed to assess and treat uncomplicated vestibular dysfunction as well as incidence, diagnosis and treatment of balance related disorders. Attendees will learnthe various types of vestibular disorders, how they affect different populations and basic clinical tools for appropriate evaluation and treatment strategies. The instructor will frequently use case studies and hands on labs to bring real world relevance.
Available as:
6-Hour Online Video
6-Hour Live Session
Highlights
- Inner-ear Anatomy and Physiology and what every therapist needs to know
- Various diagnoses and their impact on vestibular/balancecontrol such as BPPV, Meniere's, Vestibular Labyrinthitis & Neuronitis, etc.
- Evaluation & Assessment Tools needed for evaluation and treatment of vestibular and balance disorders
- Hands-on Labs of Evaluation and Treatment Techniques for better patient outcomes
- Case Studies and Pharmacological implications
- The Balance Control System and its direct impact on a patient's ability to maintain balance and function in daily living
Karen Hogan-Curran, PT, DPT, has been a physical therapist since 1996, with clinical experience across general, cardiac, pediatric, outpatient, and vestibular rehab settings. Dr. Hogan-Curran is currently the Senior Vestibular Therapist for Peak Performance Physical Therapy in New Hyde Park, New York. Dr. Hogan-Curran is also responsible for training and evaluation of adult vestibular and balance patients with acute and chronic neurological diagnoses. She was awarded the Susan Herdman Certificate of Competency in Vestibular Rehab in 2002 from Emory University and spent six years at the renowned Rusk Institute of Rehabilitation where she was a senior physical therapist gaining experience with pediatrics, neurological rehab, cardiac rehab, and orthopedics. Dr. Hogan-Curran also spent one year at Rusk treating patients with vestibular and balance disorders using infrared goggles, Frenzel lenses and the Smart Balance Master.
DISCLOSURES
FINANCIAL: Karen Hogan-Curran is compensated by Summit and as an instructor.
NONFINANCIAL: Karen Hogan-Curran has no nonfinancial relationships to disclose.
- Incidence & Diagnosis of Vestibular & Balance Disorders
- Age and population
- Undiagnosed / misdiagnosed
- Anatomy of the inner Ear & Function of Parts
- Inner ear anatomy and function
- Neurophysiology of balance
- History
- Significance of past medical history
- Mechanism of injury
- Symptom description, intensity, duration
- Pharmacology
- Evaluation
- Balance Assessment
- Gait Assessment
- Vestibular Assessment
- Evaluation Lab
- Dix Hallpike
- Oculomotor testing
- Balance testing
- Differential Diagnosis
- Labyrinthitis
- Vestibular Neuritis
- Meniere's
- BPPV
- Central pathology
- Treatment Lab
- Psychological implications
- Exercises to improve balance
- Progression of Balance Exercises
- Vestibular Exercises
- Progression of Vestibular Exercises
- Epley Maneuver
- Case Studies and Videos
- Determine the incidence and etiology of vestibular dysfunction.
- Demonstrate an appropriate understanding of the vestibular system, the various disorders and the subsequent implications on a patient's ability to perform ADLs.
- Identify various fundamental assessment tools for testing vestibular dysfunction and begin to learn how to use them during a hands-on lab session.
- Describe the balance control system and the interdependence of gaze and postural stabilization on maintaining balance.
- Demonstrate knowledge of the assessment and treatment of BPPV.
- Identify common clinical signs and symptoms of the dizzyand imbalanced patient and how to incorporate and progress appropriate treatment. in daily living