Certificate Program
Comprehensive Vestibular Rehabilitation (Certificate)
Advance your career in vestibular rehabilitation.
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About this Certificate Program
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.
Target audience
Physical therapists
Physical therapist assistants
Occupational therapists
Occupational therapist assistants
Goals & objectives
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Recognize benign paroxysmal positional vertigo (BPPV) and other vestibular system disorders, including unilateral vestibular disorders, bilateral vestibular disorders, and central vestibular disorders
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Perform and interpret office-based vestibular testing
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Perform and interpret HINTS testing
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Recognize indications for vestibular lab testing
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Administer commonly utilized performance-based balance tests
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Determine the appropriateness of vestibular rehabilitation and identify indications for further medical/diagnostic consultation
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Evaluate the appropriateness and effectiveness of canalith repositioning maneuvers
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Design a treatment plan to address vestibular hypofunction, PPPD, and benign paroxysmal positional vertigo (BPPV)
What’s included in the Certificate Program
Accredited Online Courses*
14 hours of online video lectures and patient demonstrations.
Case Study Interviews
Recorded Q&A sessions between instructors and practice managers.
Interactive Learning Assessments
Case-based quizzes to evaluate and improve clinical reasoning.
Certificate Program overview
Section 1
Fundamentals and Pathophysiology 4 ItemsVestibular Anatomy and Physiology Course
Chapter 1: Semicircular Canals
Content will focus on semicircular canal anatomy and physiology critical to management of vestibular disorders. Instruction will emphasize labyrinthine/canal spatial orientation and cupula-related mechanics, which is particularly helpful for management of BPPV and other vestibular-related disorders.
Chapter 2: Otolithic Organs, Otoconia, and Dark Cells
Instruction will emphasize otolithic organ structure and function, which is critical to management of vestibular disorders. Instruction will include a special emphasis on otoconia and dark cells, which are important for understanding risk factors for BPPV.
Chapter 3: Motor Functions of the Vestibular System
Instruction will focus on motor functions of the vestibular system, including gaze stability and postural control. Instruction will emphasize specific features of the vestibulo-ocular reflex, which is critical in the differential diagnoses of vestibular disorders. This chapter will also review the role of the vestibular system in postural control.
Identification and Management of Unilateral Vestibular Disorders Course
Chapter 1: Vestibular-Related Pharmacologic Agents
This chapter will focus on common pharmacologic agents utilized in the management of acute vestibular-related symptoms in individuals with dizziness. Therapy-related implications will be reviewed.
Chapter 2: Stable Unilateral Vestibular Disorders
Instruction will include a review of common stable unilateral vestibular disorders along with a discussion of the appropriateness of vestibular rehabilitation. Concerning and nonconcerning audiometric findings will be discussed. Medical management options will be reviewed.
Chapter 3: Unstable/Progressive Unilateral Vestibular Disorders, Part 1
Content will include a review of the features of unstable/progressive unilateral vestibular disorders along with a discussion of the appropriateness of vestibular rehabilitation. Medical management, including surgical indications, will be reviewed. Ménière’s disease, vestibular schwannoma, and superior canal dehiscence will be discussed.
Chapter 4: Unstable/Progressive Unilateral Vestibular Disorders, Part 2
Content will include a review of the features of unstable/progressive unilateral vestibular disorders along with a discussion of the appropriateness of vestibular rehabilitation. Medical management, including surgical indications, will be reviewed. Ménière’s disease, vestibular schwannoma, and superior canal dehiscence will be discussed.
Chapter 5: Q&A
This is a Q&A session with Michael Teixido on surgical and medical management of unilateral vestibular disorders.
Bilateral Vestibular Disorders and PPPD Course
Chapter 1: Bilateral Vestibular Disorders
Instruction will focus on etiologic factors for bilateral vestibular disorders along with a discussion of the appropriateness of vestibular rehabilitation. To improve awareness of common associated impairments, a patient interview will be shared. Medical management options will be reviewed.
Chapter 2: Persistent Postural-Perceptual Dizziness (PPPD)
Content will review the common symptoms associated with PPPD. Treatment guidelines will be reviewed, including the role of vestibular rehabilitation. This chapter will include a PPPD-related question-and-answer session with Neil Shepard, PhD, professor emeritus, Mayo Clinic College of Medicine.
Central Vestibular Disorders and HINTS Testing Course
Chapter 1: Central Vestibular Disorders
Content will include features of central nervous system (CNS) disorders that may present with vestibular-related issues. Recognition of concerning causes of vestibular symptoms and indications for further medical management is important for clinicians involved in vestibular testing and rehabilitation.
Chapter 2: Traits of Central-Origin Oculomotor Findings
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. Common abnormalities noted with MS, stroke, cerebellar disorders, and parkinsonism-like disorders will be demonstrated. Recognition of red flags is important in alerting clinicians to a potentially more concerning cause of vestibular symptoms.
Chapter 3: HINTS Testing
HINTS testing, which can be helpful in identifying a potentially sinister cause of symptoms in subjects with acute and ongoing vertigo, will be reviewed. The components of HINTS testing will be demonstrated, and video case examples will be presented.
Section 2
Vestibular Examination 2 ItemsVestibular Examination: Oculomotor Testing Course
Chapter 1: Oculomotor Examination
Instruction will focus on completion of essential oculomotor screening. Findings of central vs. peripheral vestibular involvement will be reviewed, which is critical for the purposes of differential diagnosis. Case-based video examples will be reviewed to reinforce content.
Chapter 2: Vestibular-Ocular Reflex Testing: Part 1
Training will emphasize functional testing of the vestibulo-ocular reflex (VOR). Proper performance and interpretation of VOR testing will be reviewed. Identification of head-motion-induced oscillopsia is one of the chief indications for vestibular rehabilitation.
Chapter 3: Vestibular-Ocular Reflex Testing: Part 2
Training will emphasize functional testing of the vestibulo-ocular reflex (VOR). Proper performance and interpretation of VOR testing will be reviewed. Identification of head-motion-induced oscillopsia is one of the chief indications for vestibular rehabilitation.
Chapter 4: Vestibular Function Tests
Content will focus on common laboratory-based vestibular function tests that can be helpful in defining the site of lesion in individuals with vestibular system disorders. This chapter will include a question-and-answer session with Neil Shepard, PhD.
Vestibular Examination: Postural Control Testing Course
Chapter 1: Postural Control Testing
Bedside postural control testing will be discussed, including the Modified Clinical Test of Sensory Interaction in Balance. Testing provides valuable insight into the functional impact of a vestibular disorder. Postural control testing can enhance investigation into how efficiently vestibular cues are being utilized for balance.
Chapter 2: Performance-Based Outcome Measures
Performance-based postural control tests 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, providing valuable insight into the functional impact of a vestibular disorder.
Section 3
Treatment of Vestibular Hypofunction and Clinical Resources 1 ItemVestibular Compensation Exercises and Clinical Resources Course
Chapter 1: Introduction
Compensation fundamentals and mechanisms of recovery of gaze stabilization will be reviewed. Video case examples will be utilized to reinforce subject matter. Comprehending the mechanisms of vestibular compensation provides valuable insight into treatment-related principles.
Chapter 2: Gaze Stabilization Exercises
Exercise suggestions will focus on head-motion-induced oscillopsia related to vestibular hypofunction. Instruction will focus on proper treatment administration and progression. Improvements in gaze stabilization during dynamic activities can facilitate improvements in activities of daily living.
Chapter 3: Balance Exercises
Exercise suggestions will emphasize vestibular-related balance impairment. Instruction will focus on proper treatment administration and progression guidelines. Improvements in balance can facilitate improvements in activities of daily living and potentially reduce fall risk.
Chapter 4: Clinical Resources
Chapter content will include a question-and-answer session with Danielle Tate, DPT, regarding suggested vestibular-related testing and treatment equipment. Comparative information on Frenzel lenses and video infrared goggles, which are helpful examination tools, will be discussed. Additionally, the chapter will discuss recommended resources to promote professional growth in vestibular rehabilitation.
Section 4
BPPV: Identification and Treatment 3 ItemsBPPV Pathophysiology and Differential Diagnosis of Positional Vertigo Course
Chapter 1: Demographic Features, Predisposing Factors, and Pathophysiology
Instruction will review demographic features, predisposing factors, and estimated prevalence of BPPV. The mechanics and clinical implications of canalithiasis and cupulolithiasis will be discussed, which is helpful to properly identify and treat BPPV.
Chapter 2: BPPV Subtypes
Nystagmus characteristics of the mechanics of common BPPV variants will be discussed, which is helpful with differential diagnosis. Subjective and secondary BPPV will also be reviewed. Video cases will be utilized to emphasize learning objectives.
Chapter 3: Alternative Causes of Positional-Type Dizziness
Differentiating features of alternative (non-BPPV) causes of positional vertigo will be discussed. Recognition of non-BPPV-related dizziness is critical for appropriate patient management. This chapter will include a question-and-answer session regarding BPPV-related controversies with Michael Teixido, MD.
Diagnostic Maneuvers for BPPV Course
Chapter 1: Testing for Posterior Canal Canalithiasis
Instruction will emphasize optimal testing maneuvers for posterior canal canalithiasis. Proper performance of diagnostic maneuvers is essential to optimize test sensitivity for identification of BPPV. Training in the following diagnostic maneuvers will be included: loaded Dix–Hallpike and sidelying test.
Chapter 2: Testing for Posterior Canal Cupulolithiasis
This chapter will review suggested testing maneuvers for posterior canal cupulolithiasis. Proper performance of diagnostic maneuvers is essential to optimize test sensitivity for identification of BPPV. Training in the following diagnostic maneuvers will be included: half Dix–Hallpike and reverse Dix–Hallpike.
Chapter 3: Testing for Horizontal Canal Canalithiasis and Cupulolithiasis
Suggested testing maneuvers for horizontal canal canalithiasis and cupulolithiasis will be reviewed. Proper performance of diagnostic maneuvers is essential to optimize test sensitivity for identification of BPPV. Training in the following diagnostic maneuvers will be included: supine roll test and bow and lean test.
Treatment Maneuvers for BPPV Course
Chapter 1: Canalith Repositioning Maneuvers for Posterior Canal BPPV
Instruction will focus on canalith repositioning maneuvers utilized to treat posterior canal BPPV. Training in the following treatment maneuvers will be included: modified Epley maneuver and liberatory (Semont) maneuver. Properly administered canalith repositioning maneuvers are highly effective in treating posterior canal BPPV.
Chapter 2: Canalith Repositioning Maneuvers for Horizontal Canal BPPV
Instruction will focus on canalith repositioning maneuvers utilized to treat horizontal canal BPPV. Training in the following treatment maneuvers will be included: Gufoni maneuver and cupulolith repositioning maneuver.
Chapter 3: BPPV Management Guidelines
BPPV treatment-related management guidelines will be reviewed. Application of the guidelines are helpful in optimizing BPPV. This chapter will include a BPPV treatment-related question-and-answer session with neurotologist Michael Teixido, MD.
Instructors
Jeff Walter
DPT, NCS
CEU approved
14
total hours*
of accredited coursework.
Medbridge accredits each course individually so you can earn CEUs as you progress.
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Browse PlansFrequently asked questions
Everything you need to know about Certificate Programs.
Accreditation Hours
Each course is individually accredited and exact hours will vary by state and discipline. Check each course for specific accreditation for your license.
When do I get my certificate?
You will receive accredited certificates of completion for each course as you complete them. Once you have completed the entire Certificate Program you will receive your certificate for the program.
Do I get CEU credit?
Each course is individually accredited. Please check each course for your state and discipline. You can receive CEU credit after each course is completed.
Do I have to complete the courses in order?
It is not required that you complete the courses in order. Each Certificate Program's content is built to be completed sequentially but it is not forced to be completed this way.
How long do I have access to the Certificate Program?
You will have access to this Certificate Program for as long as you are a subscriber. Your initial subscription will last for one year from the date you purchase.
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