Comprehensive Clinical Approach to Vestibular Rehabiliation

Evaluation and Treatment of Patients with Dizziness & Balance Disorders

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Comprehensive Clinical Approach to Vestibular Rehab

Instructor: Patrick A. Tino, PT, DPT

Course Length: 5 hours | Tuition: $199 or FREE for Elite Passport Members

This is a livestream, interactive course.  The instructor will teach in real time and you will have the opportunity to ask and answer questions.

Benefits of Attending

  • Perform evidence-based testing when assessing and differentiating between peripheral and central vestibular dysfunction
    • Various hands-on strategies for programming interventions for various forms of BPPV, PNS/CNS mediated vertigo, motion sensitivity, and non-vestibular dizziness
    • Implement motor planning and learning methods when establishing plan of care and functional goal writing
    • Using a ‘case-scenario’ format to recognize the subtle differences and overt similarities that can exist between “balance training” and “vestibular training” and which to focus on


This course will cover the functional anatomy and physiology and pathology of the vestibular and balance systems across neurologic, orthopedic, and cognitive domains. Emphasis will be placed upon formulating a working differential diagnosis for central and peripheral mediated vertigo. Additionally, equal focus will be placed on understanding how to assess and treat BPPV arising from anterior, horizontal, and posterior canalithiasis and cupulolithiasis. Guided by case scenarios and demonstrations, you will utilize and examine evidence-based assessment and intervention tools that are designed to effectively manage patients with easy and straightforward diagnosis to those who have difficult-to-diagnose complex deficits which severely impair function. The material presented in this course ranges from intermediate to advance and is applicable to multiple clinical settings ranging from acute to home to SNF to outpatient.


  1. Identify various risk factors for falls common among the growing “baby boomer” & elderly population.
  2. Implement functional balance assessment & outcome tools used to determine fall risk.
  3. Recognize “yellow” and “red” flags when screening for medical pathology that would be considered outside clinician scope of practice.
  4. Identify common clinical signs and symptoms of the dizzy and imbalanced patient and how to incorporate and progress appropriate assessment and intervention.
  5. Identify the difference between central and peripheral vestibular etiology.
  6. Differentiate between BPPV of the anterior, horizontal, and horizontal canals.
  7. Explore key documentation phrases that can be utilized to optimize reimbursement using Medicare & commercial insurance approved outcome tools.
  8. Develop comprehensive treatment plans for balance dysfunction in geriatric, neurologic, & orthopedic populations across multiple practice settings such as acute care, sub-acute, SNF, Home Health, and OP.


  1. Instructor and course intro, review course objectives
  2. Review and discuss relevant anatomy & physiology of the vestibular system
  3. Cervicogenic Dizziness (What is it, what it isn’t)
  4. Vestibular Ocular Reflex (VOR) and Nystagmus explanation and videos
  5. Oculomotor Exam and VOR Exam and videos
    1. CN’s 3, 4, 6, smooth pursuit, saccades, HINTS exam (now and later)
  6. Peripheral Vestibular Hypofunction
    1. BPPV, UVH, BVH, Meniere’s
  7. Central Vestibular Disorders
    1. 3PD, Migraine, Concussion
  8. Vestibular Evaluation
    1. Subjective, PMHx, Meds
  9. Balance Tests
    1. Romberg, TUG, DGI, FGA, FSST, MSQ
  10. Benign Paroxysmal Positional Vertigo (BPPV) Testing and Treatment Maneuvers
    1. CPG’s, Dix-Hallpike, Roll, Epley, Semont, Liberatory, BBQ, Gufoni
  11. Vestibular Hypofunction Testing and Treatment
    1. CPG’s, DVA, HIT, Gaze Stab, Visual-Vestibular, Oculomotor Neuro Re-ed
  12. Course wrap-up, Q&A, Adjourn