Vestibular Rehabilitation Course

Lesson 1 • Inner Ear Structural Overview

Covers bony and membranous labyrinth components and their spatial relationships. Provides the anatomical baseline for all subsequent clinical reasoning.

Lesson 2 • Neurotransmitters and Pharmacology Basics

Identifies key neurotransmitters in vestibular signaling and how medications alter them. Prepares clinicians to anticipate drug effects on assessment findings.

Lesson 3 • Sensory Organs of the Vestibular System

Examines the utricle, saccule, and semicircular canals as motion detectors. Links receptor function to the types of movement each organ encodes.

Lesson 4 • Vestibulo-Ocular and Vestibulospinal Reflexes

Defines the VOR and VSR circuits that stabilize gaze and posture. Grounds reflex testing rationale in neurophysiological mechanisms.

Lesson 1 • Center of Mass and Base of Support

Defines biomechanical limits of stability and strategies used to maintain them. Provides the mechanical vocabulary for postural analysis.

Lesson 2 • Vestibular Compensation Mechanisms

Describes central adaptation processes that restore function after peripheral lesions. Sets expectations for recovery timelines and rehabilitation targets.

Lesson 3 • Gaze Stabilization During Movement

Examines how the VOR and smooth pursuit maintain clear vision during head motion. Directly informs dynamic visual acuity testing rationale.

Lesson 4 • Falls Risk and Vestibular Dysfunction

Quantifies the relationship between vestibular impairment and fall incidence. Motivates outcome-focused rehabilitation planning.

Lesson 1 • Outcome Measures and Questionnaires

Selects validated self-report tools to capture handicap, anxiety, and activity limitation. Establishes baseline scores for tracking rehabilitation progress.

Lesson 2 • Oculomotor Examination Techniques

Teaches bedside assessment of nystagmus, saccades, and smooth pursuit. Identifies oculomotor patterns that localize lesion site.

Lesson 3 • Head Impulse and Positional Testing

Applies the video head impulse test and Dix-Hallpike maneuver to detect canal paresis and BPPV. Interprets corrective saccades and positional nystagmus patterns.

Lesson 4 • Static and Dynamic Balance Testing

Administers Romberg, tandem stance, and dynamic gait tests to quantify postural deficits. Connects test scores to functional impairment levels.

Lesson 1 • Canalith Repositioning Procedures

Teaches Epley, Semont, and Gufoni maneuvers with precise head positioning sequences. Ensures correct particle trajectory through each canal during treatment.

Lesson 2 • BPPV Pathophysiology and Canal Variants

Explains canalith and cupulolithiasis mechanisms in each semicircular canal. Grounds variant-specific treatment selection in pathomechanical reasoning.

Lesson 3 • Challenging and Atypical BPPV Cases

Addresses bilateral BPPV, post-surgical cases, and persistent symptoms after repositioning. Develops clinical reasoning for complex presentations.

Lesson 4 • Treatment Outcomes and Recurrence

Evaluates resolution criteria and recurrence risk factors after repositioning. Prepares clinicians to counsel patients on long-term prognosis.

Lesson 1 • Gaze Stabilization Exercise Progression

Prescribes VOR x1 and x2 exercises with systematic increases in speed and complexity. Targets VOR gain improvement through repetitive head-target movement.

Lesson 2 • Functional and Community Reintegration

Advances training to dual-task walking, crowded environments, and occupational demands. Bridges clinic-based gains to real-world performance.

Lesson 3 • Static and Dynamic Balance Retraining

Progresses balance tasks from stable to unstable surfaces and single-leg stance. Integrates sensory conflict conditions to promote vestibular reweighting.

Lesson 4 • Pathophysiology of Unilateral Hypofunction

Describes the asymmetric resting rate and dynamic imbalance caused by unilateral loss. Explains why spontaneous nystagmus and oscillopsia occur acutely.

Lesson 1 • Long-Term Management and Monitoring

Establishes maintenance exercise programs and periodic reassessment schedules. Addresses psychosocial impact of permanent vestibular loss.

Lesson 2 • Sensory Substitution Strategies

Trains visual and somatosensory systems to compensate for absent vestibular input. Addresses the limits of substitution in low-light and unstable surface conditions.

Lesson 3 • Assessing Residual Vestibular Function

Uses video head impulse testing and dynamic visual acuity to quantify remaining canal function. Guides exercise intensity based on residual gain measurements.

Lesson 4 • Etiology and Clinical Presentation

Identifies common causes including ototoxicity, autoimmune disease, and bilateral Meniere's. Describes the characteristic oscillopsia and gait ataxia presentation.

Lesson 1 • Vestibular Migraine Assessment

Applies diagnostic criteria for vestibular migraine and differentiates it from Meniere's disease. Guides appropriate physiotherapy scope within a multidisciplinary model.

Lesson 2 • Central Versus Peripheral Lesion Differentiation

Contrasts nystagmus direction, fixation suppression, and head impulse findings across lesion sites. Builds a reliable bedside algorithm for rapid triage.

Lesson 3 • Persistent Postural-Perceptual Dizziness

Defines PPPD as a functional vestibular disorder driven by maladaptive cortical processing. Introduces graded exposure and cognitive-behavioral principles for management.

Lesson 4 • Safe Referral and Multidisciplinary Collaboration

Establishes criteria for urgent neurological referral and imaging requests. Defines the physiotherapist's role within neurology, audiology, and ENT teams.

Lesson 1 • Monitoring Progress and Modifying Programs

Uses repeated outcome measures and clinical re-examination to guide program modification. Identifies plateaus and applies strategies to restore progress.

Lesson 2 • Exercise Prescription Principles

Applies dose-response principles of frequency, intensity, and specificity to vestibular exercise. Balances symptom provocation with recovery to optimize neuroplastic adaptation.

Lesson 3 • Integrating Assessment Data into Treatment Plans

Translates impairment findings, outcome scores, and patient goals into prioritized treatment targets. Demonstrates clinical reasoning documentation for complex cases.

Lesson 4 • Managing Comorbidities in Vestibular Patients

Adapts rehabilitation for patients with concurrent anxiety, cervicogenic dizziness, or neurological conditions. Identifies when comorbidities require modified or staged approaches.