Jeff Walter, DPT, NCS, returns to Neuro Navigators to share even more clinical practice tips for clinicians who are both new and experienced with vestibular rehab. Host JJ Mowder-Tinney and Jeff dive into the vestibular management hidden gems that could be the strategies to transform your clinical practice. From alternative benign paroxysmal positional vertigo (BPPV) assessment techniques to under-recognized treatments for Meniere’s disease to emerging treatments for vestibular-related imbalance and falls, you’ll walk away with practical tools you can apply immediately. Whether you are a physical or occupational therapy practitioner, this episode is for you. Don’t miss this engaging discussion filled with actionable takeaways to enhance your confidence in treating dizziness and balance disorders.

Learning Objectives

• Analyze the evidence regarding optimal management of vestibular disorders
• Apply evidence-based, practical strategies to actionably address the efficient evaluation and treatment of vestibular-related dizziness
• Solve patient case scenarios involving frequent falls and disabling vertigo to support participation in instrumental activities of daily living (IADLs), such as community mobility and home management

Timestamps

• (00:00:00) Welcome
• (00:00:15) Welcome back, guest Jeff Walter, DPT, NCS
• (00:00:55) Jeff’s background and work at Geisinger Medical Center
• (00:02:11) Evolution of Jeff’s vestibular specialization
• (00:03:12) Overview: tips for clinicians with foundational vestibular knowledge
• (00:04:42) Sidelying test: what it is and why to use it
• (00:06:54) How to perform the sidelying test with exact head positioning cues
• (00:08:21) Embedding the sidelying test into functional mobility assessments
• (00:11:55) Splinting the patient’s head: comfort and compliance tips
• (00:13:21) Half Dix-Hallpike: identifying short-arm posterior canal BPPV
• (00:16:40) Flashlight fixation-blocking: a goggle-free nystagmus test
• (00:18:11) When to use it and how to prep the patient
• (00:25:10) Mastoid vibration test: screening for vestibular hypofunction
• (00:26:00) Interpretation: direction-fixed nystagmus and its implications
• (00:26:40) When and why to use mastoid vibration (TBI, falls, etc.)
• (00:34:04) Gentamicin injections: managing Meniere’s-related vertigo
• (00:40:00) Vestibular drop attacks (Tumarkin events): signs and screening tips
• (00:42:30) Real-life example and how to follow up when falls are unexplained
• (00:46:00) Vibrotactile belt: a future-forward sensory substitution device
• (00:47:00) Who it’s for, how it works, and early user feedback
• (00:52:50) Wrapping up: Jeff’s top takeaways for novice and experienced physical and occupational therapy practitioners
• (00:56:25) Superpower time: Jeff’s vestibular-themed wishes
• (00:58:00) Closing remarks and where to listen to Episode 1

Resources Mentioned in Episode

• Alonso, S. M., & Caletrío, Á. B. (2024). Clinical Advancements in Skull Vibration-Induced Nystagmus (SVIN) over the Last Two Years: A Literature Review. Journal of Clinical Medicine, 13(23), 7236.

Neuro Naviagators is brought to you by Medbridge. If you’d like to earn continuing education credit for listening to this episode and access bonus takeaway handouts, log in to your Medbridge account and navigate to the course where you’ll find accreditation details. If applicable, complete the post-course assessment and survey to be eligible for credit. The takeaway handout on Medbridge gives you the key points mentioned in this episode, along with additional resources you can implement into your practice right away.

To hear more episodes of Neuro Naviagators, visit https://www.medbridge.com/neuro-navigators

If you’d like to subscribe to Medbridge, visit https://www.medbridge.com/pricing/

IG: https://www.instagram.com/medbridgeteam/