Best practice to treat vestibular disorders


Alexander Ring, APAM, answers some questions about two exciting upcoming courses created by professor Susan Herdman, Rick Clendaniel and colleagues, who are a few of the pioneers of vestibular rehabilitation.

Why is this the pre-eminent vestibular rehabilitation course available for physiotherapists?

The first vestibular rehabilitation competency- based course was held over 20 years ago. This was the first and only competency- based course held at the time, and to my knowledge is the only series of courses where the participants are evaluated as thoroughly on clinical skills, clinical reasoning, and basic knowledge. Co-sponsored by the American Physical Therapy Association, the courses are delivered internationally and will often sell out. The faculty of this course are nationally and internationally recognised clinicians and clinician–scientists in the field of vestibular rehabilitation.

Who is the course best targeted to? 

This is an intense, evidence-based competency course designed for physiotherapists with experience treating people with vestibular disorders and have completed a previous vestibular course. The course consists of lecture and hands- on laboratory sessions with additional self-study sessions, via written, video and practical skills examinations, all participants will be expected to demonstrate assessment skills to the faculty including oculomotor examination, with emphasis on the identification of nystagmus and canal involvement, balance, gait, falls risk and functional assessments. Participants will also be expected to demonstrate appropriate treatment procedures for BPPV affecting posterior, anterior and horizontal canals for both cupulolithiasis and canalithiasis, for unilateral and bilateral peripheral vestibular disorders, and for central vestibular disorders, including traumatic brain injury and stroke. Emphasis will be on utilising assessment results to develop an effective treatment plan.

How will the course improve participants’ clinical reasoning and competency in the assessment and treatment of vestibular disorders?

The course is informed by the best available, cutting-edge evidence presented by those heavily involved in its development. The teaching, research and clinical experience of the presenters allows them to synthesise the evidence and present it in a way that makes practical and clinical sense. Importantly, the course has a focus on clinical reasoning.

Various modes of presenting include interactive lectures, video case presentations, and hands-on practical skills sessions to challenge and improve participants’ clinical reasoning. Practical techniques and skills are taught and practised within a framework of clinical reasoning.

What can participants expect to take away from this six-day course?

Two certificates are given in this course— one for attendance and one for passing all the examinations. Participants will finish the course ready to see patients with dizziness related to vestibular disorders with greater confidence. Participants will be prepared to think more critically to assess and treat dizzy patients, better able to critically reason through the best available evidence, and synthesise that with a structured and efficient history and examination process— all underpinning an effective, individualised treatment approach. We expect that participants will improve their practice, and as a result of that improve the outcomes of their patients.

Vestibular rehabilitation: a competency-based course VIC 24–29 February 2020. Register at

For those who have completed the vestibular rehabilitation competency- based course, the ‘Advances in vestibular rehabilitation: a competency-based renewal’ course will be held in VIC from 22 to 24 February 2020. Registration is via an EOI application for both courses and strict criteria apply.

Alexander Ring is a physiotherapist from Perth, Western Australia, and since graduating in 1988, has spent time working in Australia and overseas in the areas of neurology, neurosurgical and vestibular rehabilitation (VR). Alec has completed all the vestibular rehabilitation competency courses under the guidance of Professor Susan Herdman.

© Copyright 2018 by Australian Physiotherapy Association. All rights reserved.