CCVR Course Objectives
After successfully completing the Certificate of Competency in Vestibular Rehabilitation (CCVR) Course, the participant will be able to:
- Explain anatomy and physiology of the vestibular system to apply to peripheral and central vestibular disorders
- Identify the primary roles of the vestibular system in eye coordination, postural control, and autonomic nervous system contributions
- Be familiar with the guiding principles of nystagmus and physiology of vestibular compensation
- Explain the clinical usefulness in vestibular diagnostics (VNG, VEMP, vHIT, ABR, and ECochG) and comprehensive audiograms for in patients suffering from dizziness and/or balance disorders
- Utilize clues from the history and categorize dizziness with a comprehensive intake to create a working diagnosis
- Identify descriptors during the intake to determine visual dysfunction
- Identify key components of a comprehensive clinical vestibular examination, utilizing reliable and valid bedside and functional vestibular tests
- Identify the most common peripheral vestibular disorders and be familiar with the most appropriate management, including medical management
- Identify key components of an abbreviated ocular screen and be familiar with criteria to recognize tropias and phorias
- Identify upper motor neuro screening tests to identify potential central involvement as well as how to segmentally assess the upper and lower cervical spine for restrictions of mobility and describe specific strength testing to identify impairments of the cervical musculature
- Be familiar with how to assess the integrity of the ligaments and stability of the upper cervical spine
- Be familiar with the biomechanics of BPPV to apply in the differential diagnosis of both typical and atypical presentations, including differential criteria between horizontal canal BPPV vs Light Cupula vs central pathology
- Identify patients who are good candidates for further referral and/or vestibular rehabilitation, including specific interventions for visual processing impairments and visually induced dizziness
- Describe appropriate vestibular exercises to optimize adaptation or compensation, including targeted strategies for vestibular ocular reflex exercises
- Describe exercises for ocular stretches, saccades training, smooth pursuits training, vergence training, central-peripheral visual integrations, and visual spatial processing
- Identify the most appropriate canalith repositioning maneuver(s) for both typical and atypical BPPV
- Describe targeted gait training activities to improve speed and stride length for minimizing risk for falls and optimizing efficiency in ambulatory tasks
- Define evidence-based medicine and recognize the strengths and limitations of testing procedures and interventions in patients with dizziness and balance disorders
- Identify at least 3 assessment and 3 treatment strategies to address impairments post-concussion
- Understand basic principles for evaluating patients involved in litigation and role as an unbiased agent of the court
- Identify the "red flags" that heighten concern for malingering and exaggeration
- Identify three treatment strategies to address vestibular deficits in the school age child
- List 5 red flags of vestibular dysfunction in the school age child
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