Balance Dysfunction & Intervention: An Advanced Evidence-Based Course

May 14-15, 2022
8:00 AM - 5:30 PM Saturday

8:00 AM - 3:30 PM Sunday



[Click to Register on our Partner's Site

Course Description

Balance Dysfunction is seen in patients with a variety of pathologies across all practice settings and across the lifespan and may have diverse causes. This two-day advanced evidence-based course is designed for physical and occupational therapists who have a basic knowledge of balance dysfunction and would like to refine their skills. This course will provide the participant with the skills to determine the case of imbalance, employ appropriate outcome measures, and implement treatment. All examination and intervention strategies discussed will be evidence-based and relevant to the patient with balance dysfunction. Vestibular, neurological, and orthopedic causes of imbalance will be discussed, including pathologies such as stroke, Multiple Sclerosis, Parkinson's Disease, cerebellar dysfunction, total joint arthroplasties, lumbar spine dysfunction, and vestibular dysfunction. Special consideration will be given to pathologies such as BPPV, cervicogenic causes of dizziness and imbalance, concussion, traumatic brain injury and higher level balance training, and fall risk assessment and intervention. Participants will learn both impairment and disease-specific examination techniques and will be given guidelines to identify the right examination techniques for specific diagnoses. Recommendations will be based on the APTA Neurology Section EDGE guidelines for outcome measures. Clinical skills that will be taught include assessment of sensory and motor systems that contribute to balance, cervicogenic screening, ocular motor examination, BPPV treatments, higher level balance testing, and treatment of balance dysfunction across the spectrum. Laboratory time will be provided for practice of examination and intervention skills. Participants will apply the material learned in small group case application for both examination and intervention.

Course Objectives

At the conclusion of this course, participants will be able to:

1. Compare and contrast the systems underlying balance.

2. Compare and contrast changes in the balance system with neurological, orthopedic, and vestibular pathologies.

3. Describe changes in the balance system across the lifespan.

4. Perform a balance examination, including examination of sensory and motor contributions to balance

5. Interpret the findings of a balance examination based on diagnosis and impairments.

6. Differentiate neurological, orthopedic, and vestibular causes of balance dysfunction.

7. Examine and treat neurological causes of balance dysfunction, including Parkinson's Disease, Multiple Sclerosis, stroke, peripheral nervous system disorders, and cerebellar dysfunction.

8. Develop evidence-based intervention for patients with vestibular, neurological, and cervicogenic dysfunction.

9. Perform a comprehensive examination to differentially diagnose BPPV and develop a progressive program to treat BPPV.

10. Describe the pathology of vestibular balance dysfunction.

11. Examine and treatment vestibular causes of balance dysfunction, including cervicogenic dizziness, migraine-related vestibulopathy, and anxiety-related dizziness.

12. Develop a fall-risk assessment and intervention program.

13. Apply the material presented to representative patient cases.

About the Instructor

Diane M. Wrisley, Ph.D., PT, NCS, is an Associate Professor in the Doctor of Physical Therapy program at Wingate University, is Director of Post-Professional Programs, and is board-certified in Neurologic Physical Therapy. Dr. Wrisley holds a Bachelor's Degree in Physical Therapy from the State University of New York at Buffalo, a post-professional Master's Degree from Old Dominion University, and a Ph.D. in Rehabilitation Science from the University of Pittsburgh. She completed a post-doctoral fellowship in the Balance Disorders Laboratory at the Neurological Sciences Institute of Oregon Health and Sciences University under the mentorship of Dr. Fay Horak and Dr. Robert Perterka. Dr. Wrisley has received pre-doctoral and post-doctoral fellowship grants from the National Institute for Deafness and Communication. She has over 30 years of clinical experience and has extensive experience in the evaluation and treatment of patients with vestibular and balance deficits and was awarded the APTA Neurology Section's award for Clinical Excellence in Neurological Physical Therapy in 2002. Dr. Wrisley has published numerous research articles and book chapters and presented both nationally and internationally. Her research interests include sensory influences on balance, including the role of the cervical afferents on dizziness and balance, the evaluation and treatment of balance disorders, and physical therapy outcomes for people with vestibular and balance dysfunction.


Day One
07:30-08:00 Course Registration & Sign-in/Breakfast

08:00-08:15 Application of theories to balance dysfunction to patient care

08:15-10:15 Physiology of balance function across the lifespan

  • Motor and sensory contributions to balance and how they relate to assessment and treatment
  • Motor and sensory changes across the lifespan
  • Key components of vestibular anatomy and physiology important to understand the clinical assessment and treatment of balance dysfunction

10:15-10:30 Break

10:30-12:00 Examination of balance

  • Examination of motor function, including balance strategies
  • Examination of sensory function: vestibular, visual, and somatosensory contributions to balance

12:00-01:00 Lunch (on your own)

01:00-02:00 Examination lab

  • Visual, vestibular, and balance assessment

02:00-02:45 Differentiating causes of balance dysfunction

  • Vestibular and non-vestibular causes of balance dysfunction
  • Neurological and orthopedic causes of balance dysfunction

02:45-03:00 Break
03:00-03:30 Case application:

  • Apply the examination techniques and differential diagnosis to representative patient cases in small groups: vestibular and non-vstibular causes of balance dysfunction, neurological and orthopedic causes of balance dysfunction

03:30-04:00 Neurological contributions to balance

  • Special considerations for examination and treatment of Parkinson's Disease, Multiple Sclerosis, stroke peripheral nervous system disorders, and cerebellar dysfunction

04:00-05:30 Benign paroxysmal positional vertigo (lecture and lab)

  • Examination and treatment of anterior, horizontal, and posterior canals
  • Modification for different pathologies and settings

Day Two

07:00-07:30 Sign-in/Breakfast

07:30-08:30 Cervicogenic and orthopedic contributions to balance

  • Special considerations for examination and intervention
  • Cervicogenic contributions to balance
  • Total joint arthroplasty
  • Lumbar spine dysfunction

08:30-10:15 Advanced vestibular causes of imbalance

  • Migraine-related vestibulopathy
  • Cervicogenic dizziness
  • Anxiety-related dizziness

10:15-10:30 Break

10:30-12:00 Traumatic brain injury and concussion-high level balance training

  • Special considerations for examination and intervention of people with traumatic brain injury and concussion
  • High level balance training
  • Vestibular rehabilitation for people with concussion

12:00-12:30 Lunch (on your own)

12:30-01:45 Fall risk assessment and intervention

  • Examination and intervention of systems that contribute to fall risk
  • Development of a fall prevention program

01:45-02:00 Break

02:00-03:00 Case application

  • Small group work of application of treatment strategies to patient cases discussed earlier

03:00-03:30 Questions/wrap-up




Texas Children's Hospital Feigin Center

1st Floor Conference Room A
1102 Bates Street
Houston, TX 77030

Click here for directions

Hotel Accommodations

Coming soon....

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Who Should Attend

This course is applicable for PTs, PTAs, OTs, and ATs.


15 contact hours or CCU's.