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Beginners Guide to Practicing Vestibular Physical Therapy


This blog is for physical therapists who may want to expand their practice and offer vestibular evaluations and vestibular rehabilitation therapy. Drawing on insights from e3 Diagnostics balance experts, here is what you need to know to start.

The top reasons to offer vestibular rehabilitation and assessment are:

  1. Provide a vital medical service addressing concerns 90 million Americans seek help for annually.
  2. Improve patients' quality of life and reduce their risk of falls, especially critical for older adults.
  3. Expand your professional expertise and differentiate yourself from the competition.
  4. Build lasting relationships with patients while helping them regain independence and confidence.

In the United States, there are no requirements for physical therapists to offer vestibular therapy. Many physical therapy graduate programs often do not include significant vestibular training. After graduation, you can take additional courses to improve your ability to provide these services. These options include:

  1. Online courses are a fantastic way to improve your comfort and competence. Some examples of online courses are:
    Interacoustics Academy Balance Testing Training
    360 Neurohealth
    Health Click: Physical Therapy Continuing Education
  2. Enroll in post-graduate programs or courses designed explicitly for vestibular rehabilitation. Here are some program examples:
    Vestibular Physical Therapist Certificate Program | University of Pittsburgh
    Physical Therapy Continuing Education | Duke University
  3. Seek certification and hands-on training through professional organizations like the American Institute of Balance (AIB).
  4. Become a Neurologic Clinical Specialist. A Neurologic Clinical Specialist (NCS) is a highly specialized and licensed physical therapist who has demonstrated exceptional expertise in the field of neurologic rehabilitation.

To obtain this title, you need to have 2,000 hours of practical experience. This experience should be in treating patients with conditions like stroke, brain injury, multiple sclerosis, or spinal cord injury.

Many educational institutes offer residency programs to become neurological physical therapists. You can find a list of residency programs accredited by the American Physical Therapy Association (APTA) here.

The simple answer is anyone with a history of falls or complaining of dizziness, vertigo, or imbalance. Physical therapists are adept at treating various vestibular disorders, including benign paroxysmal positional vertigo (BPPV), vestibular neuritis, labyrinthitis, Ménière's disease, and central vestibular disorders.

Adding balance equipment into your practice as a physical therapist offers several significant benefits, including:

  • Enhances your ability to accurately assess your patients' conditions, providing a more comprehensive understanding of their needs.
  • Allows for implementing highly targeted and precise treatment plans, improving patient outcomes, and minimizing discomfort during therapy.
  • Recording capabilities simplify the evaluation process, eliminating the need for repetitive maneuvers. The ability to record results not only reduces patient frustration but also optimizes the efficiency of your treatment.
  • Using advanced equipment can reduce the number of trials needed to address your patients' concerns. This leads to more efficient and successful care.
  • Therapists can visually demonstrate a patient's progress using objective data, comparing it to previous sessions. This concrete proof of improvement inspires patients and encourages their continued participation.
  • Using the latest technology in competitive markets can attract and keep physical therapy patients, making your clinic stand out.

Balance Equipment Essentials

The VisualEyes™ 505 Video Frenzel system offers comprehensive clinical data and nystagmus detection for diagnosing vestibular disorders.

To enhance your functional assessments, consider adding the VORTEQ™ Assessment bundle. This bundle includes additional tests such as Advanced Dix-Hallpike, Lateral Head Roll, Gaze Stabilization, and Dynamic Visual Acuity.


Balance Equipment Additions

Using a force plate can offer you a more comprehensive understanding. Studying the center of movement or pressure provides more accurate information about someone's balance than simply observing their swaying. This allows for a better understanding of their balance. This capability offers valuable biofeedback, enabling PTs to gauge a patient's condition and track progress.

For those seeking practical tools for balance assessment, the Virtualis system stands out. It provides both static and balance versions, making it a versatile and cost-effective solution.

With Virtualis, you can accurately measure and assess balance problems, leading to personalized treatment plans.

Virtualis StaticVR

Virtualis BalanceVR

Once you establish yourself as the balance expert, consider acquiring additional equipment to effectively assist all your patients. Other specialized equipment may include:

Interacoustics Orion Rotary Chair

Interacoustics TRV Chair

When adding vestibular therapy to your practice, it is essential to understand the CPT codes associated with these services.
The most common CPT codes for vestibular therapy are:

  • 97112: Neuromuscular reeducation
  • 97116: Gait training
  • 97110: Therapeutic exercises
  • 97140: Manual therapy techniques
  • 92540: Basic vestibular evaluation
  • 92541: Comprehensive vestibular evaluation

Codes may differ by insurance provider, so it is crucial to check with each company to ensure accurate billing.

*Note: this blog is not an official billing document and should not be used for billing vestibular services.

Marketing your vestibular rehabilitation services is crucial to attract patients and grow your practice. Here are some effective strategies to consider:

  • Build a professional website highlighting your vestibular services, teams, and success stories.
  • Use your current patient database to announce your added services via email marketing or newsletter.
  • Partner with local news broadcasts to showcase your specialized services and innovative equipment.
  • Implement SEO strategies to boost your website's visibility in search results.
  • Create valuable blog posts, videos, and social media content that address common vestibular issues and highlight your expertise.
  • Work with doctors and specialists to get patients referred and hold workshops or webinars to educate about vestibular disorders.
  • Foster relationships with local healthcare providers and encourage patient referrals through word-of-mouth recommendations.

In closing here is some advice from e3 Diagnostic's balance expert Michael Hoeper, former practicing vestibular physical therapist:

"The most important advice I could offer someone is you don’t need to be an expert to make a difference in your patient’s life. There are a lot of patients that need these services, and a lot of the skills are useful for other patient populations as well. The more data you have, the easier it will be to understand what your patient needs, monitor their progress, and provide effective treatment solutions.”

Providing vestibular rehab services meets healthcare needs and is a rewarding specialization for physical therapists to pursue. To succeed in this field, you need dedication and the right tools. The rewards for patients and your practice are significant.

Seeking expert guidance on integrating vestibular services into your practice? Reach out to your nearby e3 Diagnostics representative today.

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Thank you to Michael Hoeper PT, MPT, and Patrick Olivio for contributing expert insights for this article.

Michael Hoeper PT, MPT, a physical therapist and vestibular and balance therapy specialist, holds a competency-based certification in vestibular rehabilitation. As a Regional Balance Specialist with e3 Diagnostics, he brings extensive expertise. Mike, a University of Wisconsin graduate with a master’s degree in physical therapy, started at The Monroe Clinic in 2006, evolving from an orthopedic therapist to a specialist in neurologic, balance, and vestibular impairments since 2008. Actively engaged with Computerized Dynamic Posturography since 2007, he became the lead neuro and vestibular PT at Monroe Clinic in 2011. Mike joined e3 Diagnostics in November 2020.

Patrick Olivo, with over 15 years in the healthcare industry, currently serves as the US Business Manager at e3 Diagnostics. His dedication to enhancing patient outcomes through education in balance and virtual reality solutions is unmatched. Previously, he was the General Manager at Virtualis VR, leading the go-to-market strategy for patient rehabilitation innovations in the Balance and Mobility business. Patrick also held multiple roles at Philips medical, focusing on business development for National Key Accounts in oral healthcare products, including Sonicare and Zoom Whitening.

Other Good Reads: e3 Diagnostics Adds Virtual Reality Balance Equipment


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