• Any member of the Academy of Neurologic Physical Therapy (ANPT) of the APTA can be a SIG member
• Just click on the orange icon “Sign UP! Join a Special Interest Group” on the Academy of Neurologic Physical Therapy Home page: http://www.neuropt.org/about-us
• The Vestibular Rehabilitation SIG welcomes international physical therapists. If you live in a country other than the United States and are not eligible for membership in the APTA, you can become a SIG member, by join the ANPT  Partners Program.
• The partners program brochure and application can be found on the Join tab of the ANPT website: http://www.neuropt.org/join/partners-program

• The Vestibular Rehabilitation SIG acknowledges new members with a welcome email soon after signing up. Some therapists have used this welcome letter to verify membership
• Members that volunteer in leadership roles or contribute to SIG initiatives are always acknowledged. Written verification of your participation to those types of activities can be attained from ANPT  or SIG leaders.
• The resources provided by this SIG are free to any member of the ANPT.

• Being a member, learning more about Vestibular Rehabilitation, exchanging ideas, and using our resources may be enough for some. However, if you would like to be more involved, these are some suggestions.
• The best way to meet members and our leadership group is to attend our Business Meeting at CSM. You can refer to programming materials for specific details about this meeting.
• The individuals who lead this group and contribute to its activities are always willing to talk about Vestibular Rehabilitation. You can find contact information on the leadership page.
• The best way to get more involved is to email the Vestibular Rehabilitation SIG Chair. The Chair may be able to match you to activities or jobs that are needed. Some examples include: writing fact sheets or articles for our newsletter or helping with the Abstract of the Week, the podcasts, the webpage, or the Dizzy Pub Fare.
• Periodically, when a new initiative comes out, such as the Vestibular Rehabilitation EDGE Taskforce. The ANPT may send out requests for individuals with Vestibular Rehabilitation experience to participate. This is usually done through email and there may be an application process to participate.

• There are many courses advertised to improve knowledge and skill in Vestibular Rehabilitation.
• Courses may be offered at different clinical experience levels. Courses may cover an overview of Vestibular Rehab, or be specific to a diagnostic group.
• There are also many different organizations that sponsor courses in Vestibular Rehabilitation.
• Tips for selecting courses:

1. Evaluate your level of expertise and ask what level the course is being taught
   • Introduction Courses are for those who have no (or little) experience and little knowledge.If you had a good introduction in your physical therapy program, but have not been able to practice in this area, this would be a good place to start
   • Intermediate Courses are for those who have taken an introduction and have begun to evaluate and treat individuals with vestibular related symptoms or pathologies, but would like to further their clinical skills or expand the scope of practice.
   • Advanced Courses are for those who have taken a few courses in Vestibular Rehabilitation, have good clinical expertise, and they wish to enhance problems solving and capability to work with complex patients and atypical presentations.
2. Evaluate your scope of practice in vestibular rehabilitation
   1. The scope of VR practice is increasing. Many populations, diagnostic groups or practice settings may not be covered well in a general Vestibular Rehabilitation course.
   2. More courses are developed for a specific population or setting.
      1. Courses that focus on pediatrics, acute care, cervicogenic, BBPV, central disorders, or post-concussion management are examples of courses or CSM program sessions that have been given in the past
      2. If you want to expand your practice in one of these areas you should search under that content and look for experts in that field to be primary speakers.
3. Evaluate the authority of the speakers and/or organization that is presenting the material.
   1. A course should have speaker biographies with documented history of advanced vestibular clinical practice and/or research.
   2. A course should be able to provide reference lists to verify that information is current and accurate.
   3. A course should evaluate course outcomes and participant satisfaction.

Universities or professional organizations are more likely to present high quality courses.   For example:  The ANPT of the APTA sponsors two Vestibular Rehabilitation courses: An Introductory course and an Advanced Vestibular Rehabilitation course.  These courses are usually presented at least 2 times a year at various locations across the country.  Multiple clinicians and researchers have developed these courses. The Academy of Neurologic Physical Therapy Educational Committee evaluates all sponsored courses for quality.

The Vestibular Rehabilitation Special Interest Group has outlined this pathway to assist physical therapists interested in advancing their vestibular assessment and rehabilitation skillset.  Click HERE for the document.

• Currently the APTA does not offer a certification process for physical therapists in Vestibular Rehabilitation. APTA does co-sponsor a competency-based course series in Vestibular Rehabilitation with Emory University. Therapists often mistake those courses as certification courses.
  

• There is a link to a map of vestibular rehabilitation providers located on the Vestibular SIG website.
• If you are not listed on this map and would like to be added, there are instructions listed on the website.
• Other vestibular disorder support groups, such as VEDA (www.vestibular.org), list vestibular providers on their webpage.

• Educate yourself regarding the scope of Vestibular Rehab and types of patients seen.
  1. Participating in appropriate (level of difficulty, patient population) continuing education courses is one of the best ways to further your knowledge
  2. If there are other therapists practicing vestibular therapy in your area or at your clinic, hands on or observational learning may be another option.
  3. Utilize resources such as those provided on the Vestibular SIG website such as patient and physician fact sheets. You may also want to purchase a comprehensive textbook on vestibular rehabilitation to have available for reference.
  4. Through your learning process, you should note if there is any equipment that needs to be purchased in order properly assess and treat patients with vestibular disorders. (see below for recommendations)
  5. The Vestibular Rehabilitation SIG can provide you with opportunities to stay up to date with research and current practice. Some options include: attending CSM vestibular programming, reading the “Abstract of the Week” emails, following the “Dizzy Pub Fare” article review, and reading articles in the Vestibular Rehabilitation SIG Newsletter.
• Equipment: There are both low cost and high cost options depending on the needs and budget of your clinic.
  1. Simple-low cost options:
     • Educational posters of Vestibular system
     • Ear Model with vestibular system
     • AVOR app on iPad (free)-helpful for patient and MD education
     • Vibrator for maneuvers
     • Test foam for consistent measure (neurocom foam)
     • Frenzels lens (~$700)
     • Proprioception devices(various tilt and wobble boards, etc)
  2. Complex- higher cost options:
     • Infrared Goggles ($4-6K range)
       • Include computerized recording
     • Computerized Balance Measuring Devices
       • Neurocom/Natus (various units with differing costs)
       • Biodex
• Reimbursement:
  1. The Vestibular Rehabilitation SIG has outlined codes and references for outcome measures in detail on the website.
  2. The APTA practice and advocacy page has a FAQ page on reimbursement for Vestibular Rehab.
  3. Common codes used for reimbursement include 97110 (Therapeutic exercise),97112 (Neuromuscular reeducation), and 95992 (canalith repositioning maneuver)
• Marketing:
  1. Physicians (ENTs, Neurologists, General Practitioners, Orthopedics)
     • Educate physicians, CRNP’s, PA’s regarding peripheral dysfunction and the role of balance and gait as well as potential fall risk. Education should include peripheral dysfunction, central disorders, age related dysfunction and co-morbidities such as neuropathy.
  2. Community
     • Consider writing articles for local newspaper and using resources of social media. Posting videos and podcasts can be useful for education and promotion.
     • List your name on the provider map of the VR SIG website and on VEDA website (members only) as resources for patients seeking out vestibular therapy.
     • Host or participate in educational forums in your clinic for community and/or physicians.
     • Consider your target population when using written advertisement
       • Utilize keywords that label patient symptoms to help draw their attention. Keywords from5 DHI predictor questions (Whitney 2005): vertigo with looking up, rolling over in bed, bending, quick head movements, getting out of bed
       • Use large print and good contrast sensitivity for aging eyes