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Basic Vestibular Rehabilitation

Part 1 : 19th 20th November 2011 Part 2 : 3rd December 2011 (Competency Exams)
SYNOPSIS Vestibular Rehabilitation adopts an exercise-based approach in the management of dizziness and balance disorders associated with vestibular pathology. This course aims to equip physiotherapists with the knowledge and skills to evaluate and treat common vestibular disorders, such as benign paroxysmal positional vertigo (BPPV), unilateral and bilateral vestibular loss resulting from peripheral vestibular dysfunctions, traumatic brain injury and stroke. This Basic Vestibular Rehabilitation Workshop has been conducted since 2001, including 2 sessions in Kuala Lumpur, Malaysia and 3 runs in Hong Kong. The same faculty has also conducted the first Advanced Vestibular Rehabilitation Workshop in Singapore in March 2011. METHODOLOGY There will be lectures and practical sessions aimed at promoting the integration and application of evaluation and treatment techniques for patients with complex vestibular disorders. The course will also include interactive video laboratory sessions and case studies, which aim to challenge physiotherapists toward a problem-solving approach in management of patients with vestibular dysfunction. The clinical competency and written exams at the end of the workshop are designed to assess physiotherapists skill sets in vestibular rehabilitation and test their knowledge based of this specialized field of physiotherapy. TARGET PARTICIPANTS Physiotherapists specializing in the areas of vestibular rehabilitation, neurology, geriatric, medical & musculoskeletal will benefit from the workshop. COURSE OBJECTIVES Upon completion of this workshop, participants will be able to : 1. Gain an understanding of the anatomy and physiology of the vestibular system. 2. Recognize common clinical signs and symptoms and relate them to functional implications. 3. Distinguish between peripheral and central causes of dizziness and imbalance. 4. Perform vestibular assessment, integrate clinical findings and patients symptoms to formulate appropriate treatment plans. 5. Perform appropriate treatment techniques for benign paroxysmal positional vertigo, unilateral and bilateral vestibular loss, and central vestibular disorders. 6. Evaluate the effects of vestibular rehabilitation. WORKSHOP DETAILS Date Time : 19th 20th Nov 2011 & 3rd Dec 2011 : 19th Nov : 8.30 am 7.00 pm 20th Nov : 8.30 am 6.30 pm 3rd Dec : 1.00 pm 5.00 pm Closing date For enquiry Fee : $600 for SPA members $720 for Non-SPA members : 20th October 2011 : AHINet@ttsh.com.sg

Venue : 19th Nov am : TTSH Conference Room 3 (TTSH Level 1)

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19th Nov pm, 20th Nov & 3rd Dec : Physiotherapy Outpatient Clinic (TTSH Level B1)
* Certificate of achievement will be conferred upon completion of course & passing of the competency exams.

TRAINERS MS TEE LEE HUAN Principal Physiotherapist (TTSH, Singapore) Vestibular Rehabilitation Therapist (USA) B (Phty) (Australia), MPhty (Neurology) (Australia)
Lee Huan received her Masters in Physiotherapy (Neurology) from the University of Queensland, Australia in 2002. She has completed the Vestibular Rehabilitation Competency-based Course and Advances in Vestibular Rehabilitation Competency-based Course in USA by Dr Susan Herdman and faculty in 2001 and 2007 respectively. She has also attended the NeuroCom Balance Master Clinical Integration Seminar. With a great interest in rehabilitating patients with both peripheral and central vestibular dysfunctions, Lee Huan currently manages patients with neurological conditions at the Physiotherapy Department, Tan Tock Seng Hospital. In addition, she also treats patients with vestibular and balance disorders in the Vestibular Rehab Clinic at the Department of Otolaryngology. Lee Huan also has a strong passion in teaching and mentoring in the areas of neurological and vestibular rehab and has conducted Vestibular workshops both locally and regionally.
Publications: 1) Tee LH, Chee NWC (2005) Vestibular Rehabilitation Therapy for Dizzy patients. Annals of the Academy of Medicine journal. 2) Tee LH, Chee NWC, Zhu M & Jin J. Is activity restriction essential after Canalith Repositioning Treatment for Benign Paroxysmal Positional Vertigo? - pending publication 3) Tee LH, Chee NWC, Zhu M & Jin J (2010). Functional Outcomes after Customized Vestibular Rehabilitation in Subjects with Chronic Vestibular Dysfunction. Physiotherapy Singapore 13 (2); 4 - 7 Paper Presentation: 1) Is activity restriction essential after Canalith Repositioning Treatment for Benign Paroxysmal Positional Vertigo? - presented at Singapore Physiotherapy Congress 2006 (Singapore) 2) Functional Outcomes after Customized Vestibular Rehabilitation in Subjects with Chronic Vestibular Dysfunction - presented at Combined Scientific Meeting 2005 (Singapore) 3) The normative values for unipedal stance, time up & go test & functional reach test for community dwellers in Singapore - presented at Tan Tock Seng Hospital 9th Annual Scientific Meeting 2001. Awarded best poster award for nursing/ paramedical 4) Vestibular Rehabilitation - presented during the 1st, 2nd and 3rd Singapore Hands on Vertigo workshop for GPs in 2009 & 2010 - presented during Tan Tock Seng Hospital 1st Vertigo Masterclass Workshop for Doctors in 2009 5) Vestibular Rehab and Home Therapy - presented during 1st Otology and Skull Update 2010 (Singapore) 6) Presented during 3rd Vertigo Masterclass: Falls and Balance Symposium Vestibular Rehab 19 Feb 2011 7) Presented during 4th Singpaore Practical Vertigo Workshop Home Therapy in Vertigo 21 May 2011

MS SEAH WEI WEI Senior Physiotherapist (TTSH, Singapore) Vestibular Rehabilitation Therapist (USA) MSci Physiotherapy (United Kingdom), MPhty (Neurology) (Australia)
Wei Wei obtained her Masters in Science (Physiotherapy) from King's College London in 2002 and Masters in Physiotherapy (Neurology) from the University of Queensland, Australia in 2006. She has a strong interest in working with patients with acute and chronic vestibular dysfunction. Her work experience also includes working with patients with neurological disorders including stroke and brain injury as well as elderly patients. In 2008 Wei Wei completed the Vestibular Rehabilitation A Competency Based Course in Atlanta, USA by Dr Susan Herdman and faculty and in 2010, the Spinning beyond Basics an Advanced Vestibular Rehabiltiation Course by Dr J. Holmberg in New Mexico USA. Wei Wei has been actively involved in conducting workshops for physiotherapists in the areas of neurological, geriatric and vestibular rehabilitation as well as peer mentoring in vestibular rehabilitation. Currently, Wei Wei manages both inpatients and outpatients with vestibular dysfunctions as well as patients with acute neurological conditions. She is currently the Unit Head for Neuroscience team of physiotherapy department at Tan Tock Seng Hospital.
Paper Presentation: 1) Presented plenary lecture at 7th National Congress of Singapore Physiotherapy Association 2009 : Non-specific dizziness in elderly 2) Presented during 3rd Vertigo Masterclass: Falls and Balance Symposium Further Assessment of Balance-Posturography 19 Feb 2011

MR WEE SENG KWEE Principal Physiotherapist (TTSH, Singapore) Certified Brain Injury Specialist (USA), Vestibular Rehabilitation Therapist (USA) Certified International Lokomat Instructor (Switzerland) BSc (Hons) Phty (United Kingdom)
Seng Kwee is a Principal Physiotherapist, who holds the Rehabilitation Education portfolio at Tan Tock Seng Hospital Rehabilitation Centre. He graduated from King s College London with BSc(Hons) Physiotherapy and has been working with TTSH since 1995. Seng Kwee has completed the Vestibular Rehabilitation Competency-based Course & Advances in Vestibular Rehabilitation Competency-based Course in USA by Dr Susan Herdman & faculty in 2001 & 2007 respectively. He has also attended a workshop in Vestibular Testing and Rehabilitation Therapy in Missouri, USA, in 2000. Seng Kwee has a strong passion for working with brain-injured clients and has been with the Brain Injury Team for the past 14 years. In addition, he further specialised to become a Certified Brain Injury Specialist after excelling in the examinations accredited by the American Academy for Certified Brain Injury Specialists (ACBIS) in 2007. Currently, he manages traumatic brain injury patients with vestibular dysfunction. He has been sharing his experience and expertise in spasticity management using serial casting (upper and lower extremity), toe-spreader and neurorehabilitation techniques as well as vestibular rehabilitation in brain injury population through numerous workshops since 1999. He has also published and presented papers on brain injury and vestibular rehabilitation in scientific conferences. In recent years, he has conducted workshops in Laos, Spain, Hong Kong, Taiwan, China, South Korea and Malaysia. Seng Kwee has also been invited to chair and speak at several plenary lectures at national physiotherapy conferences. He was a Guest Speaker and Facilitator for the HMDP program (HMDP Rehabilitation Technology and Robotics Rehabilitation 2009) organised by National University Hospital. Seng Kwee has opportunity to be involved as a collaborator in a robotic upper limb trainer (Haptic Knob) with National University of Singapore. He is a Certified International Lokomat Instructor who conducts training in the use of Lokomat, the worlds first robotic gait orthosis which automates locomotion therapy on a treadmill.
Publications: 1) Wee SK and Lim PH (1999). Serial casting. N & G Network, Newsletter of the Neuroscience and Geriatric Special Interest Group; March issue; 1. 2) Niam S and Wee SK (1999). Relationship of unipedal stance time, age and falls in healthy Asian elderly. Physiotherapy Singapore; 2; 124 127. 3) Wee SK (2000). Serial casting and splinting. In Coping with Brain Injury : A guide for Patients and Families. Singapore : Future Print Pte Ltd. 4) Wee SK (2002). Vestibular rehabilitation for a patient with severe traumatic brain injury : a case study. Physiotherapy Singapore; 5; 59 65. 5) Wee SK (2007). Dizziness and balance problems after traumatic brain injury. In Coping after Brain Injury : Empowering Families, Moving Ahead. Singapore : Future Print Pte Ltd. 6) Kong KH, Wee SK, Ng CY, Chua SG, Chan KF, Venketasubramanian N, Chen C (2009). A double-blind, placebo-controlled, randomized phase II pilot study to investigate the potential efficacy of the Traditional Chinese Medicine Neuroaid (MLC 601) in enhancing recovery after stroke (TIERS). Cerebrovascular Diseases; 28; 514 521. 7) Wee SK (2010). Management of multiple canal involvement in benign paroxysmal positional vertigo. Physiotherapy Singapore 13(2) ; 8 - 11. 8) Co-author for Clinical Practice Guide for Rancho Levels for usage within Tan Tock Seng Hospital. October 2008 9) Co-editor for TTSH neuroREHAB brochures English and Chinese versions January 2009 Paper Presentation: 1) Normative Values of Unipedal Stance Time in Healthy, Asian Elderly - presented together with Ms Susan Niam at Tan Tock Seng Hospital Annual Scientific Meeting 1996 - awarded the Best Paramedical / Nursing Paper 2) Vestibular Rehabilitation for a patient with severe traumatic brain injury Case Report - presented at the World Confederation of Physical Therapy (Asia-Pacific region) July 2001, Singapore 3) Management of multiple canal involvement in patients with benign paroxysmal positional vertigo - presented at 6th National Congress of the Singapore Physiotherapy Association Aug 2006, Singapore 4) Incidence and treatment of benign paroxysmal positional vertigo in traumatic brain injury patients - presented at National Healthcare Group Annual Scientific Congress 2008, November 2008, Singapore 5) Presented plenary lecture at 7th National Congress of Singapore Physiotherapy Association 2009 : The trend of neurorehabiliatation - is there evidence of higher technology training 6) Presented lecture at Annual Scienitifc Meeting 2010, Hong Kong Association of Rehabilitation Medicine : Robot-Assisted Gait Rehabilitation 7) Presented lecture at The 5th Beijing International Forum on Rehabilitation 2010, Beijing, China : Lokomat Evidence : Looking Beyond the Robotic Exoskeleton

PROGRAMME Saturday : 19th November 2011 0830 0900 REGISTRATION 0900 0945 Lecture: Anatomy & Physiology of the Vestibular System (Wei Wei) 0945 1100 Lecture: Clinical Examination of Patient with Dizziness (Seng Kwee) 1100 1115 TEA BREAK 1115 1145 Lecture: Vestibular Function Tests (Seng Kwee) 1145 1300 Practical 1: Oculomotor Examination (Part 1) (All Trainers) 1300 1345 LUNCH 1345 1500 Practical 1: Oculomotor Examination (Part 2) (All Trainers) 1500 1600 Lecture: Pathology of the Vestibular System (Peripheral) (Wei Wei) 1600 1700 Lecture: Management of Patients with Peripheral Vestibular Disorders (Lee Huan) 1700 1715 TEA BREAK 1715 1730 Practical 2: Video Presentation on Advanced Vestibular and Balance Exercises (All Trainers) 1730 1830 Practical 3: Treatment Techniques for Patients with Vestibular Dysfunction (All Trainers) 1830 1900 Question & Answer / Discussion (All Trainers) Sunday : 20th November 2011 0830 0900 Oculomotor Examination Discussion (All Trainers) 0900 1000 Lecture: Clinical Assessment of Balance and Gait (Wei Wei) 1000 1015 TEA BREAK 1015 1215 Lecture: Benign Paroxysmal Positional Vertigo (BPPV) Assessment & Treatment of Posterior, Anterior and Horizontal Canal BPPV (Lee Huan) 1215 1230 Practical 4: Video Presentation on Nystagmus (BPPV) (All Trainers) 1230 1315 LUNCH 1315 1445 Practical 5: Assessment & Treatment of Posterior, Anterior & Horizontal Canal BPPV (Part 1)
(All Trainers)

1445 1545 Practical 5: Assessment & Treatment of Posterior, Anterior & Horizontal Canal BPPV (Part 2)
(All Trainers)

1545 1600 TEA BREAK 1600 1700 Lecture: Management of Patients with Central Vestibular Disorders (Seng Kwee) 1700 1730 Case Study (Lecture) (Lee Huan) 1730 1800 Nystagmus Video Case Studies (All Trainers) 1800 1830 Question and Answer / Discussion (All Trainers) Saturday : 3rd December 2011 1300 1515 Clinical Competency Exams (All Trainers) 1515 1530 TEA BREAK 1530 1600 Nystagmus Video Exams (All Trainers) 1600 1700 Written Exams (MCQ) (All Trainers) 1700 END OF COURSE