40138 - EVALUATION AND TREATMENT OF THE VERTIGOOUS PATIENT

Subject type: Optional

Coordinator: Marc Terradellas Fernández

Trimester: Second term

Credits: 4

Academic year: 2024

Teaching course: 4

• Catalan

In this subject, the basics of Vestibular Physiotherapy, a field of action still under development in our country, will be addressed. Students will know and understand the anatomy and physiology of the vestibular system, located in the inner ear and a fundamental element to be able to generate the correct postural reactions of stability and balance. The detailed review of the physiology will ground and facilitate the understanding of the proposal for the exploration in the dizzy patient or with a deficit of postural stability. During the practical development of the clinical examination, the main clinical tests of the vestibular function will be reviewed. In addition, specific clinical vestibular tests such as the Hamalgy, Head Shaking Test, Dix Hallpike and Mc Clure maneuvers will also be performed. In a very specific way, the students will learn to interpret the examination with the use of videonystagmoscopy, a fundamental element in the diagnosis to be able to detect the presence of a nystagmus (a sign always associated with the patient's vertigo). A conceptual review will be made of the main clinical entities such as Meniere's disease, vestibular neuritis, vestibular hypofunction, neurinoma of the acoustic nerve, vestibular migraine and BPPV (benign paroxysmal positional vertigo). Taking into account the recommendations of the main international guidelines for clinical practice, physiotherapy treatment will be addressed in these pathologies and, more specifically, in the case of BPPV, since it represents the most prevalent form of vertigo in the population with high scientific evidence of the the effectiveness of the treatment maneuvers used (Epley, Semont and Lempert maneuvers). In a practical way, students will be able to design intervention programs aimed at improving the vestibular-spinal function, understanding in a parallel way the principles of rotary vestibular stimulation and optokinetic stimulation as integral elements of Physiotherapy treatment vestibular

The distribution of the theoretical and/or practical content of the subject can be consulted in the timetable and sections of the corresponding virtual classroom before it starts. This subject aims to introduce the gender perspective in its content and development. In addition, the objectives are aligned with the Sustainable Development Goals (SDGs) of the 2030 Agenda of the United Nations. 

The classroom (physical or virtual) is a safe space, free of sexist, racist, homophobic, transphobic and discriminatory attitudes, either towards students or towards teachers. We trust that together we can create a safe space where we can make mistakes and learn without having to suffer prejudice from others.  

Topic 1. Anatomy and physiology of the vestibular system.

Physiological bases of postural control

Functions of the vestibular system

Anatomy and physiology of the vestibular system

Topic 2. Pathophysiology of central and peripheral vestibular disorders.

Clinical semiology of vestibular dysfunction

Main clinical entities

Medical treatment of the dizzy patient

Topic 3. Instrumental diagnostic tests for peripheral vestibular pathology

Caloric vestibular scan, videonystagmography, vHIT and vestibular Vemps)

Topic 4. Clinical evaluation of the dizzy patient

Clinical questioning

Clinical evaluation of oculomotor function

Clinical evaluation of vestibular-spinal function

Exploration of spontaneous nystagmus and provocation maneuvers (Head Shaking Test, Dix Hallpike).

Clinical interpretation of the Hamalgyi maneuver or Head Thrust Test

Functional tests and assessment scales for patients with balance disorders or vertigo.

Topic 5. Evaluation and treatment of the patient with BPPV

Clinical maneuvers for BPPV exploration

Otolithic repositioning maneuvers

Topic 6. Basics and general principles of vestibular physiotherapy

The central compensation

Principles of rotary stimulation

Principles of oculomotor and vestibular-spinal work

Principles of optokinetic stimulation

This subject may consider the following indicators detailed in the table in the evaluation proposal:

A system of quantitative (from 0 to 10) and qualitative (suspended, approved, notable, excellent, honorary registration) is used according to RD 1125/2003.  

The subjects will have evaluation and recovery activities in accordance with the teaching guide and the subject's learning plan, published in their virtual classroom and which will establish the necessary requirements to be able to participate.  

In accordance with current UPF regulations, all students who, having participated in the learning and assessment activities during the term, have obtained a failing grade for the corresponding subject in the quarterly assessment may participate in the recovery process . Those who have not participated in the learning and assessment activities or who have waived the assessment will not be able to participate. If the grade is "not submitted", you will not be able to opt for recovery and therefore the subject will have to be taken again in its entirety in the following academic year. 

In the event of copying, plagiarism or illegitimate use of generative artificial intelligence in any assessment activity, you must consult the TecnoCampus University Center's Undergraduate and Master's Course Assessment Regulations.  

Assistance and Rules of Conduct

Attending class without respecting the basic rules of hygiene and uniform dress may be sanctioned. During the practices in class, students may not wear objects that could interfere with the execution of the techniques, such as rings, watches, bracelets, long earrings, etc.

It will be essential to comply with an attendance of no less than 80% of the hours in order to pass the subject. In case of non-compliance with this rule, the subject will be suspended and will have to be re-enrolled in the following academic year.

Chays, A. Florant, E. Ulmer. Vertigo, 2nd edition. Elsevier Masson SAS; 2009.

Herdman, SJ, Clendaniel, RA Vestibular Rehabilitation, 4th Ed. Philadelphia: Davis Company; 2014

Jean-Pierre Sauvage. Vertigo: diagnosis and rehabilitation manual, 2nd edition. Barcelona: Elsevier Spain; 2017

Hassid, N. Hennaux, C. Van Nechel, C. Vestibular rehabilitation. Paris: Éditions Frison-Roche; 2009.