Vestibular Rehabilitation

Base Knowledge

– Anatomophysiology of the peripheral and central vestibular system;
– Clinical evaluation of the patient with vestibular symptoms;
– Analysis and interpretation of vestibular assessment tests;
– Relate the results of the vestibular evaluation tests with the vestibular syndromes and symptoms.

Teaching Methodologies

Theoretical-practical classes of expository and dialogical teaching using audiovisual media, which can be taught remotely, up to 25% of the hours. Conducting little groups work in the classroom and viewing videos and scientific articles on clinical cases.
The practical classes will have demonstrative and practical teaching, which will allow students to learn in a
roleplay dynamic.

Practical classes will also be taught in a hospital context with real clinical cases.

Learning Results

In TP componente, the student is expected to:

– Aqcuire knowledge on the principles of vertibular rehabilitation, its indications and contraindications;
– Know the equipments and strategies avaiable to use in vestibular rehabilitation;
– Know the role of the Audiology licentiate in a vestibular rehabilitation inter-disciplinar team.

In PL component, the aim is for the student to able to:

– know how to do individual vestibular rehabilitation plans for each clinical situation.

Program

– Presentation and definition of dates and evaluation methodologies – 2h
– Repositioning maneuvers (BPPV) – 4h
– VR: General principles – 2h
Vestibular Compensation, Adaptation, Habituation and Substitution; Objectives, Indications and Contraindications;
– VR: Materials and equipment – 6h
Rotating Chair; Optokinetic Stimulation; Eye stability exercises; Posturography with virtual reality;

– VR strategies – 6h
Unilateral vestibulopathy; Bilateral vestibulopathy; Central vestibular disosders; Acute and chronic vestibular deficit.
– VR in psychogenic vertigo and in presbyvertigo – 2h
– Elaboration and Evaluation of the VR Plan – 4h
– Vestibular implant – 2h
– Written assessment – 2h

Practical classes: 30 hours for each group:
Repositioning maneuvers (BPPV)
Rotating chair at low and high frequencies
VR exercises through the posturography with virtual reality
Viewing of films with practical examples on the various topics covered
Analysis of clinical cases and preparation of RV plans
Observation of patients doing vestibular rehabilitation
Evaluation of the practical

Curricular Unit Teachers

Maria Inês Cardoso Araújo

Grading Methods

Continuous evaluation:
- T/P evaluation = 70% of the final grade
60% written frequency + 20% group work (with a minimum grade of 9.5 in each of the evaluations) + 20% of
the work carried out during classes.
- PL Evaluation = 30% in the final grade, whose classification must be at least 9.5 values:
15% repositioning maneuvers for BPPV + 15% questions about group work carried out in T/P.
The final evaluation consists of 70% of the final grade of the T/P component (whose classification must be at
least 9.5) + 30% of the final grade of the practical component (PL) (whose classification must be at least 9.5).

Exam evaluation:

- T/P component = 70% (written exam)

- PL component = 30% (15% repositioning maneuvers + 15% vestibular system assessment tests)


    Internship(s)

    NAO

    Bibliography

    Priority:
    – Eggers, S., Bistdorft, A.,Brevern, M., Zee, D., Kim, J., Perez-Fernandez, N. Newman-Toker, D. (2019).Classification of vestibular signs and examination techniques: nystagmus and nystagmus-like movements. Journal of vestibular Research, 29: 57-87.
    – Giardi, M., Randolph, A., Nakayama, M. (2005). Vestibular rehabilitation therapy for the patient with dizziness and balance disorders: exercise protocols. Canadá: Vestibular Techologies Publications
    – Herdman, S.J. (2002). Reabilitação vestibular. 2ª Edição. Barueri:Manole.
    – Herdman, S. J. (2007). Vestibular Rehabilitation. 3ª Edição. Philadelphia: Davis Company
    – Associação Portuguesa de Otoneurologia (2012). Reabilitação Vestibular. Abbot Laboratórios, Lda. Retrieved from:
    https://www.otoneuro.pt/images/stories/noticias/Reunioes_de_inverno/Livro_IV_Reuniao_Inverno_2012.pdf
    – Associação Portuguesa de Otoneurologia. (2017). Vertigem Posicional. Campo Maior. Retrieved from:
    https://www.otoneuro.pt/images/stories/noticias/Reunioes_de_inverno/Livro_IX_Reuniao_Inverno_2017_Livro.pdf
    – Associação Portuguesa de Otoneurologia. (2019). Vestibulppatia Bilateral. Cascais. retrieved from:
    https://www.otoneuro.pt/images/stories/noticias/Reunioes_de_inverno/xi_reuniao_de_inverno_2019.pdf
    – Baloh, R. W., Honrubia, V. (2001). Clinical Neurophysiology of the Vestibular System. Third Edition. Oxford University Press. 2001

    Optional:
    – Bronstein, A. M. e Lempert, T. (2007). Dizziness: A Practical Approach to Diagnosis and Management. Cambridge University Press.
    – Girardi, M. (2005). Vestibular Rehabilitation Therapy for the Patient With Dizziness and Balance Disorders: Exercise Protocols. Vestibular Technologies, L L C.
    – Jacobson, G. P. Shepard, N. T. (2008). Balance Funtion Assessment and Management. Plural Publishing. San Diego.
    -Maia, F., Albernaz, P., & Carmona, S. (2014). Otoneurologia Atual. Rio de Janeiro: Revinter