Telerreabilitação e fisioterapia: proposta de avaliação fisioterapêutica aplicada às disfunções vestibulares

Abstract

Background: telerehabilitation has been applied for respiratory rehabilitation in patients with COVID-19, neurological rehabilitation in post-stroke patients, musculoskeletal rehabilitation after hospital discharge, and several other areas of physiotherapy. However, there are still few studies related to the application of this resource for the evaluation and treatment of vestibular disorders. Objectives: to propose a physiotherapeutic evaluation protocol applied to central and peripheral vestibular dysfunctions for the remote format. Methods: Initially, physiotherapists with experience in the field of Vestibular Physiotherapy held meetings to discuss adaptation strategies for the remote format of face-to-face physical therapy assessment. Then, a bibliographic review on telehealth in the context of physiotherapy was carried out to support the elaboration of the protocol using the following databases: Pubmed and SciELO. The search strategy comprised the terms “telehealth”, “telerehabilitation”, “vestibular disease”, “dizziness”, “vertigo” and “postural balance”. Results: the physiotherapeutic assessment protocol for the remote format contains the adaptation of nine oculomotor tests, two static balance tests, a dynamic gait balance test, the use of a questionnaire that assesses the impact of dizziness on quality of life, observation cervical mobility, in addition to collecting data on the intensity and characteristics of dizziness. Conclusion: despite the existence of barriers in telerehabilitation, such as technical problems related to the quality of the equipment and the stability of the internet network, this approach comprises a way of expanding clinical practice, allowing it to reach populations that are more distant from large urban centers, individuals with difficulty accessing locomotion or even contexts of social isolation such as the one faced in the pandemic of the new coronavirus. Thus, new studies can be carried out to verify the measurement properties of the proposed protocol in relation to face-to-face care.