Question 37291 — health professions

Summary

Mr. Jean-Pierre Door draws the attention of the Minister of Solidarity and Health to the definition of people authorized to carry out vestibular rehabilitation. Vestibular rehabilitation is a sensory balance rehabilitation that uses the interaction between vision, the balance organ located in the inner ear, the mechanical sensors of the muscles of the spinal column and the feet. Today it constitutes a very widely recognized specialization of physiotherapy and it is widely practiced, including in hospitals because it is based on incontestable scientific data. Vestibular physiotherapy occupies a specific place in the therapeutic arsenal against dizziness and balance and walking disorders. It aims in fact to correct three categories of disorder: a postural, proprioceptive or neuro-visual. However, certain paramedical professionals, under cover of authorization to perform neurosensory assessments, practice vestibular physiotherapy, outside of any legislative or regulatory framework. Thus certain orthoptists whose function is to detect, analyze and treat visual disorders, competent in vestibulo-visual rehabilitation, broaden their interventions by practicing the rehabilitation of patients suffering from a vestibular disorder in the broad sense of the term. Today the exercise of vestibular rehabilitation is much broader than originally. The method has become a rehabilitation specialty, with the implementation of a precise clinical examination that is increasingly codified, a diagnosis of vestibular function which integrates an otoneurological, neurological and musculoskeletal assessment, as well as treatment procedures. specific. He asks why health insurance covers a higher cost of the neurosensory assessment, when it is carried out by an orthoptist rather than by a vestibular physiotherapist, the only one legally authorized to practice it. He therefore also asks why vestibular rehabilitation procedures also practiced by other professionals outside the general nomenclature of professional procedures are reimbursed by health insurance. Finally, he asks if there are plans to better delimit and adapt, to articles R. 4321-5 et seq. of the public health code, the scope of competence of the vestibular physiotherapist.

Machine translation from French. The official text remains authoritative.

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