{"id":8026,"date":"2023-11-23T22:53:32","date_gmt":"2023-11-23T22:53:32","guid":{"rendered":"https:\/\/langs.physio-pedia.com\/introduction-to-vestibular-rehabilitation-it\/"},"modified":"2026-03-31T15:25:28","modified_gmt":"2026-03-31T15:25:28","slug":"introduction-to-vestibular-rehabilitation-it","status":"publish","type":"page","link":"https:\/\/langs.physio-pedia.com\/it\/introduction-to-vestibular-rehabilitation-it\/","title":{"rendered":"Introduzione alla riabilitazione vestibolare"},"content":{"rendered":"<div class=\"mw-parser-output\">\n<div class=\"editorbox\"><b>Redazione originale <\/b>&#8211; <a title=\"User:Jess Bell\" href=\"\/User:Jess_Bell\">Jess Bell<\/a> sulla base del corso di <a class=\"external text\" href=\"https:\/\/members.physio-pedia.com\/course_tutor\/bernard-tonks\/\" rel=\"nofollow\">Bernard Tonks<\/a><br \/>\n<b>Collaboratori principali<\/b> &#8211; <a class=\"mw-userlink\" title=\"User:Jess Bell\" href=\"\/User:Jess_Bell\"><bdi>Jess Bell<\/bdi><\/a>, <a class=\"mw-userlink\" title=\"User:Kim Jackson\" href=\"\/User:Kim_Jackson\"><bdi>Kim Jackson<\/bdi><\/a>, <a class=\"mw-userlink\" title=\"User:Lucinda hampton\" href=\"\/User:Lucinda_hampton\"><bdi>Lucinda hampton<\/bdi><\/a>, <a class=\"mw-userlink\" title=\"User:Tarina van der Stockt\" href=\"\/User:Tarina_van_der_Stockt\"><bdi>Tarina van der Stockt<\/bdi><\/a>, <a class=\"mw-userlink\" title=\"User:Rucha Gadgil\" href=\"\/User:Rucha_Gadgil\"><bdi>Rucha Gadgil<\/bdi><\/a>, <a class=\"mw-userlink\" title=\"User:Nupur Smit Shah\" href=\"\/User:Nupur_Smit_Shah\"><bdi>Nupur Smit Shah<\/bdi><\/a>, <a class=\"mw-userlink\" title=\"Utente:Jorge Rodr\u00edguez Palomino\" href=\"\/User:Jorge_Rodr%C3%ADguez_Palomino\"><bdi>Jorge Rodr\u00edguez Palomino<\/bdi><\/a> e <a class=\"mw-userlink\" title=\"User:Stacy Schiurring\" href=\"\/User:Stacy_Schiurring\"><bdi>Stacy Schiurring<\/bdi><\/a><\/div>\n<div id=\"toc\" class=\"toc\" role=\"navigation\" aria-labelledby=\"mw-toc-heading\"><input id=\"toctogglecheckbox\" class=\"toctogglecheckbox\" style=\"display: none;\" role=\"button\" type=\"checkbox\"><\/p>\n<div class=\"toctitle\" dir=\"ltr\" lang=\"en\">\n<h2 id=\"mw-toc-heading\">Contenuti<\/h2>\n<\/div>\n<ul>\n<li class=\"toclevel-1 tocsection-1\"><a href=\"#Introduction\"><span class=\"tocnumber\">1<\/span> <span class=\"toctext\">Introduzione<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-2\"><a href=\"#Epidemiology\"><span class=\"tocnumber\">2<\/span> <span class=\"toctext\">Epidemiologia<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-3\"><a href=\"#Defining_Dizziness_and_Vertigo\"><span class=\"tocnumber\">3<\/span> <span class=\"toctext\">Definire le vertigini e i capogiri<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-4\"><a href=\"#Causes_of_Dizziness_and_Vertigo\"><span class=\"tocnumber\">4<\/span> <span class=\"toctext\">Cause delle vertigini e dei capogiri<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-5\"><a href=\"#Signs_and_Symptoms_of_Vestibular_Disorders\"><span class=\"tocnumber\">5<\/span> <span class=\"toctext\">Segni e sintomi dei disturbi vestibolari<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-6\"><a href=\"#Anatomy_of_the_Peripheral_Vestibular_System\"><span class=\"tocnumber\">6<\/span> <span class=\"toctext\">Anatomia del sistema vestibolare periferico<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-7\"><a href=\"#Semicircular_Canals\"><span class=\"tocnumber\">7<\/span> <span class=\"toctext\">Canali semicircolari<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-8\"><a href=\"#Planes_of_Movement\"><span class=\"tocnumber\">7.1<\/span> <span class=\"toctext\">Piani di movimento<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-9\"><a href=\"#Ampullae\"><span class=\"tocnumber\">7.2<\/span> <span class=\"toctext\">Ampolla<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-10\"><a href=\"#Cupula\"><span class=\"tocnumber\">7.3<\/span> <span class=\"toctext\">Cupola<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-11\"><a href=\"#Otolith_Organs\"><span class=\"tocnumber\">8<\/span> <span class=\"toctext\">Organi otolitici<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-12\"><a href=\"#Vestibular_Reflexes\"><span class=\"tocnumber\">9<\/span> <span class=\"toctext\">Riflessi vestibolari<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-13\"><a href=\"#Vestibulo-spinal_reflex_(VSR)\"><span class=\"tocnumber\">9.1<\/span> <span class=\"toctext\">Riflesso vestibolo-spinale (VSR)<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-14\"><a href=\"#Vestibulo-Ocular_Reflex_(VOR)\"><span class=\"tocnumber\">9.2<\/span> <span class=\"toctext\">Riflesso vestibolo-oculomotore (VOR)<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-15\"><a href=\"#Push-Pull_Arrangement_of_the_VOR\"><span class=\"tocnumber\">9.3<\/span> <span class=\"toctext\">Meccanismo push-pull del VOR<\/span><\/a>\n<ul>\n<li class=\"toclevel-3 tocsection-16\"><a href=\"#Gain\"><span class=\"tocnumber\">9.3.1<\/span> <span class=\"toctext\">Guadagno<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-17\"><a href=\"#Nystagmus\"><span class=\"tocnumber\">10<\/span> <span class=\"toctext\">Nistagmo<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-18\"><a href=\"#Summary\"><span class=\"tocnumber\">11<\/span> <span class=\"toctext\">Sintesi<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-19\"><a href=\"#References\"><span class=\"tocnumber\">12<\/span> <span class=\"toctext\">Citazioni<\/span><\/a><\/li>\n<\/ul>\n<\/div>\n<h2><span id=\"Introduction\" class=\"mw-headline\">Introduzione<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Introduction\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;veaction=edit&amp;section=1\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Introduction\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;action=edit&amp;section=1\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<div class=\"floatright\"><a class=\"image\" href=\"\/File:Ear_Anatomy.png\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/8\/80\/Ear_Anatomy.png\/300px-Ear_Anatomy.png\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/8\/80\/Ear_Anatomy.png\/450px-Ear_Anatomy.png 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/8\/80\/Ear_Anatomy.png\/600px-Ear_Anatomy.png 2x\" alt=\"Anatomia dell'orecchio.png\" width=\"300\" height=\"242\" data-file-width=\"3100\" data-file-height=\"2500\"><\/a><\/div>\n<p>La riabilitazione vestibolare \u00e8 un approccio supportato dalle evidenze per gestire vertigini, capogiri, sensibilit\u00e0 al movimento, <a title=\"Equilibrio\" href=\"https:\/\/langs.physio-pedia.com\/it\/balance-it\/\">equilibrio<\/a> e problemi di controllo posturale che si presentano a causa di una disfunzione <a title=\"Sistema vestibolare\" href=\"\/Vestibular_System\">vestibolare<\/a> .<sup id=\"cite_ref-:0_1-0\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><sup id=\"cite_ref-2\" class=\"reference\"><a href=\"#cite_note-2\">(2)<\/a><\/sup><sup id=\"cite_ref-3\" class=\"reference\"><a href=\"#cite_note-3\">(3)<\/a><\/sup><sup id=\"cite_ref-4\" class=\"reference\"><a href=\"#cite_note-4\">(4)<\/a><\/sup><sup id=\"cite_ref-5\" class=\"reference\"><a href=\"#cite_note-5\">(5)<\/a><\/sup><\/p>\n<p>I pazienti con disturbi vestibolari hanno tipicamente problemi di stabilit\u00e0 dello sguardo, sensibilit\u00e0 al movimento, equilibrio e controllo posturale. La riabilitazione vestibolare si concentra quindi sulla risoluzione di queste aree di patologia o disfunzione. Tuttavia, l&#8217;approccio terapeutico specifico dipender\u00e0 dalla patologia e dalla presentazione unica di ciascun paziente.<sup id=\"cite_ref-:0_1-1\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup> \u00c8 quindi essenziale avere una conoscenza dettagliata del sistema vestibolare quando si tratta questo gruppo di pazienti.<\/p>\n<h2><span id=\"Epidemiology\" class=\"mw-headline\">Epidemiologia<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Epidemiology\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;veaction=edit&amp;section=2\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Epidemiology\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;action=edit&amp;section=2\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<div class=\"floatright\"><a class=\"image\" href=\"\/File:Ear.jpeg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/d\/db\/Ear.jpeg\/300px-Ear.jpeg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/d\/db\/Ear.jpeg\/450px-Ear.jpeg 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/d\/db\/Ear.jpeg\/600px-Ear.jpeg 2x\" alt=\"Orecchio.jpeg\" width=\"300\" height=\"182\" data-file-width=\"4441\" data-file-height=\"2690\"><\/a><\/div>\n<p>I disturbi vestibolari sono un problema significativo a livello globale.<sup id=\"cite_ref-6\" class=\"reference\"><a href=\"#cite_note-6\">(6)<\/a><\/sup> Si stima che il 35,4% dei nordamericani di et\u00e0 superiore ai 40 anni abbia avuto una qualche forma di disfunzione vestibolare. La probabilit\u00e0 di incorrere in una disfunzione vestibolare aumenta con l&#8217;et\u00e0.<sup id=\"cite_ref-:1_7-0\" class=\"reference\"><a href=\"#cite_note-:1-7\">(7)<\/a><\/sup><\/p>\n<ul>\n<li>L&#8217;80% delle persone di et\u00e0 superiore ai 65 anni soffre di capogiri, che nel 30-50% dei casi sono causati da <a title=\"Introduzione alla vertigine parossistica posizionale benigna\" href=\"\/Introduction_to_Benign_Paroxysmal_Positional_Vertigo\">vertigine parossistica posizionale benigna (BPPV)<\/a><sup id=\"cite_ref-:0_1-2\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/li>\n<li>Il 75% degli adulti di et\u00e0 superiore ai 70 anni ha problemi di equilibrio<sup id=\"cite_ref-:2_8-0\" class=\"reference\"><a href=\"#cite_note-:2-8\">(8)<\/a><\/sup><\/li>\n<li>Quasi l&#8217;85% degli adulti di et\u00e0 superiore agli 80 anni ha una disfunzione vestibolare<sup id=\"cite_ref-:2_8-1\" class=\"reference\"><a href=\"#cite_note-:2-8\">(8)<\/a><\/sup><\/li>\n<\/ul>\n<p>Le persone con disfunzioni vestibolari hanno una probabilit\u00e0 otto volte maggiore di <a title=\"Falls\" href=\"https:\/\/langs.physio-pedia.com\/it\/falls-it\/\">cadere,<\/a><sup id=\"cite_ref-:2_8-2\" class=\"reference\"><a href=\"#cite_note-:2-8\">(8)<\/a><\/sup> il che \u00e8 significativo in quanto le cadute sono associate ad un tasso importante di morbilit\u00e0 e mortalit\u00e0<sup id=\"cite_ref-:2_8-3\" class=\"reference\"><a href=\"#cite_note-:2-8\">(8)<\/a><\/sup> e a costi economici significativi.<sup id=\"cite_ref-9\" class=\"reference\"><a href=\"#cite_note-9\">(9)<\/a><\/sup> Inoltre, il numero di persone con disfunzioni vestibolari \u00e8 destinato a crescere per via dell&#8217;invecchiamento della popolazione.<sup id=\"cite_ref-:0_1-3\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<h2><span id=\"Defining_Dizziness_and_Vertigo\" class=\"mw-headline\">Definire le vertigini e i capogiri<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Modificare la sezione: Definire le vertigini e i capogiri\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;veaction=edit&amp;section=3\">modifica<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Modificare la sezione: Definire le vertigini e i capogiri\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;action=edit&amp;section=3\">modifica fonte<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Vertigini e capogiri non sono termini intercambiabili:<sup id=\"cite_ref-:0_1-4\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<ul>\n<li>Capogiri \u00e8 un termine non specifico utilizzato per descrivere una serie di sensazioni come stordimento, disorientamento e presincope<sup id=\"cite_ref-10\" class=\"reference\"><a href=\"#cite_note-10\">(10)<\/a><\/sup><\/li>\n<li>Le vertigini sono un tipo specifico di capogiri in cui si ha l&#8217;illusione di movimento nell&#8217;ambiente (ad esempio, rotazione, vortice)<sup id=\"cite_ref-:0_1-5\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/li>\n<\/ul>\n<p>Le vertigini sono causate da malattie vestibolari sia periferiche che centrali.<sup id=\"cite_ref-11\" class=\"reference\"><a href=\"#cite_note-11\">(11)<\/a><\/sup> Spesso sono rotatorie (cio\u00e8 la stanza gira intorno al paziente), ma possono anche verificarsi disturbi lineari o, meno comunemente, il paziente potrebbe avere la sensazione che il suo corpo si muova rispetto all&#8217;ambiente.<sup id=\"cite_ref-:0_1-6\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<p>Le vertigini e i capogiri sono entrambi fenomeni puramente soggettivi. Non esistono strumenti <a title=\"Outcome Measures\" href=\"\/Outcome_Measures\">oggettivi<\/a> per misurarli, quindi la storia soggettiva del paziente \u00e8 fondamentale.<sup id=\"cite_ref-:0_1-7\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<h2><span id=\"Causes_of_Dizziness_and_Vertigo\" class=\"mw-headline\">Cause delle vertigini e dei capogiri<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Causes of Dizziness and Vertigo\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;veaction=edit&amp;section=4\">modifica<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Causes of Dizziness and Vertigo\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;action=edit&amp;section=4\">fonte edit<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Le cause delle vertigini e dei capogiri sono molteplici, tra cui:<\/p>\n<ul>\n<li>Disfunzione <a title=\"Sistema cardiovascolare\" href=\"\/Cardiovascular_System\">cardiovascolare<\/a> <sup id=\"cite_ref-:0_1-8\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup>\n<ul>\n<li><a title=\"Ictus\" href=\"\/Stroke\">Ictus<\/a> &#8211; recenti rapporti suggeriscono che l&#8217;ictus \u00e8 la causa sottostante dei sintomi in circa il 3-5% dei pazienti che si recano al pronto soccorso con vertigini\/capogiri<sup id=\"cite_ref-:3_12-0\" class=\"reference\"><a href=\"#cite_note-:3-12\">(12)<\/a><\/sup><\/li>\n<li><a title=\"Orthostatic Hypotension\" href=\"\/Orthostatic_Hypotension\">Ipotensione ortostatica<\/a><\/li>\n<li><a class=\"mw-redirect\" title=\"Aritmie cardiache: Valutazione\" href=\"\/Heart_Arrhythmias:_Assessment\">Aritmie<\/a><\/li>\n<\/ul>\n<\/li>\n<li><a title=\"Neurological Disorders\" href=\"\/Neurological_Disorders\">Disfunzione neurologica<\/a><sup id=\"cite_ref-:0_1-9\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup>\n<ul>\n<li><a title=\"Multiple Sclerosis (MS)\" href=\"\/Multiple_Sclerosis_(MS)\">Sclerosi multipla<\/a> (SM)<sup id=\"cite_ref-:4_13-0\" class=\"reference\"><a href=\"#cite_note-:4-13\">(13)<\/a><\/sup> &#8211; la sclerosi multipla pu\u00f2 simulare una disfunzione vestibolare e causare sintomi come vertigini\/capogiri<\/li>\n<\/ul>\n<\/li>\n<li>Disfunzioni della vista<sup id=\"cite_ref-:0_1-10\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><sup id=\"cite_ref-:5_14-0\" class=\"reference\"><a href=\"#cite_note-:5-14\">(14)<\/a><\/sup>\n<ul>\n<li>Qualsiasi condizione che influisce sull&#8217;input visivo pu\u00f2 causare capogiri<\/li>\n<li>Queste potrebbero interessare l&#8217;occhio (ad esempio, degenerazione maculare, cataratta), essere correlate al <a title=\"Nervo ottico\" href=\"\/Optic_Nerve\">nervo ottico<\/a> o essere dovute a problemi di elaborazione visiva<\/li>\n<\/ul>\n<\/li>\n<li>Capogiri psicogeni<sup id=\"cite_ref-:0_1-11\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup>\n<ul>\n<li>Le vertigini possono scatenare l&#8217;ansia e l&#8217;ansia pu\u00f2 causare i capogiri<sup id=\"cite_ref-:5_14-1\" class=\"reference\"><a href=\"#cite_note-:5-14\">(14)<\/a><\/sup><\/li>\n<li>Tuttavia, non \u00e8 frequente osservare vertigini e capogiri puramente psicogeni<\/li>\n<\/ul>\n<\/li>\n<li><a title=\"Vertigini cervicogeniche: screening\" href=\"\/Cervicogenic_dizziness:_screening\">Vertigini cervicogeniche (CGD)<\/a>\n<ul>\n<li>Sindrome clinica caratterizzata dalla presenza di capogiri e dolore al collo associato. Non esistono test clinici o di laboratorio definitivi per le vertigini cervicogeniche e, pertanto, le vertigini cervicogeniche sono una diagnosi di esclusione<sup id=\"cite_ref-15\" class=\"reference\"><a href=\"#cite_note-15\">(15)<\/a><\/sup><\/li>\n<li>Le strutture muscolo-scheletriche della colonna vertebrale cervicale (ad esempio gli <a title=\"Golgi Tendon Organ\" href=\"\/Golgi_Tendon_Organ\">organi tendinei del golgi<\/a>, i recettori articolari, i <a class=\"mw-redirect\" title=\"Muscle spindles\" href=\"\/Muscle_spindles\">fusi muscolari<\/a>) non possono in genere causare sensazioni di vertigini<sup id=\"cite_ref-:0_1-12\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/li>\n<\/ul>\n<\/li>\n<li>Disturbi del sistema vestibolare<sup id=\"cite_ref-:0_1-13\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><sup id=\"cite_ref-16\" class=\"reference\"><a href=\"#cite_note-16\">(16)<\/a><\/sup><sup id=\"cite_ref-17\" class=\"reference\"><a href=\"#cite_note-17\">(17)<\/a><\/sup>\n<ul>\n<li>Trauma cranico come <a title=\"Disturbi associati al colpo di frusta\" href=\"\/Whiplash_Associated_Disorders\">colpo di frusta<\/a> o <a title=\"Valutazione e gestione della commozione cerebrale\" href=\"\/Assessment_and_Management_of_Concussion\">commozione cerebrale<\/a><sup id=\"cite_ref-18\" class=\"reference\"><a href=\"#cite_note-18\">(18)<\/a><\/sup><\/li>\n<li>Degenerazione del sistema vestibolare (legata all&#8217;et\u00e0)<\/li>\n<li>Neurite vestibolare \/ labirintite<\/li>\n<li><a title=\"Vertigine parossistica posizionale benigna (BPPV)\" href=\"\/Benign_Positional_Paroxysmal_Vertigo_(BPPV)\">BPPV<\/a><\/li>\n<li>Idrope endolinfatica (ad es. <a title=\"Malattia di Meniere\" href=\"\/Meniere%27s_Disease\">malattia di Meniere<\/a>)<\/li>\n<li>Ototossicit\u00e0, barotrauma, <a title=\"Neuroma acustico\" href=\"\/Acoustic_Neuroma\">neuroma acustico<\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>Il video seguente fornisce ulteriori informazioni su alcune cause comuni di vertigini.<\/p>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 648px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 640px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/kx4mQB0QzvQ?\" width=\"640\" height=\"360\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-19\" class=\"reference\"><a href=\"#cite_note-19\">(19)<\/a><\/sup><\/p>\n<h2><span id=\"Signs_and_Symptoms_of_Vestibular_Disorders\" class=\"mw-headline\">Segni e sintomi dei disturbi vestibolari<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Modificare la sezione: Segni e sintomi dei disturbi vestibolari\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;veaction=edit&amp;section=5\">modifica<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Modificare la sezione: Segni e sintomi dei disturbi vestibolari\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;action=edit&amp;section=5\">fonte edit<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<ul>\n<li>Nistagmo (movimento involontario degli occhi)<\/li>\n<li>Vertigini<\/li>\n<li>Dizziness (capogiri)<\/li>\n<li>Squilibrio o <a title=\"Atassia\" href=\"\/Ataxia\">atassia<\/a><\/li>\n<li>Compromissione della stabilit\u00e0 dello sguardo (diminuzione dell&#8217;acuit\u00e0 visiva con il movimento della testa &#8211; cio\u00e8 il <a title=\"Vestibular Oculomotor Motor Screening (VOMS) Assessment\" href=\"\/Vestibular_Oculomotor_Motor_Screening_(VOMS)_Assessment\">riflesso vestibolo-oculomotore<\/a> (VOR) \u00e8 compromesso)<\/li>\n<\/ul>\n<h2><span id=\"Anatomy_of_the_Peripheral_Vestibular_System\" class=\"mw-headline\">Anatomia del sistema vestibolare periferico<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Modificare la sezione: Anatomia del sistema vestibolare periferico\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;veaction=edit&amp;section=6\">modifica<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Modificare la sezione: Anatomia del sistema vestibolare periferico\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;action=edit&amp;section=6\">modifica fonte<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<div class=\"floatright\"><a class=\"image\" href=\"\/File:EarAnatomy_InternalEar.png\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/5\/54\/EarAnatomy_InternalEar.png\/399px-EarAnatomy_InternalEar.png\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/5\/54\/EarAnatomy_InternalEar.png\/599px-EarAnatomy_InternalEar.png 1.5x, https:\/\/www.physio-pedia.com\/images\/5\/54\/EarAnatomy_InternalEar.png 2x\" alt=\"\" width=\"399\" height=\"399\" data-file-width=\"720\" data-file-height=\"720\"><\/a><\/div>\n<p>L&#8217;orecchio esterno \u00e8 costituito dal meato acustico esterno. La membrana timpanica (cio\u00e8 il timpano) separa l&#8217;orecchio esterno dall&#8217;orecchio medio. L&#8217;orecchio interno contiene l&#8217;apparato vestibolare e la coclea.<sup id=\"cite_ref-:0_1-14\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<p>Come illustrato nella Figura 3, l&#8217;apparato vestibolare \u00e8 costituito da:<\/p>\n<ol>\n<li>Tre canali semicircolari<\/li>\n<li>L&#8217;utricolo e il sacculo, che insieme formano gli organi otolitici<sup id=\"cite_ref-:6_20-0\" class=\"reference\"><a href=\"#cite_note-:6-20\">(20)<\/a><\/sup>; gli organi otolitici sono posizionati nella camera centrale nota come vestibolo<\/li>\n<\/ol>\n<p>Anche la coclea \u00e8 posizionata nell&#8217;orecchio interno ed \u00e8 responsabile dell&#8217;udito.<\/p>\n<p>All&#8217;interno del labirinto membranoso dell&#8217;orecchio interno scorre un fluido chiaro e viscoso chiamato endolinfa:<sup id=\"cite_ref-:0_1-15\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><sup id=\"cite_ref-:6_20-1\" class=\"reference\"><a href=\"#cite_note-:6-20\">(20)<\/a><\/sup><\/p>\n<ul>\n<li>L&#8217;accelerazione dell&#8217;endolinfa nell&#8217;apparato vestibolare permette di percepire l&#8217;equilibrio e il bilanciamento<\/li>\n<li>Nel condotto cocleare, l&#8217;endolinfa svolge un ruolo importante nella percezione del suono<\/li>\n<\/ul>\n<p>Poich\u00e9 l&#8217;endolinfa viaggia sia nell&#8217;apparato vestibolare che in quello cocleare, qualsiasi condizione che provochi un aumento della pressione endolinfatica nell&#8217;apparato vestibolare (ad esempio, la malattia di Meniere) avr\u00e0 ripercussioni anche sulla coclea.<sup id=\"cite_ref-:0_1-16\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<h2><span id=\"Semicircular_Canals\" class=\"mw-headline\">Canali semicircolari<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Modificare la sezione: Canali semicircolari\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;veaction=edit&amp;section=7\">modifica<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Modificare la sezione: Canali semicircolari\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;action=edit&amp;section=7\">modifica fonte<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>I canali semicircolari contengono meccanorecettori specializzati che forniscono informazioni sulla velocit\u00e0 angolare.<sup id=\"cite_ref-21\" class=\"reference\"><a href=\"#cite_note-21\">(21)<\/a><\/sup><\/p>\n<p>Ci sono tre canali semicircolari su ciascun lato del corpo (quindi sei in totale):<\/p>\n<ul>\n<li>Anteriore<\/li>\n<li>Posteriore<\/li>\n<li>Orizzontale (o laterale)<\/li>\n<\/ul>\n<p>I canali anteriore e posteriore hanno un canale congiunto, chiamato crus comune.<sup id=\"cite_ref-:0_1-17\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<h3><span id=\"Planes_of_Movement\" class=\"mw-headline\">Piani di movimento<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Edit section: Planes of Movement\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;veaction=edit&amp;section=8\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Edit section: Planes of Movement\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;action=edit&amp;section=8\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 302px;\"><a class=\"image\" href=\"\/File:Semicircular_Canals_Planes_Movement.png\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/c\/cb\/Semicircular_Canals_Planes_Movement.png\/300px-Semicircular_Canals_Planes_Movement.png\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/c\/cb\/Semicircular_Canals_Planes_Movement.png\/450px-Semicircular_Canals_Planes_Movement.png 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/c\/cb\/Semicircular_Canals_Planes_Movement.png\/600px-Semicircular_Canals_Planes_Movement.png 2x\" alt=\"\" width=\"300\" height=\"356\" data-file-width=\"607\" data-file-height=\"720\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Figura 2. Canali semicircolari &#8211; Piani di movimento<\/p>\n<\/div>\n<\/div>\n<\/div>\n<p>Il sistema vestibolare ha tre piani di movimento. Ogni piano di movimento ha due canali semicircolari al suo interno, quindi ci sono tre coppie complanari.<sup id=\"cite_ref-22\" class=\"reference\"><a href=\"#cite_note-22\">(22)<\/a><\/sup> Si veda Figura 2.<\/p>\n<ul>\n<li>I canali anteriore e posteriore si trovano sul piano verticale<\/li>\n<li>I canali anteriore e posteriore sono orientati anche lungo due piani diagonali:\n<ul>\n<li>Piano LARP = piano anteriore sinistro posteriore destro<\/li>\n<li>Piano RALP = piano anteriore destro posteriore sinistro<\/li>\n<\/ul>\n<\/li>\n<li>I canali orizzontali sono posizionati con un angolo di 30 gradi (cio\u00e8 vicino all&#8217;orizzontale)<\/li>\n<\/ul>\n<h3><span id=\"Ampullae\" class=\"mw-headline\">Ampolla<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Modifica la sezione: Ampolle\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;veaction=edit&amp;section=9\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Modifica la sezione: Ampolle\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;action=edit&amp;section=9\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>L&#8217;ampolla \u00e8 un&#8217;area allargata dei canali semicircolari (si veda Figura 3). Contiene i neuroni che rilevano il movimento della testa. I neuroni sono inseriti in una matrice di vasi sanguigni e tessuto connettivo chiamata cresta ampollare. A questi neuroni sono collegati dei meccanorecettori specializzati chiamati &#8220;cellule ciliate&#8221;.<sup id=\"cite_ref-:7_23-0\" class=\"reference\"><a href=\"#cite_note-:7-23\">(23)<\/a><\/sup> Ogni cellula ciliata contiene un gran numero di filamenti di actina incrociati, chiamati stereocilia. Le stereocilia si muovono in risposta all&#8217;accelerazione dell&#8217;endolinfa.<sup id=\"cite_ref-:7_23-1\" class=\"reference\"><a href=\"#cite_note-:7-23\">(23)<\/a><\/sup> In sostanza, agiscono come sensori di movimento che convertono i movimenti angolari della testa in scariche neurali afferenti.<sup id=\"cite_ref-:0_1-18\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<h3><span id=\"Cupula\" class=\"mw-headline\">Cupola<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Modifica la sezione: Cupula\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;veaction=edit&amp;section=10\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Modifica la sezione: Cupula\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;action=edit&amp;section=10\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width: 302px;\"><a class=\"image\" href=\"\/File:Vestibular_Equilibrium_and_Semicircular_Canals.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"thumbimage\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/0\/0d\/Vestibular_Equilibrium_and_Semicircular_Canals.jpg\/300px-Vestibular_Equilibrium_and_Semicircular_Canals.jpg\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/0\/0d\/Vestibular_Equilibrium_and_Semicircular_Canals.jpg\/450px-Vestibular_Equilibrium_and_Semicircular_Canals.jpg 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/0\/0d\/Vestibular_Equilibrium_and_Semicircular_Canals.jpg\/600px-Vestibular_Equilibrium_and_Semicircular_Canals.jpg 2x\" alt=\"\" width=\"300\" height=\"148\" data-file-width=\"1280\" data-file-height=\"631\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><\/div>\n<p>Figura 3. Ampolla e cupola<\/p>\n<\/div>\n<\/div>\n<\/div>\n<p>La cupola \u00e8 la parte gelatinosa della cresta ampollare in cui sono incorporate le cellule ciliate. Si estende dalla cresta al tetto dell&#8217;ampolla.<sup id=\"cite_ref-:0_1-19\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<p>La cupola crea una barriera di fluidi: l&#8217;endolinfa non pu\u00f2 circolare all&#8217;interno della cupola, ma \u00e8 influenzata dai movimenti dell&#8217;endolinfa intorno ad essa:<sup id=\"cite_ref-:8_24-0\" class=\"reference\"><a href=\"#cite_note-:8-24\">(24)<\/a><\/sup><\/p>\n<ul>\n<li>Quando un individuo ruota la testa (cio\u00e8 un movimento angolare), l&#8217;inerzia dell&#8217;endolinfa genera una forza sulla cupola, spingendola in direzione opposta alla direzione in cui si muove la testa (vedi Figura 3)<\/li>\n<li>Questo muove le cellule ciliate nella cresta<\/li>\n<\/ul>\n<p>Le accelerazioni lineari, invece, creano una forza uguale su entrambi i lati della cupola, quindi lo spostamento non avviene.<sup id=\"cite_ref-:8_24-1\" class=\"reference\"><a href=\"#cite_note-:8-24\">(24)<\/a><\/sup> I canali semicircolari, quindi, non sono in grado di rilevare schemi di movimento lineare e sono anche insensibili alla gravit\u00e0.<sup id=\"cite_ref-:0_1-20\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<h2><span id=\"Otolith_Organs\" class=\"mw-headline\">Organi otolitici<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Otolith Organs\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;veaction=edit&amp;section=11\">modifica<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Otolith Organs\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;action=edit&amp;section=11\">modifica fonte<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>A differenza dei canali semicircolari, gli organi otolitici rilevano movimenti traslazionali o lineari,<sup id=\"cite_ref-:8_24-2\" class=\"reference\"><a href=\"#cite_note-:8-24\">(24)<\/a><\/sup> tra cui:<sup id=\"cite_ref-:0_1-21\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<ul>\n<li>Avanti e indietro<\/li>\n<li>Su e gi\u00f9<\/li>\n<li>Da un lato all&#8217;altro (senza ruotare)<\/li>\n<li>Posizione statica della testa rispetto alla gravit\u00e0<\/li>\n<\/ul>\n<p>Sia l&#8217;utricolo che il sacculo contengono una macula in cui sono ancorate le cellule ciliate neuronali.<sup id=\"cite_ref-:0_1-22\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><sup id=\"cite_ref-:9_25-0\" class=\"reference\"><a href=\"#cite_note-:9-25\">(25)<\/a><\/sup> Le cellule ciliate si trovano sotto uno strato gelatinoso, che a sua volta si trova sotto la membrana otolitica.<sup id=\"cite_ref-:9_25-1\" class=\"reference\"><a href=\"#cite_note-:9-25\">(25)<\/a><\/sup><\/p>\n<p>La membrana otolitica presenta cristalli di carbonato di calcio, noti come otoconi, incorporati in essa.<sup id=\"cite_ref-:9_25-2\" class=\"reference\"><a href=\"#cite_note-:9-25\">(25)<\/a><\/sup><\/p>\n<p>La membrana otolitica \u00e8 pi\u00f9 pesante delle strutture e dei fluidi circostanti a causa del peso degli otoconi. Per via di questo peso, quando un individuo inclina la testa, la gravit\u00e0 fa s\u00ec che la membrana si muova rispetto alla macula. Questo sposta le cellule ciliate e genera un potenziale recettoriale.<sup id=\"cite_ref-:9_25-3\" class=\"reference\"><a href=\"#cite_note-:9-25\">(25)<\/a><\/sup><\/p>\n<p>L&#8217;anatomia del sistema vestibolare \u00e8 riassunta nel seguente video.<\/p>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 648px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 640px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/P3aYqxGesqs?\" width=\"640\" height=\"360\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-26\" class=\"reference\"><a href=\"#cite_note-26\">(26)<\/a><\/sup><\/p>\n<h2><span id=\"Vestibular_Reflexes\" class=\"mw-headline\">Riflessi vestibolari<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Modificare la sezione: Riflessi vestibolari\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;veaction=edit&amp;section=12\">modifica<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Modificare la sezione: Riflessi vestibolari\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;action=edit&amp;section=12\">modifica fonte<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<h3><span id=\"Vestibulo-spinal_reflex_.28VSR.29\"><\/span><span id=\"Vestibulo-spinal_reflex_(VSR)\" class=\"mw-headline\">Riflesso vestibolo-spinale (VSR)<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Modifica della sezione: Riflesso vestibolo-spinale (VSR)\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;veaction=edit&amp;section=13\">modifica<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Modifica della sezione: Riflesso vestibolo-spinale (VSR)\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;action=edit&amp;section=13\">modifica fonte<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Il VSR stabilizza il corpo. <sup id=\"cite_ref-:10_27-0\" class=\"reference\"><a href=\"#cite_note-:10-27\">(27)<\/a><\/sup> Tuttavia, sebbene la valutazione dell&#8217;equilibrio attivi il riflesso vestibolo-spinale di un individuo, non fornisce informazioni sufficienti sull&#8217;apparato vestibolare per essere rilevante in questo gruppo di pazienti.<sup id=\"cite_ref-:0_1-23\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<h3><span id=\"Vestibulo-Ocular_Reflex_.28VOR.29\"><\/span><span id=\"Vestibulo-Ocular_Reflex_(VOR)\" class=\"mw-headline\">Riflesso vestibolo-oculomotore (VOR)<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Modifica della sezione: Riflesso vestibolo-oculare (VOR)\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;veaction=edit&amp;section=14\">modifica<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Modifica della sezione: Riflesso vestibolo-oculare (VOR)\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;action=edit&amp;section=14\">modifica fonte<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Il VOR mantiene stabile la visione durante il movimento della testa.<sup id=\"cite_ref-28\" class=\"reference\"><a href=\"#cite_note-28\">(28)<\/a><\/sup> Il VOR \u00e8 composto da due componenti ed entrambi lavorano insieme per garantire la stabilit\u00e0 dello sguardo durante la rotazione della testa.<sup id=\"cite_ref-:0_1-24\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><sup id=\"cite_ref-:10_27-1\" class=\"reference\"><a href=\"#cite_note-:10-27\">(27)<\/a><\/sup><\/p>\n<ul>\n<li>VOR angolare<sup id=\"cite_ref-:10_27-2\" class=\"reference\"><a href=\"#cite_note-:10-27\">(27)<\/a><\/sup>\n<ul>\n<li>Mediato dai canali semicircolari<\/li>\n<li>Compensa la rotazione<\/li>\n<li>Responsabile principale della stabilizzazione dello sguardo<\/li>\n<\/ul>\n<\/li>\n<li>VOR lineare<sup id=\"cite_ref-:10_27-3\" class=\"reference\"><a href=\"#cite_note-:10-27\">(27)<\/a><\/sup>\n<ul>\n<li>Mediato dagli organi otolitici<\/li>\n<li>Compensa la traslazione<\/li>\n<li>Pi\u00f9 importante quando si osserva da vicino e quando la testa si muove a frequenze ragionevolmente elevate<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3><span id=\"Push-Pull_Arrangement_of_the_VOR\" class=\"mw-headline\">Meccanismo push-pull del VOR<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a class=\"mw-editsection-visualeditor\" title=\"Modifica della sezione: Disposizione push-pull del VOR\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;veaction=edit&amp;section=15\">modifica<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a title=\"Modifica della sezione: Disposizione push-pull del VOR\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;action=edit&amp;section=15\">modifica sorgente<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Quando un individuo ruota la testa verso destra:<sup id=\"cite_ref-:0_1-25\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<ul>\n<li>Il canale orizzontale destro \u00e8 eccitato e il sinistro \u00e8 inibito (in un meccanismo push-pull)<\/li>\n<li>Il canale orizzontale destro attiva i muscoli retto mediale destro e retto laterale sinistro per tirare gli occhi verso sinistra<\/li>\n<li>Il canale orizzontale sinistro inibisce i muscoli retto laterale destro e retto mediale sinistro, consentendo questo movimento<\/li>\n<\/ul>\n<p>Il VOR \u00e8 il riflesso umano pi\u00f9 veloce: funziona in circa 14 millisecondi.<sup id=\"cite_ref-:0_1-26\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup> Il motivo di questa velocit\u00e0 \u00e8 che il percorso VOR:<sup id=\"cite_ref-:11_29-0\" class=\"reference\"><a href=\"#cite_note-:11-29\">(29)<\/a><\/sup><\/p>\n<ul>\n<li>\u00c8 relativamente breve<\/li>\n<li>Utilizza solo le informazioni sensoriali del sistema vestibolare per attivare i motoneuroni necessari<\/li>\n<\/ul>\n<p>Per via di questa velocit\u00e0, il VOR deve essere molto preciso (98% o pi\u00f9) per garantire che non si verifichino sfocature o salti del campo visivo quando un individuo muove la testa.<sup id=\"cite_ref-:0_1-27\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><sup id=\"cite_ref-:11_29-1\" class=\"reference\"><a href=\"#cite_note-:11-29\">(29)<\/a><\/sup><\/p>\n<p>Il video seguente fornisce una descrizione dettagliata del VOR.<\/p>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 648px;\">\n<div class=\"embedvideo autoResize\">\n<div class=\"embedvideowrap\" style=\"width: 640px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/r_6y2D-6oDQ?\" width=\"640\" height=\"360\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-30\" class=\"reference\"><a href=\"#cite_note-30\">(30)<\/a><\/sup><\/p>\n<h4><span id=\"Gain\" class=\"mw-headline\">Guadagno<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Modificare la sezione: Guadagno\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;veaction=edit&amp;section=16\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Modificare la sezione: Guadagno\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;action=edit&amp;section=16\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<p>Il guadagno (gain) del VOR \u00e8 definito come il rapporto tra la velocit\u00e0 degli occhi e la velocit\u00e0 della testa durante i movimenti della testa. Viene spesso utilizzato come misura fisiologica della funzione vestibolare e tende a diminuire con l&#8217;et\u00e0.<sup id=\"cite_ref-:12_31-0\" class=\"reference\"><a href=\"#cite_note-:12-31\">(31)<\/a><\/sup><\/p>\n<p>Idealmente, il guadagno del VOR si avvicina a 1.0.<sup id=\"cite_ref-:12_31-1\" class=\"reference\"><a href=\"#cite_note-:12-31\">(31)<\/a><\/sup> Ci\u00f2 significa che l&#8217;ampiezza della velocit\u00e0 degli occhi dovrebbe essere uguale all&#8217;ampiezza della velocit\u00e0 della testa.<sup id=\"cite_ref-32\" class=\"reference\"><a href=\"#cite_note-32\">(32)<\/a><\/sup> Il guadagno del VOR si aggira in genere intorno a 0,96-0,97, ma pu\u00f2 funzionare da 0,5 a 2.<sup id=\"cite_ref-:0_1-28\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup> \u00c8 stato proposto che un guadagno del VOR inferiore a 0,68 sia il punto di demarcazione tra normale e troppo basso.<sup id=\"cite_ref-:12_31-2\" class=\"reference\"><a href=\"#cite_note-:12-31\">(31)<\/a><\/sup><\/p>\n<p>Il guadagno del VOR \u00e8 mediato dal controllo del sistema nervoso centrale (SNC) in un processo chiamato adattamento. Quando il SNC modifica il guadagno del VOR, cambia la sensibilit\u00e0 del riflesso per consentire alle persone di adattarsi all&#8217;ambiente. Pertanto, gli esercizi di stabilizzazione dello sguardo, che fanno parte della riabilitazione vestibolare, possono essere considerati esercizi di adattamento.<sup id=\"cite_ref-:0_1-29\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<h2><span id=\"Nystagmus\" class=\"mw-headline\">Nistagmo<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Modificare la sezione: Nistagmo\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;veaction=edit&amp;section=17\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Modificare la sezione: Nistagmo\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;action=edit&amp;section=17\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Il nistagmo \u00e8 uno dei segni di disfunzione vestibolare ed \u00e8 definito come &#8220;un movimento ritmico, involontario, rapido e oscillatorio degli occhi&#8221;.<sup id=\"cite_ref-:13_33-0\" class=\"reference\"><a href=\"#cite_note-:13-33\">(33)<\/a><\/sup><\/p>\n<p>Pu\u00f2 comportare movimenti lenti o veloci o una combinazione dei due.<sup id=\"cite_ref-:13_33-1\" class=\"reference\"><a href=\"#cite_note-:13-33\">(33)<\/a><\/sup> I movimenti possono essere:<sup id=\"cite_ref-34\" class=\"reference\"><a href=\"#cite_note-34\">(34)<\/a><\/sup><\/p>\n<ul>\n<li>Da un lato all&#8217;altro (nistagmo orizzontale)<\/li>\n<li>Su e gi\u00f9 (nistagmo verticale)<\/li>\n<li>In cerchio (nistagmo rotatorio)<\/li>\n<li>Continui o improvvisi<sup id=\"cite_ref-:13_33-2\" class=\"reference\"><a href=\"#cite_note-:13-33\">(33)<\/a><\/sup><\/li>\n<li>Relativi a specifici fattori scatenanti dello sguardo o del posizionamento della testa<sup id=\"cite_ref-:13_33-3\" class=\"reference\"><a href=\"#cite_note-:13-33\">(33)<\/a><\/sup><\/li>\n<li>Patologici o fisiologici (cio\u00e8 normali)<sup id=\"cite_ref-:0_1-30\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/li>\n<\/ul>\n<p>Sebbene ogni riflesso abbia una componente centrale e una periferica, il sistema delle saccadi (cio\u00e8 i movimenti rapidi degli occhi) \u00e8 considerato pi\u00f9 mediato a livello centrale, mentre il VOR \u00e8 pi\u00f9 mediato a livello periferico. Pertanto, il nistagmo pu\u00f2 essere considerato una combinazione di riflessi mediati a livello periferico e centrale.<sup id=\"cite_ref-:0_1-31\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/p>\n<p>I tipi di nistagmo includono:<\/p>\n<ul>\n<li>Jerk:\n<ul>\n<li>L&#8217;occhio si muove lentamente verso il lato in cui c&#8217;\u00e8 inibizione, o diminuzione dell&#8217;attivit\u00e0, e poi &#8220;scatta&#8221; di nuovo verso il centro<sup id=\"cite_ref-35\" class=\"reference\"><a href=\"#cite_note-35\">(35)<\/a><\/sup><\/li>\n<li>Pu\u00f2 essere mediato centralmente o perifericamente<sup id=\"cite_ref-:0_1-32\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Pendolare:<sup id=\"cite_ref-36\" class=\"reference\"><a href=\"#cite_note-36\">(36)<\/a><\/sup>\n<ul>\n<li>L&#8217;occhio si muove con un andamento sinusoidale (come un pendolo)<\/li>\n<li>Sono presenti solo movimenti oculari lenti &#8211; in genere non c&#8217;\u00e8 una fase veloce<\/li>\n<li>Mediato centralmente<sup id=\"cite_ref-:0_1-33\" class=\"reference\"><a href=\"#cite_note-:0-1\">(1)<\/a><\/sup><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2><span id=\"Summary\" class=\"mw-headline\">Sintesi<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: Summary\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;veaction=edit&amp;section=18\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: Summary\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;action=edit&amp;section=18\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<ul>\n<li>La disfunzione vestibolare \u00e8 un problema significativo soprattutto negli <a title=\"Older People - An Introduction\" href=\"\/Older_People_-_An_Introduction\">adulti pi\u00f9 anziani<\/a><\/li>\n<li>Esistono diverse cause di capogiri, tutte gestite in modo diverso<\/li>\n<li>Le vertigini e i capogiri non sono termini intercambiabili<\/li>\n<li>La comprensione dell&#8217;anatomia del sistema vestibolare \u00e8 essenziale per creare un piano di gestione della riabilitazione vestibolare efficace<\/li>\n<\/ul>\n<h2><span id=\"References\" class=\"mw-headline\">Citazioni<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a class=\"mw-editsection-visualeditor\" title=\"Edit section: References\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;veaction=edit&amp;section=19\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a title=\"Edit section: References\" href=\"\/index.php?title=Introduction_to_Vestibular_Rehabilitation&amp;action=edit&amp;section=19\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<div class=\"mw-references-wrap mw-references-columns\">\n<ol class=\"references\">\n<li id=\"cite_note-:0-1\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:0_1-0\">1.00<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-1\">1.01<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-2\">1.02<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-3\">1.03<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-4\">1.04<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-5\">1.05<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-6\">1.06<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-7\">1.07<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-8\">1.08<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-9\">1.09<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-10\">1.10<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-11\">1.11<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-12\">1.12<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-13\">1.13<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-14\">1.14<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-15\">1.15<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-16\">1.16<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-17\">1.17<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-18\">1.18<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-19\">1.19<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-20\">1.20<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-21\">1.21<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-22\">1.22<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-23\">1.23<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-24\">1.24<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-25\">1.25<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-26\">1.26<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-27\">1.27<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-28\">1.28<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-29\">1.29<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-30\">1.30<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-31\">1.31<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-32\">1.32<\/a><\/sup> <sup><a href=\"#cite_ref-:0_1-33\">1.33<\/a><\/sup><\/span> <span class=\"reference-text\">Tonks B. 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Available from: <a class=\"external free\" href=\"https:\/\/dizziness-and-balance.com\/practice\/nystagmus\/pendular.html\" rel=\"nofollow\">https:\/\/dizziness-and-balance.com\/practice\/nystagmus\/pendular.html<\/a><\/span><\/li>\n<\/ol>\n<\/div>\n<p><!-- \nNewPP limit report\nCached time: 20260331080521\nCache expiry: 0\nReduced expiry: true\nComplications: (show\u2010toc)\nCPU time usage: 0.197 seconds\nReal time usage: 0.214 seconds\nPreprocessor visited node count: 771\/1000000\nPost\u2010expand include size: 148\/2097152 bytes\nTemplate argument size: 0\/2097152 bytes\nHighest expansion depth: 3\/100\nExpensive parser function count: 0\/100\nUnstrip recursion depth: 0\/20\nUnstrip post\u2010expand size: 27283\/5000000 bytes\n--><br \/>\n<!--\nTransclusion expansion time report (%,ms,calls,template)\n100.00%   11.528      1 Special:Contributors\/Introduction_to_Vestibular_Rehabilitation\n100.00%   11.528      1 -total\n--><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Redazione originale &#8211; Jess Bell sulla base del corso di Bernard Tonks Collaboratori principali &#8211; Jess Bell, Kim Jackson, Lucinda hampton, Tarina van der Stockt, Rucha Gadgil, Nupur Smit Shah, Jorge Rodr\u00edguez Palomino e Stacy Schiurring Contenuti 1 Introduzione 2 Epidemiologia 3 Definire le vertigini e i capogiri 4 Cause delle vertigini e dei capogiri [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-8026","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/langs.physio-pedia.com\/it\/wp-json\/wp\/v2\/pages\/8026","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/langs.physio-pedia.com\/it\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/langs.physio-pedia.com\/it\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/langs.physio-pedia.com\/it\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/langs.physio-pedia.com\/it\/wp-json\/wp\/v2\/comments?post=8026"}],"version-history":[{"count":7,"href":"https:\/\/langs.physio-pedia.com\/it\/wp-json\/wp\/v2\/pages\/8026\/revisions"}],"predecessor-version":[{"id":13793,"href":"https:\/\/langs.physio-pedia.com\/it\/wp-json\/wp\/v2\/pages\/8026\/revisions\/13793"}],"wp:attachment":[{"href":"https:\/\/langs.physio-pedia.com\/it\/wp-json\/wp\/v2\/media?parent=8026"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}