Having recently completed the portfolio titling pathway in neurology, neurological and vestibular physiotherapist Ethan Marrinan APAM MACP says that Queensland physiotherapists are in a prime position to support people presenting with dizziness.

Since 2020, Ethan has worked as a senior vestibular physiotherapist at Logan Hospital in Brisbane’s south-east, which is leading the way in management of the dizzy patient.

His role includes the provision of advanced case management and vestibular rehabilitation to patients who attend from across the state and, at times, from neighbouring states.

It is part of a statewide service known as the Complex Vestibular Service, within Logan Hospital’s Integrated Specialist ENT Service.

Ethan also manages ‘first point of contact’ vestibular clinics, where he diverts patients from neurology and ear, nose and throat (ENT) specialist outpatient waiting lists to investigate and treat their dizziness.

In about 90–95 per cent of cases, patients are discharged directly after physiotherapy without the need to return to see the medical specialist.

‘Forty per cent of people over the age of 40 experience dizziness; it’s incredibly common and it’s just not very well managed in some cases.

‘Dizziness strikes fear in the heart of a lot of practitioners when patients report it.

‘Overseas it is usually managed purely by ENT surgeons and neurologists but in Queensland physiotherapy has really led the way.’

Benign paroxysmal positional vertigo is the most common cause of dizziness.

Symptoms can include spinning vertigo, nausea and vomiting.

It can cause falls, with symptoms so significant that patients present to hospital.

‘It’s a health problem that affects people daily.

‘Each time they move their head they experience dizziness.

‘It is debilitating and a massive disruption to their lives, restricting their independence and causing a poor quality of life—research indicates that people who are dizzy have a similar quality of life to people living with HIV/AIDS.’

Graduating from the University of Queensland with a Bachelor of Physiotherapy and honours in research in 2014 and gaining experience in both tertiary and regional hospitals, such as the Prince Charles Hospital and Toowoomba Hospital, Ethan says he initially ‘fell into’ his career path.

‘I didn’t even know that neurological physiotherapy existed prior to starting as a physiotherapy student.

‘I really enjoyed my neuro training at uni by Specialist Neurological Physiotherapist (as awarded by the Australian College of Physiotherapists in 2008) Dr Katrina Williams FACP, who has done a lot of really interesting and cool things.

‘Katrina is very well regarded in her field and she instilled in me a love for neuro.’

Impressed with Ethan’s work ethic, Katrina invited Ethan to cover a short-term locum at her specialised vestibular and neurological clinic, UpRight Physiotherapy.

Ethan Marrinan has recently completed the Australian College of Physiotherapists titling pathway in neurology.

Five years later, Ethan continues to work alongside Katrina in the Wooloowin clinic in Brisbane.

‘I also work APA Neurological Physiotherapist Leia Barnes, who is the first consultant vestibular physiotherapist in Queensland. 

‘I’m nestled between these two giants of neurological and vestibular disorders. 

‘And I’m very fortunate to learn a lot from both of them.

‘I appreciate the many opportunities I have had, including working with people who advocate for the profession, educating and providing training to other physiotherapists and seeking out new technology and treatment options to help people with debilitating conditions.

‘I am proud to be part of a team whose work is having an impact on patients with neurological conditions.’

A career highlight was travelling to Denmark to train in the use of a multiaxial repositioning chair (TRV Chair), a high-tech piece of medical equipment that was introduced to Logan Hospital last year.

Ethan describes the TRV Chair as a diagnostic and treatment device that manoeuvres patients into the ideal therapeutic position for treating benign paroxysmal positional vertigo and says it has proven effective for complex cases.

‘The TRV Chair is used by neurologists or ENT surgeons overseas and it is one of only two of this type in Australia, the second one being in Melbourne.

‘I’m fortunate to be the most experienced physiotherapist working with the TRV Chair in Australia and I’ve seen the impact it is having.

‘It is giving people their independence and it saves patients from the need for rare and technically risky surgical plugging.

‘Prior to the TRV Chair coming to Logan Hospital, patients had to travel interstate for chair-based treatments.

‘This gives them the benefit of reduced travel time and improved access to local care.’

Another career highlight was taking a five-kilometre walk with a patient he was seeing for four years post-spinal cord injury.

‘When I first met him, he was unable to transfer independently.

‘The commitment and bond you have with a patient can be life-changing.’

Ethan believes that completing the titling program will improve patient access to neurological physiotherapy, along with visibility for this area of practice.

‘The scope of what neurological physiotherapy can do is not always clear to the general public; people are more familiar with a women’s health physiotherapist or a sports physio.

‘I’m really hoping that titling will allow neurological physiotherapy to be better known publicly.

‘Titling makes it very clear that you are what you say you are and that you’re backed up by your profession, which carries a lot of weight.

‘I think that will help patients when they are deciding exactly what care they need and it may be particularly helpful for patients on the National Disability Insurance Scheme.’

The titling framework will also help new graduates to identify professional development and skills pathways when exploring areas of practice.

‘I think it will be helpful for people wanting to be recognised for skills and knowledge that they haven’t acquired through a master’s program.’

As with any professional development or study program, there are benefits and challenges, he says, including navigating assessment requirements such as marking criteria.

‘I’d encourage anyone who has a passion for neurological physiotherapy to go through the process.

‘It can take a while and it’s important to practise the time constraints of the video.

‘I also found it challenging to find a neuro patient who was new to film so consider what type of patient would be required and how to get consent prior to seeing them.

‘Overall, I see the titling and specialisation pathways as a way to encourage people to stay in the profession.

‘It will help physios feel valued and offer an avenue for recognition of their skills and experience, which is important.’

Visit the Australian College of Physiotherapists or email acp@australian.physio for more information.