Effectiveness of primary care-based vestibular rehabilitation for chronic dizziness

Yardley, Lucy, Donovan-Hall, Margaret, Smith, Helen E, Walsh, Bronagh M, Mullee, Mark and Bronstein, Adolfo (2004) Effectiveness of primary care-based vestibular rehabilitation for chronic dizziness. Annals of Internal Medicine, 141 (8). pp. 598-605. ISSN 0003-4819

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Abstract

Background: Dizziness is a very common symptom and is usually managed in primary care. Vestibular rehabilitation for dizziness is a simple treatment that may be suitable for primary care delivery, but its effectiveness has not yet been determined.

Objective: To evaluate the effectiveness of nurse-delivered vestibular rehabilitation in primary care for patients with chronic dizziness.

Design: Single-blind randomized, controlled trial.

Setting: 20 general practices in southern England.

Patients: 170 adult patients with chronic dizziness who were randomly assigned to vestibular rehabilitation (n = 83) or usual medical care (n = 87).

Intervention: Each patient received one 30- to 40-minute appointment with a primary care nurse. The nurse taught the patient exercises to be carried out daily at home, with the support of a treatment booklet.

Measurements: Primary outcome measures were baseline, 3-month, and 6-month assessment of self-reported spontaneous and provoked symptoms of dizziness, dizziness-related quality of life, and objective measurement of postural stability with eyes open and eyes closed.

Results: At 3 months, improvement on all primary outcome measures in the vestibular rehabilitation group was significantly greater than in the usual medical care group; this improvement was maintained at 6 months. Of 83 treated patients, 56 (67%) reported clinically significant improvement compared with 33 of 87 (38%) usual care patients (relative risk, 1.78 [95% CI, 1.31 to 2.42]).

Limitations: Psychological elements of the therapy may have contributed to outcomes, and the treatment may be effective only for well-motivated patients.

Conclusions: Vestibular rehabilitation delivered by nurses in general practice improves symptoms, postural stability, and dizziness-related handicap in patients with chronic dizziness.

Item Type: Article
Schools and Departments: Brighton and Sussex Medical School > Primary Care and Public Health
Depositing User: Jane Harle
Date Deposited: 08 Oct 2008
Last Modified: 27 Apr 2018 15:59
URI: http://sro.sussex.ac.uk/id/eprint/1955
Google Scholar:70 Citations

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