Effectiveness of Primary Care–Based Vestibular Rehabilitation for Chronic Dizziness
Open accessAbstract
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.
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Eight studies reported significant improvements in HRQOL.
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- Authors
- Yardley, L., Donovan-Hall, M., Smith, H. E., Walsh, B. M., Mullee, M., & Bronstein, A. M.
- Affiliations
- Brighton and Sussex Medical School (GB)
- From University of Southampton, Southampton; Brighton and Sussex Medical School, Brighton; and Imperial College London, London, United Kingdom.
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 2004-10-19
- Volume
- 141
- Issue
- 8
- Pages
- 598-605
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W2058661822
- Cited by
- 227
- References
- 35
- Citations by year
- 2026: 9 · 2025: 14 · 2024: 10 · 2023: 14 · 2022: 16 · 2021: 9 · 2020: 5 · 2019: 10 · 2018: 13 · 2017: 11 · 2016: 15 · 2015: 7 · 2014: 12 · 2013: 10 · 2012: 7
- FWCI
- 6.35
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- Sussex Research Online (University of Sussex) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Topics
- Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Keywords
- vestibular rehabilitation, chronic dizziness, primary care, home-based exercise, postural stability, general practice
- MeSH terms
- Chronic Disease, Dizziness, Exercise Therapy, Follow-Up Studies, Humans, Middle Aged, Posture, Primary Health Care, Vestibule, Labyrinth, Single-Blind Method, Treatment Outcome
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