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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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Orthostatic hypotension, dizziness, and syncope
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Postural and Perceptual Measurements during Performance of Static Standing Balance Exercises
Alsubaie, S. F. (2017) · D-Scholarship@Pitt (University of Pittsburgh)
Vestibular Rehabilitation in Primary Care
Saitz, R., FACP., F., & Fasam (2004) · Journal watch · doi:10.1056/jw200411230000002
Rodriguez, A. I. (2016) · ThinkTech (Texas Tech University)
Guidelines for vestibular rehabilitation of unilateral and bilateral vestibular hypofunction
Maslovara, S., Soldo, S. B., Drviš, P., Sunara, D., Sekelj, A., Marković, N. L., Mendeš, T., Šestak, A., Imširović, M., Maslovara, K., et al. (2020) · Liječnički vjesnik · doi:10.26800/lv-142-9-10-43
Metadata
- 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 › Cardiology and Cardiovascular Medicine › 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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