Effectiveness of primary care-based vestibular rehabilitation for chronic dizziness
Yardley, L., Donovan-Hall, M., Smith, H.E., Walsh, B.M., Mullee, M. and Bronstein, A.M. (2004) Effectiveness of primary care-based vestibular rehabilitation for chronic dizziness. Annals of Internal Medicine, 141, (8), 598-605.
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.
|Keywords:||adult, article, assessment, care, chronic, outcome, outcomes, practice, quality, quality of life, rehabilitation, therapy|
|Subjects:||R Medicine > RT Nursing
R Medicine > RM Therapeutics. Pharmacology
B Philosophy. Psychology. Religion > BF Psychology
|Divisions:||University Structure - Pre August 2011 > Superseded (SONM) > Superseded (HSR)
University Structure - Pre August 2011 > School of Psychology > Division of Human Wellbeing
University Structure - Pre August 2011 > School of Medicine > Community Clinical Sciences
|Date Deposited:||05 Jun 2006|
|Last Modified:||28 Jun 2012 10:05|
|Contact Email Address:||L.Yardley@soton.ac.uk|
|RDF:||RDF+N-Triples, RDF+N3, RDF+XML, Browse.|
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