Effectiveness of primary care-based vestibular rehabilitation for chronic dizziness
Effectiveness of primary care-based vestibular rehabilitation for chronic dizziness
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.
adult, article, assessment, care, chronic, outcome, outcomes, practice, quality, quality of life, rehabilitation, therapy
598-605
Yardley, L.
64be42c4-511d-484d-abaa-f8813452a22e
Donovan-Hall, M.
5f138055-2162-4982-846c-5c92411055e0
Smith, H.E.
9acc9970-a37b-4e8f-a917-52bb47c61c2b
Walsh, B.M.
5818243e-048d-4b4b-88c5-231b0e419427
Mullee, M.
fd3f91c3-5e95-4f56-8d73-260824eeb362
Bronstein, A.M.
01957923-f0f4-4a3b-9569-08b7360676a6
19 October 2004
Yardley, L.
64be42c4-511d-484d-abaa-f8813452a22e
Donovan-Hall, M.
5f138055-2162-4982-846c-5c92411055e0
Smith, H.E.
9acc9970-a37b-4e8f-a917-52bb47c61c2b
Walsh, B.M.
5818243e-048d-4b4b-88c5-231b0e419427
Mullee, M.
fd3f91c3-5e95-4f56-8d73-260824eeb362
Bronstein, A.M.
01957923-f0f4-4a3b-9569-08b7360676a6
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), .
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.
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Published date: 19 October 2004
Keywords:
adult, article, assessment, care, chronic, outcome, outcomes, practice, quality, quality of life, rehabilitation, therapy
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Local EPrints ID: 24563
URI: http://eprints.soton.ac.uk/id/eprint/24563
ISSN: 0003-4819
PURE UUID: 269441a2-5710-46c9-817a-2de6587c9008
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Date deposited: 05 Jun 2006
Last modified: 16 Mar 2024 03:02
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Author:
H.E. Smith
Author:
A.M. Bronstein
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