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Internet-based vestibular rehabilitation for older adults with chronic dizziness: a randomised controlled trial in primary care

Internet-based vestibular rehabilitation for older adults with chronic dizziness: a randomised controlled trial in primary care
Internet-based vestibular rehabilitation for older adults with chronic dizziness: a randomised controlled trial in primary care
Purpose: Vestibular Rehabilitation (VR) is an effective intervention for dizziness due to vestibular dysfunction, but is seldom provided. We aimed to determine the effectiveness of internet-based VR for older adults experiencing dizziness in primary care. Methods: A single centre, single blind randomised controlled trial comparing an internet-based VR intervention with usual primary care was conducted with patients from 54 primary care practices in southern England (ISRCTN: 86912968). Patients aged 50 years and over with current dizziness exacerbated by head movements were included in the trial. Patients accessed an automated internet-based intervention that taught VR exercises and suggested cognitive behavioural management strategies. Dizziness was measured by the Vertigo Symptom Scale Short-Form (VSS-SF) at baseline, 3 and 6 months. The primary outcome was VSS-SF score at 6 months. Results: A total of 296 patients were randomized into the trial (66% female, median age 67). The VSS-SF was completed by 250 participants at 3 months (84%: 123 intervention (77%), 127 usual care (93%)) and 230 participants at 6 months (78%: 112 intervention (70%), 118 usual care (87%)). At 3 and 6 months dizziness symptoms were significantly lower in the internet-based VR group compared to usual care (2.75, 95% CI, 1.39 to 4.12; p<0.001 and 2.26, 95% CI, 0.39 to 4.12; p=0.018 respectively). Dizziness-related disability was also significantly lower in the internet-based VR condition, at 3 (6.15 95% CI, 2.81 to 9.49; p<0.001) and 6 month (5.58, 95% CI, 1.19 to 10.0; p=0.013). Conclusions: Internet-based VR improves dizziness and reduces dizziness-based disability in older primary care patients without requiring clinical support, and has potential for wide application in community settings.
1544-1709
209-216
Geraghty, Adam
2c6549fe-9868-4806-b65a-21881c1930af
Essery, Rosie
6bf53e81-577f-4a95-ba45-11aa64d1ee53
Kirby, Sarah
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Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Turner, David
d5bb7776-9b4f-482a-bb98-a5c5ab905c0f
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Bronstein, Adolfo
315b48fe-f09e-4aa1-a374-a76b87f49731
Andersson, Gerhard
1965d18a-9891-41f3-8149-ce6aebe2f5ff
Carlbring, Per
0b7ffcfa-66a5-435d-a64e-a3b6606adc71
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Geraghty, Adam
2c6549fe-9868-4806-b65a-21881c1930af
Essery, Rosie
6bf53e81-577f-4a95-ba45-11aa64d1ee53
Kirby, Sarah
9be57c1b-5ab7-4444-829e-d8e5dbe2370b
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Turner, David
d5bb7776-9b4f-482a-bb98-a5c5ab905c0f
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Bronstein, Adolfo
315b48fe-f09e-4aa1-a374-a76b87f49731
Andersson, Gerhard
1965d18a-9891-41f3-8149-ce6aebe2f5ff
Carlbring, Per
0b7ffcfa-66a5-435d-a64e-a3b6606adc71
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e

Geraghty, Adam, Essery, Rosie, Kirby, Sarah, Stuart, Beth, Turner, David, Little, Paul, Bronstein, Adolfo, Andersson, Gerhard, Carlbring, Per and Yardley, Lucy (2017) Internet-based vestibular rehabilitation for older adults with chronic dizziness: a randomised controlled trial in primary care. Annals of Family Medicine, 15 (3), 209-216. (doi:10.1370/afm.2070).

Record type: Article

Abstract

Purpose: Vestibular Rehabilitation (VR) is an effective intervention for dizziness due to vestibular dysfunction, but is seldom provided. We aimed to determine the effectiveness of internet-based VR for older adults experiencing dizziness in primary care. Methods: A single centre, single blind randomised controlled trial comparing an internet-based VR intervention with usual primary care was conducted with patients from 54 primary care practices in southern England (ISRCTN: 86912968). Patients aged 50 years and over with current dizziness exacerbated by head movements were included in the trial. Patients accessed an automated internet-based intervention that taught VR exercises and suggested cognitive behavioural management strategies. Dizziness was measured by the Vertigo Symptom Scale Short-Form (VSS-SF) at baseline, 3 and 6 months. The primary outcome was VSS-SF score at 6 months. Results: A total of 296 patients were randomized into the trial (66% female, median age 67). The VSS-SF was completed by 250 participants at 3 months (84%: 123 intervention (77%), 127 usual care (93%)) and 230 participants at 6 months (78%: 112 intervention (70%), 118 usual care (87%)). At 3 and 6 months dizziness symptoms were significantly lower in the internet-based VR group compared to usual care (2.75, 95% CI, 1.39 to 4.12; p<0.001 and 2.26, 95% CI, 0.39 to 4.12; p=0.018 respectively). Dizziness-related disability was also significantly lower in the internet-based VR condition, at 3 (6.15 95% CI, 2.81 to 9.49; p<0.001) and 6 month (5.58, 95% CI, 1.19 to 10.0; p=0.013). Conclusions: Internet-based VR improves dizziness and reduces dizziness-based disability in older primary care patients without requiring clinical support, and has potential for wide application in community settings.

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Geraghty et al. Internet-based VR RCT - Accepted - AFM - Accepted Manuscript
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More information

Accepted/In Press date: 10 February 2017
e-pub ahead of print date: 8 May 2017
Published date: May 2017

Identifiers

Local EPrints ID: 406158
URI: https://eprints.soton.ac.uk/id/eprint/406158
ISSN: 1544-1709
PURE UUID: 0e4d540e-519c-4059-9cd8-f44ecb8ac7aa
ORCID for Sarah Kirby: ORCID iD orcid.org/0000-0003-1759-1356
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X

Catalogue record

Date deposited: 10 Mar 2017 10:40
Last modified: 20 Jul 2019 01:11

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