University of Sussex
Browse

File(s) under permanent embargo

Effectiveness of primary care-based vestibular rehabilitation for chronic dizziness

journal contribution
posted on 2023-06-07, 14:49 authored by Lucy Yardley, Margaret Donovan-Hall, Helen E Smith, Bronagh M Walsh, Mark Mullee, Adolfo Bronstein
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.

History

Publication status

  • Published

File Version

  • Published version

Journal

Annals of Internal Medicine

ISSN

0003-4819

Publisher

American College of Physicians

Issue

8

Volume

141

Page range

598-605

Department affiliated with

  • Primary Care and Public Health Publications

Full text available

  • No

Peer reviewed?

  • Yes

Legacy Posted Date

2008-10-08

First Compliant Deposit (FCD) Date

2019-07-02

Usage metrics

    University of Sussex (Publications)

    Categories

    No categories selected

    Exports

    RefWorks
    BibTeX
    Ref. manager
    Endnote
    DataCite
    NLM
    DC