Effectiveness of primary care-based vestibular rehabilitation for chronic dizziness. Export

@article{citeulike:4960160, 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.}, author = {Yardley, L. and Donovan-Hall, M. and Smith, H. E. and Walsh, B. M. and Mullee, M. and Bronstein, A. M.}, citeulike-article-id = {4960160}, citeulike-linkout-0 = {http://view.ncbi.nlm.nih.gov/pubmed/15492339}, citeulike-linkout-1 = {http://www.hubmed.org/display.cgi?uids=15492339}, day = {19}, issn = {1539-3704}, journal = {Annals of internal medicine}, keywords = {dizziness, england, neurology\_physical\_therapy, nurse\_delivered, physical\_therapy, postural\_stability, qol, rct, rehabilitation, unilateral\_vestibular\_hypofunction, vestibular, vestibular\_impariment}, month = {October}, number = {8}, pages = {598--605}, posted-at = {2009-06-25 20:18:12}, priority = {2}, title = {Effectiveness of primary care-based vestibular rehabilitation for chronic dizziness.}, url = {http://view.ncbi.nlm.nih.gov/pubmed/15492339}, volume = {141}, year = {2004} }

TY - JOUR ID - citeulike:4960160 L3 - citeulike-article-id:4960160 N2 - 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. IS - 8 JF - Annals of internal medicine SN - 1539-3704 EP - 605 TI - Effectiveness of primary care-based vestibular rehabilitation for chronic dizziness. VL - 141 SP - 598 KW - dizziness KW - england KW - neurology_physical_therapy KW - nurse_delivered KW - physical_therapy KW - postural_stability KW - qol KW - rct KW - rehabilitation KW - unilateral_vestibular_hypofunction KW - vestibular KW - vestibular_impariment AU - Yardley, L AU - Donovan-Hall, M AU - Smith, HE AU - Walsh, BM AU - Mullee, M AU - Bronstein, AM PY - 2004/10/19/ UR - http://view.ncbi.nlm.nih.gov/pubmed/15492339 ER -