Objective: To investigate whether specific rehabilitation for patients with dizziness has any effect on clinical balance measures and/or the apprehension of dizziness measured with a visual analogue scale (VAS).
Design: Randomized controlled trial.
Subjects: Forty-two patients, 50 years or older with dizziness of central or agerelated origin, identified in primary health care.
Method: The patients were randomized to either an intervention or a control group. The intervention included balance training and vestibular rehabilitation in group sessions twice a week for six weeks. All patients were assessed at baseline, after six weeks and after three months with five different balance measures and visual analogue scale.
Results: Statistically significant differences were found between the two groups comparing results at baseline and after six weeks regarding standing one leg eyes closed (SOLEC) on right foot (p 0.011). Results of SOLEC right foot after three months differed significantly between the groups (p -0.033) as did SOLEC left foot (p -0.035). No difference between the groups were found in the Romberg test, figure of eight, walking heel to toe, ‘stops walking when talking’, standing one leg eyes open or estimating the experience of dizziness measured with visual analogue scale.
Conclusions: Balance training and vestibular rehabilitation improved the ability to stand on one leg with eyes closed in persons with dizziness aged 50 years or over.
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References
1.
1 Ekvall-Hansson E, Ma°nsson N-O. What happens with the dizzy patient in primary health care? Does education influence treatment?Adv Physiother2004; 6:93-96.
2.
2 Sloane PD, Blazer D, George LK. Dizziness in a community elderly population. J Am Geriatr Soc1989; 37: 101-108.
3.
3 Grimby A, Rosenhall U. Health-related quality of life and dizziness in old age. Gerontology1995; 41: 286-298.
4.
4 Yardley L, Beech S, Zander L, Evans T, Weinman J. A randomized controlled trial of exercise therapy for dizziness and vertigo in primary care. Br J Gen Pract1998; 48: 1136-1140.
5.
5 Ekvall-Hansson E, Ma°nsson N-O. Sjukgymnastens roll i bedömning och behandling av yrsel. Nord Fysioter2001; 5:23-33.
6.
6 Bird J, Beynon G, Prevost A, Baguley D. An analysis of referral patterns for dizziness in the primary care setting. Br J Gen Pract1998; 48: 1828-1832.
7.
7 Bittar R, Pedalini M, Lorenzi M, Formigoni L. Treating vertigo with vestibular rehabilitation: results in 155 patients. Rev Laryngol Otol Rhinol2002; 123:61-65.
8.
8 Johansson M, Akerlund D, Larsen H, Andersson G. Randomized controlled trial of vestibular rehabilitation combined with cognitive-behavioral therapy for dizziness in older people. Otolaryngol Head Neck Surg2001; 125: 151-156.
9.
9 Whitney S, Rossi M. Efficacy of vestibular rehabilitation. Otolaryngol Clin North Am2000; 33: 659-672.
10.
10 Lundin-Olsson L, Nyberg L, Gustafson Y. ‘Stops walking when talking’ as a predictor of falls in elderly people. Lancet1997; 349: 617-617.
11.
11 Jarnlo G-B, Thorngren K-G. Standing balance in hip fracture patients. Acta Orthop Scand1991; 62: 427-434.
12.
12 Ledin T, Kronhed AC, Mo Ödkvist LM, Olsson B. Effects of balance training in elderly evaluated by clinical tests and dynamic posturography. J Vestib Res1990/91; 1: 129-138.
13.
13 Johansson G, Jarnlo G-B. Balance training in 70-year-old women. Physiother Theory Pract1991; 7: 121-125.
14.
14 Ringsberg KAM, Gärdsell P, Johnell O, Jónsson B, Obrant KJ, Sernbo I. Balance and gait performance in an urban and a rural population. J Am Geriatr Soc1998; 46:65-70.
15.
15 Carlsson AM. Assessment of chronic pain. Aspects of the reliability and validity of the Visual Analogue Scale. Pain1983; 16:87-101.
16.
16 Price DD, McGrath PA, Rafii A, Buckingham B. The validation of Visual Analogue Scales as ratio scale measures for chronic and experimental pain. Pain1983; 17:45-56.
17.
17 Kammerlind A, Hakansson J, Skogsberg M. Effects of balance training in elderly people with nonperipheral vertigo and unsteadiness. Clin Rehabil2001; 15: 463-470.
19 Bergenius J, Hannerz J, Lundin A, Pehrsson K, Bagger-Sjöbäck D, Tistad M. Yrsel. Lund: Studentlitteratur, 2000.
20.
20 Bohannon R, Larkin P, Cook A, Gear J, Singer J. Decrease in timed balance test scores with aging. Phys Ther1984; 64: 1067-1070.
21.
21 Gustafsson A, Möller C. Yrsel och balansrubbningar, nya behandlingsvägar. Audionytt1995; 3: 6-10.
22.
22 Horak FB, Jones-Rycewicz C, Black O, Shumway-Cook A. Effects of vestibular rehabilitation on dizziness and imbalance. Otolaryngol Head Neck Surg1992; 106: 175-180.
23.
23 Smith-Wheelock M, Shepard TN, Telian SA. Physical therapy program for vestibular rehabilitation. Am J Otology1991; 12: 218-225.
24.
24 Norré ME. Rationale of rehabilitation treatment for vertigo. Am J Otolaryngol1987; 8:31-35.
25.
25 Bergenius J, Brantberg K. Framsteg rörande yrsel och balansrubbningar. Läkartidningen1997; 94:2639-2642.
