| Yardley et al.(2222 Yardley L, Beech S, Zander L, Evans T, Weinman J. A randomised controlled trial of exercise therapy for dizziness and vertigo in primary care. Br J Gen Pract. 1998;48(429):1136-40. PMid:9667087. )
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age:
Adults 18 years of age or older.
Diagnosis:
Vestibular dizziness.
Inclusion:
Complaint of dizziness, confirmed vestibular alteration by the physician.
N= 143 (115 female and 28 male).
Group:
EG= 67 and CG= 76. |
- DHI (Dizziness Handicap Inventory).
-Vertigo Symptom Scale (self-perception of vertigo).
- HADS (Hospital Anxiety and Depression Scale).
-Short- Form 36 (physical functioning).
- Romberg (timed swing).
- Unterberger test. |
Prospective, randomized, controlled trial.
Follow up: 6 months |
EG: VR protocol with Yardley exercises, relaxation and breathing exercises. Booklet with guidelines for performing exercises at home. .Session: In group, twice a week, lasting 30 to 40 minutes.
CG: You did not receive any type of intervention for 6 weeks. After 6 months of follow-up, he received VR (same GE model). |
- The EG improved in all measures, while the control group did not show improvement, resulting in a significant difference between the two groups in the physical indexes of balance and subjective indexes of anxiety symptoms.
- The odds of improvement in treated patients for untreated patients were 3.1: 1 after six weeks (95% CI = 1.4-6.8) and 3.8: 1 after six months (95% Cl = 1.6-8.7). |
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Hansson et al.(1818 Hånsson EE, Mansson NO, Håkansson A. Effects of specific rehabilitation for dizziness among patients in primary health care: a randomized controlled trial. Clin Rehabil. 2004;18(5):558-65. http://dx.doi.org/10.1191/0269215504cr771oa. PMid:15293490.
http://dx.doi.org/10.1191/0269215504cr7...
)
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Age: 50-87 years.
Diagnosis: Dizziness of vestibular origin related to aging.
Inclusion: Subjects 50 years of age or older, with dizziness caused by aging.
n = 42 (30 females and 12 males)
Groups
EG= 23 e CG= 19. |
- Static balance with open eyes (, Romberg in tandem position and unipodal support).
- Dynamic balance: March at eight and stop walking when talking-tandem gear.
- EVA / dizziness |
Randomized randomized clinical trial.
Follow up: 3 months. |
EG: VR protocol with body balance exercises, eye movement and cephalic movement on unstable surfaces.
CG: You did not receive any type of intervention.
Session: In a group, twice a week, lasting 45 minutes (total = 6 weeks) |
- Right unipodal support with closed eyes showed a significant improvement of EG in relation to CG after 6 weeks of intervention.
- After 3 months, significant improvement in the unipodal tests in the EG, in relation to the CG.
- In the other tests there was no difference between the groups.
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- EG improved in 80% of tests and deteriorated by 5%, while CG improved by 30% and deteriorated by 55%. |
04 |
Yardley et al.(2121 Yardley L, Donovan-Hall M, Smith HE, Walsh BM, Mullee M, Bronstein AM. Effectiveness of primary care-based vestibular rehabilitation for chronic dizziness. Ann Intern Med. 2004;141(8):598-605. http://dx.doi.org/10.7326/0003-4819-141-8-200410190-00007. PMid:15492339.
http://dx.doi.org/10.7326/0003-4819-141...
)
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Age:
Adults 18 years of age or older.
Diagnosis:
Vestibular dizziness.
Inclusion:
Patients with chronic dizziness (= or> 2 years), with vestibular origin.
N = 170 patients (121 females and 59 males)
Groups:
EG= 83 and CG= 87 |
- DHI (Dizziness Handicap Inventory).
-Vertigo Symptom Scale (self-perception of vertigo).
- HADS (Hospital Anxiety and Depression Scale).
-Short- Form 36 (Physical functioning). |
Prospective, randomized and controlled trial, uni-blinded.
Follow up: 6 months
. |
EG: VR protocol with Yardley exercises.
Session: Individual consultation lasting 30-40 minutes and booklet with guidelines for performing exercises at home, once a day.
CG: routine care in PHC |
After 3 months, there was improvement in all measures of the primary endpoint and the EG measurements were significantly higher than those of the EG.
Improvement of anxiety and depression.
In EG, 67% presented improvement of symptoms and complaints, whereas in CG, the improvement was 38%.
At the 6-month follow-up, the groups did not differ (p, 0.05). |
8 |
Hansson et al.(2020 Hånsson EE, Månsson NO, Ringsberg KA, Håkansson A. Falls among dizzy patients in primary healthcare: an intervention study with control group. Int J Rehabil Res. 2008;31(1):51-7. http://dx.doi.org/10.1097/MRR.0b013e3282f28e2c. PMid:18277204.
http://dx.doi.org/10.1097/MRR.0b013e328...
)
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Age: Adults 65 years and over.
Diagnosis: Dizziness of vestibular origin related to aging.
Groups n = 58 (39 females and 19 males).
EG: 31
CG: 27 |
- Static balance with open eyes (Romberg, Romberg in tandem position and unipodal support).
- Dynamic balance: March at eight and stop walking when talking-tandem gear
- DHI (Dizziness Handicap Inventory). |
Interventional test, with control group, without randomization.
Follow up: 6,9 and 12 months. |
EG: VR protocol with body balance exercises, eye movement and cephalic movement on unstable surfaces.
CG: You did not receive any type of intervention.
Session: In a group, twice a week, lasting 50 minutes, in a circuit format. |
- VR did not reduce the risk of falls.
-There was no difference in IHD between groups.
- EG improved on five of the balance measures and deteriorated by one, while the CG worsened by four of the balance measures.
- Statistical significant differences were found between the groups after 3 months, in static and dynamic equilibrium (P = 0.038 and 0.044). |
04 |
Yardley et al.(1919 Yardley L, Barker F, Muller I, Turner D, Kirby S, Mullee M, Morris A, Little P. Clinical and cost effectiveness of booklet based vestibular rehabilitation for chronic dizziness in primary care: single blind, parallel group, pragmatic, randomised controlled trial. BMJ. 2012;344:2237-51. http://dx.doi.org/10.1136/bmj.e2237. PMid:22674920.
http://dx.doi.org/10.1136/bmj.e2237 ...
)
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Age: Adults 18 years and older.
Diagnosis: Dizziness of vestibular origin
Inclusion: Patients with a history of congestive dizziness (duration> 5 years), of vestibular origin
n = 337
Groups
EG1= 112; EG2= 113 and CG=112 |
- QUALY (Total costs in health related to dizziness per life/year).
-Vertigo Symptom Scale (Self-perception of vertigo).
- DHI (Dizziness Handicap Inventory).
- HADS: (Hospital anxiety and depression scale), |
Test
controlled, randomized, parallel and pragmatic study with blind group.
Follow up: 3 and 12 months |
EG1: Vr with booklet.
- VR: Ocular and cephalic exercises during static and dynamic functional activities.
- Booklet with detailed VR exercises and guidelines on behavioral cognitive techniques (motivation).
EG2: VR with booklet and telephone support.
- VR and booklet (identical to EG1)
- Session: In group, at 1 week, lasting 30 minutes and following up by telephone at 2 and 3 weeks, lasting 15 minutes (total = 12 weeks).
CG: Routine care in PHC
. |
- After 12 weeks, scores on the Vertigo Symptom Scale did not differ significantly between EG1, EG2 and CG.
- In 1 year, the groups EG1 and EG2, improved significantly, compared to CG.
- Analysis of the cost-effectiveness curves showed that both interventions (EG1 and EG2) were highly profitable. |
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Subtitle: VR - vestibular rehabilitation; PHC - primary health care