Guri Tokle1, Siv Mørkved1,2, Geir Bråthen3,4, Frederik Kragerud Goplen5,6, Øyvind Salvesen2, Haakon Arnesen7,4, Berit Holmeslet7, Stein Helge Glad Nordahl5,6, Kjersti Thulin Wilhelmsen8. 1. Clinic of Clinical Service, St. Olavs hospital/Trondheim University Hospital. 2. Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Faculty of Medicine and Health Sciences. 3. Neuroclinic, St. Olavs Hospital/Trondheim University Hospital. 4. Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Faculty of Medicine and Health Sciences, Trondheim. 5. Department of Otorhinolaryngology & Head and Neck Surgery, Norwegian National Advisory Unit on Vestibular Disorders, Haukeland University Hospital. 6. Department of Clinical Medicine, University of Bergen, Bergen. 7. Department of Otorhinolaryngology, St. Olavs Hospital/Trondheim University Hospital. 8. Department of Health and Function, Western Norway University of Applied Sciences, Bergen, Norway.
Abstract
OBJECTIVE: To investigate whether a vestibular rehabilitation program started early after diagnosis of vestibular neuritis combined with standard care reduces dizziness and improves functions of daily life more effectively than standard care alone in patients with acute vestibular neuritis. STUDY DESIGN: Non-blinded, randomized controlled trial with 2 parallel groups. SETTING:Specialist centers in 2 university hospitals. PATIENTS: Patients, 18-70 years, with acute vestibular neuritis confirmed by videonystagmography. INTERVENTION: Standard care was 10 days of prednisolone, general information, and counseling given to all patients. In addition to standard care, the intervention group received supervised exercise therapy (vestibular rehabilitation). Vestibular rehabilitation was given in a group format, individually tailored, and supported by home exercises. MAIN OUTCOME MEASURE: Perceived dizziness during head motion. Secondary outcomes were walking speed, standing balance, Hospital Anxiety and Depression Scale (HADS), Vertigo Symptom Scale, Visual Analog Scales (VASs), Dizziness Handicap Inventory (DHI), The University of California Los Angeles Dizziness Questionnaire. RESULTS:Sixty-five patients were included, 27 participated in the vestibular rehabilitation group. There was a statistically significant difference in favor of the vestibular rehabilitation group in overall perceived dizziness at 3 (p = 0.007) and 12 months (p = 0.001). No statistically significant differences were found in standing balance and walking speed. Results from self-report measures showed a statistically significant difference at 12 months in HADS (p = 0.039), DHI (p = 0.049) and VAS-C (p = 0.012). CONCLUSION: A vestibular rehabilitation program started early after confirmed vestibular neuritis diagnosis in addition to standard care reduces the perception of dizziness and improves functions of daily life more effectively than standard care alone.
RCT Entities:
OBJECTIVE: To investigate whether a vestibular rehabilitation program started early after diagnosis of vestibular neuritis combined with standard care reduces dizziness and improves functions of daily life more effectively than standard care alone in patients with acute vestibular neuritis. STUDY DESIGN: Non-blinded, randomized controlled trial with 2 parallel groups. SETTING: Specialist centers in 2 university hospitals. PATIENTS: Patients, 18-70 years, with acute vestibular neuritis confirmed by videonystagmography. INTERVENTION: Standard care was 10 days of prednisolone, general information, and counseling given to all patients. In addition to standard care, the intervention group received supervised exercise therapy (vestibular rehabilitation). Vestibular rehabilitation was given in a group format, individually tailored, and supported by home exercises. MAIN OUTCOME MEASURE: Perceived dizziness during head motion. Secondary outcomes were walking speed, standing balance, Hospital Anxiety and Depression Scale (HADS), Vertigo Symptom Scale, Visual Analog Scales (VASs), Dizziness Handicap Inventory (DHI), The University of California Los Angeles Dizziness Questionnaire. RESULTS: Sixty-five patients were included, 27 participated in the vestibular rehabilitation group. There was a statistically significant difference in favor of the vestibular rehabilitation group in overall perceived dizziness at 3 (p = 0.007) and 12 months (p = 0.001). No statistically significant differences were found in standing balance and walking speed. Results from self-report measures showed a statistically significant difference at 12 months in HADS (p = 0.039), DHI (p = 0.049) and VAS-C (p = 0.012). CONCLUSION: A vestibular rehabilitation program started early after confirmed vestibular neuritis diagnosis in addition to standard care reduces the perception of dizziness and improves functions of daily life more effectively than standard care alone.
Authors: Colin R Grove; Bryan C Heiderscheit; G Mark Pyle; Brian J Loyd; Susan L Whitney Journal: Arch Phys Med Rehabil Date: 2020-12-15 Impact factor: 3.966
Authors: Solmaz Surano; Helena Grip; Fredrik Öhberg; Marcus Karlsson; Erik Faergemann; Maria Bjurman; Hugo Davidsson; Torbjörn Ledin; Ellen Lindell; Jan Mathé; Fredrik Tjernström; Tatjana Tomanovic; Gabriel Granåsen; Jonatan Salzer Journal: Trials Date: 2022-06-16 Impact factor: 2.728