In addition, dizziness and imbalance increase risk of falls. Falling is a major cause of morbidity and mortality in older adults Shumway-Cook et al.
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Treatment addressing dizziness and fall risk is within the scope of physical therapy practice, but we would like to know if the evidence supports its use. We reviewed ten studies that helped answer our clinical question. These studies examined subjects with dizziness of central, peripheral, and mixed origins, as well as general imbalance.
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Evidence from multiple comparisons showed no difference in response to VBRT based on etiology or severity of dizziness or imbalance, nor any demographic characteristic, including age. Studies with moderate to high internal validity demonstrated that VBRT effectively improved balance and decreased report of dizziness symptoms. These studies reported that mean improvements meeting or exceeding the minimal clinically important difference MCID for appropriate outcome measures.
Additionally, home exercise programs HEPs appeared to have an important role in producing and maintaining improvements. Based on our appraisal of the literature, we feel confident that providing VBRT and HEPs to patients of any age presenting with dizziness and imbalance will decrease fall risk and increase quality of life. Clinical Scenario: Over the course of our clinical internships, we have seen varying frequencies of referrals for PT treatment for dizziness and fall risk.
In some clinics, many patients are seen for an extensive course of vestibular and balance rehabilitation therapy VBRT with clinical outcome measures used to justify initiation and termination of treatment. In other clinics, patients with dizziness are infrequently referred, and treatment does not necessarily include VBRT.
Given the high personal and financial costs of falling and the damaging effect of chronic dizziness on quality of life, we would like to know if VBRT is effective at decreasing fall risk and improving quality of life. If not, we might choose to spend PT treatment time on other types of interventions aimed at reducing fall risk, such as increasing strength to improve functional mobility. Clinical Question: Population—Patients of all ages with subjective complaints of dizziness and imbalance and history of loss of balance Intervention—Vestibular and balance rehabilitation therapy VBRT including habituation, substitution, gait, and balance exercises Comparison—Standard medical treatment, no treatment, or placebo Outcome—Subjective report of decreased symptoms, decreased future falls.
The digital version of this project is currently unavailable to off-campus users not affiliated with Pacific University; however, it may be accessed on campus or through interlibrary loan for eligible borrowers from Pacific University Library. View CV.
Kapiti Dizziness and Balance Centre - Training
Education B. Title of thesis: Dermatomal somatosensory evoked potential demonstration of nerve root function after 2-way traction.
- Emory Dizziness and Balance Center treats common forms of vertigo | Emory University | Atlanta, GA.
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- PhD thesis - MOVANT - University of Antwerp!
- How Can the Success of Rehabilitation Be Measured?.
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Journal of back and musculoskeletal rehabilitation. Austin spine journal Journal of Taibah university Journal of Pain Research International Journal of Therapy and Rehabilitation We covered one session in the Professional diploma in vestibular science course under the title Vestibular rehabilitation Therapy.
Selected Research Projects The effect of weight loss on normalization of postural control, gait performance and associated maladaptive neuroplastic changes. A two year prospective cohort study [ submitted to jalila foundation but not accepted yet]. Brief report: does rehabilitation of cervical lordosis influence sagittal cervical spine flexion extension kinematics in cervical spondylotic radiculopathy subjects?
Abu El Kasem , Omaima M.
The Use of Technology in Vestibular Rehabilitation and Balance Assessment
Kattabie , Neveen A. Abdel Raoof , Ibrahim M. The addition of a sagittal cervical posture corrective orthotic device to a multimodal rehabilitation program improves short and long term outcomes in patients with discogenic cervical radiculopathy. Arch Phys Med Rehabil. The effect of normalizing the sagittal cervical configuration on dizziness, neck pain, and cervicocephalic kinesthetic sensibility: a 1-year randomized controlled study.
Eur J Phys Rehabil Med. The effect of normalizing the sagittal cervical configuration for the management of cervicogenic headaches: a 2-year pilot randomized controlled trial. Journal of Manipulative and Physiological Therapeutics in press. The addition of upper cervical manipulative therapy in the treatment of patients with fibromyalgia: a randomized controlled trial.
Rheumatology International. Publisher, Springer. The effect of adding forward head posture corrective exercises in the management of lumbosacral radiculopathy: randomized controlled study. Publisher, Mosby.
Multimodal treatment program comparing 2 different traction approaches for patients with discogenic cervical radiculopathy: a randomized controlled trial. J Chiropr Med. Publisher, Elsevier. The efficacy of lumbar extension traction for sagittal alignment in mechanical low back pain: a randomized trial. J Back Musculoskelet Rehabil. Publisher, IOS Press.
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Extension traction treatment for patients with discogenic lumbosacral radiculopathy: a randomized controlled trial. Clin Rehabil. Epub Jun 8. Lumbar lordosis rehabilitation for pain and lumbar segmental motion in chronic mechanical low back pain: a randomized trial.