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Gerhard Andersson - One of the best experts on this subject based on the ideXlab platform.
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internet based vestibular rehabilitation for older adults with chronic Dizziness a randomized controlled trial in primary care
Annals of Family Medicine, 2017Co-Authors: Adam W A Geraghty, Gerhard Andersson, Rosie Essery, Sarah Kirby, Beth Stuart, David Turner, Paul Little, Adolfo M Bronstein, Per CarlbringAbstract:PURPOSE Vestibular rehabilitation is an effective intervention for Dizziness due to vestibular dysfunction, but is seldom provided. We aimed to determine the effectiveness of an Internet-based vestibular rehabilitation program for older adults experiencing Dizziness in primary care. METHODS We undertook a single-center, single-blind randomized controlled trial comparing an Internet-based vestibular rehabilitation intervention (Balance Retraining, freely available from https://balance.lifeguidehealth.org) with usual primary care in patients from 54 primary care practices in southern England. Patients aged 50 years and older with current Dizziness exacerbated by head movements were enrolled. Those in the intervention group accessed an automated Internet-based program that taught vestibular rehabilitation exercises and suggested cognitive behavioral management strategies. Dizziness was measured by the Vertigo Symptom Scale–Short Form (VSS-SF) at baseline, 3 months, and 6 months. The primary outcome was VSS-SF score at 6 months. RESULTS A total of 296 patients were randomized in the trial; 66% were female, and the median age was 67 years. The VSS-SF was completed by 250 patients (84%) at 3 months and 230 patients (78%) at 6 months. Compared with the usual care group, the Internet-based vestibular rehabilitation group had less Dizziness on the VSS-SF at 3 months (difference, 2.75 points; 95% CI, 1.39–4.12; P CONCLUSIONS Internet-based vestibular rehabilitation reduces Dizziness and Dizziness-related disability in older primary care patients without requiring clinical support. This intervention has potential for wide application in community settings.
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Randomized controlled trial of vestibular rehabilitation combined with cognitive-behavioral therapy for Dizziness in older people
Otolaryngology - Head and Neck Surgery, 2001Co-Authors: Magnus Johansson, David Åkerlund, Hans Christian Larsen, Gerhard AnderssonAbstract:OBJECTIVE: To evaluate the effectiveness of vestibular rehabilitation combined with cognitive behavioral therapy in the treatment of Dizziness in older people. STUDY DESIGN AND SETTING: A randomized controlled design was used with patients recruited via an advertisement. Nine patients completed treatment and 10 served as waiting-list controls. The intervention lasted 7 weeks with 5 weekly group sessions and consisted of vestibular exercises. Cognitive behavioral therapy components were added to promote relaxation, reduce anxiety, and avoidance of feared situations and movements. RESULTS: Statistically significant improvements on walking time, 2 Dizziness provocative movements, and on the Dizziness Handicap Inventory, but no effects on the Romberg or anxiety and depression. Of the treated patients, 89% reached statistical significant improvement on the total inventory score. CONCLUSION: Cognitive behavioral therapy combined with vestibular rehabilitation decreases Dizziness in older people. SIGNIFICANCE: These findings indicate that cognitive behavioral therapy can be combined with vestibular rehabilitation in the treatment of Dizziness.
Zhang Yanxin - One of the best experts on this subject based on the ideXlab platform.
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residual Dizziness after successful canalith repositioning maneuvers in patients with benign paroxysmal positional vertigo
Chinese Journal of General Practice, 2013Co-Authors: Zhang YanxinAbstract:Objective To study the prevalence and clinical factors associated with residual Dizziness in patients with benign paroxysmal positional vertigo( BPPV) after successful canalith repositioning maneuvers. Methods One hundred and nine patients after successful repositioning maneuvers for benign paroxysmal positional vertigo were recruited in the prospective study. All patients were followed up until the subjective Dizziness and imbalance were completely relieved. The demographic features and clinical factors associated with residual Dizziness were studied. Results Of the 109 patients,42 were males and 67 were females, aged( 52. 0 ± 10. 2) years. Sixty-one patients( 54%) reported residual Dizziness after successful repositioning maneuver. Two types of residual Dizziness were defined: continuous lightheadedness and short-lasting unsteadiness occurring during head movement,standing,or walking. The mean duration of residual Dizziness was( 9. 2 ± 10. 5) days. Cumulative fractions of residual Dizziness during the follow-up after successful repositioning indicated that the residual Dizziness subsided within 20 days in most patients. The age( OR = 1. 048,95% CI 1. 002- 1. 095) and longer symptom duration before successful reposition( OR = 1. 200, 95% CI 1. 025- 1. 405) were associated with an increased risk of residual Dizziness. No association was observed between residual Dizziness and gender,the duration of vertigo,the affected side,involved canal,the number of attacks before treatment and repositioning maneuvers before resolution,etiology of BPPV and complications( including hypertension,diabetes mellitus,coronary artery disease,and hyperlipidemia). Conclusion Residual Dizziness after successful repositioning can be observed in more than half of the patients with BPPV and disappeared within 3 months without specific treatment in all cases. The early successful repositioning can reduce the incidence of residual Dizziness.
Rémy Boussageon - One of the best experts on this subject based on the ideXlab platform.
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Efficacy of acetylleucine in vertigo and Dizziness: a systematic review of randomised controlled trials
European Journal of Clinical Pharmacology, 2019Co-Authors: Paul Vanderkam, Clara Blanchard, Florian Naudet, Denis Pouchain, Helene Vaillant Roussel, Marie Christine Perault-pochat, Nematollah Jaafari, Rémy BoussageonAbstract:Purpose To assess the efficacy of acetylleucine to improve or stop an attack of vertigo and Dizziness (vertigo/Dizziness). Methods Systematic review by 2 independent reviewers. Consultation of the Medline, Cochrane and ClinicalTrials.gov databases until September 2018. Keywords used: Acetylleucine, Tanganil®, Acetyl-DL-leucine, Acetyl-leucine. Trial selection: randomised controlled trials (RCTs) comparing acetylleucine against placebo. Results Up until 2018, no RCTs have been published on the efficacy of acetylleucine in vertigo/Dizziness. Conclusion There is no solid evidence of the efficacy of acetylleucine in vertigo/Dizziness. Given its frequent prescription and the cost generated for the French social security system, high-quality randomised trials should be carried out to assess its efficacy.
Marianne Dieterich - One of the best experts on this subject based on the ideXlab platform.
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functional Dizziness from phobic postural vertigo and chronic subjective Dizziness to persistent postural perceptual Dizziness
Current Opinion in Neurology, 2017Co-Authors: Marianne Dieterich, Jeffrey P StaabAbstract:Purpose of reviewFunctional Dizziness is the new term for somatoform or psychogenic Dizziness. The aim of this study is to review arguments for the new nomenclature, clinical features, possible pathomechanisms, and comorbidities of functional Dizziness.Recent findingsThe prevalence of functional Dizziness as a primary cause of vestibular symptoms amounts to 10% in neuro-otology centers. Rates of psychiatric comorbidity in patients with structural vestibular syndromes are much higher with nearly 50% and with highest rates in patients with vestibular migraine, vestibular paroxysmia, and Meniere's disease. Pathophysiologic processes seem to include precipitating events that trigger anxiety-related changes in postural strategies with an increased attention to head and body motion and a cocontraction of leg muscles. Personality traits with high levels of neuroticism and low levels of extraversion appear as risk factors for anxiety and depressive disorders and increased morbidity in functional disorders.SummaryCorrect and early diagnosis of functional Dizziness, as primary cause or secondary disorder after a structural vestibular syndrome, is very important to prevent further chronification and enable adequate treatment. Treatment plans that include patient education, vestibular rehabilitation, cognitive and behavioral therapies, and medications substantially reduce morbidity and offer the potential for sustained remission when applied systematically.
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psychiatric comorbidity and psychosocial impairment among patients with vertigo and Dizziness
Journal of Neurology Neurosurgery and Psychiatry, 2015Co-Authors: Claas Lahmann, Marianne Dieterich, Michael Strupp, Klaus Jahn, Annegret Eckhardthenn, Thomas Brandt, Peter Henningsen, Regina FeuereckerAbstract:Background Vertigo and Dizziness are often not fully explained by an organic illness, but instead are related to psychiatric disorders. This study aimed to evaluate psychiatric comorbidity and assess psychosocial impairment in a large sample of patients with a wide range of unselected organic and non-organic (ie, medically unexplained) vertigo/Dizziness syndromes. Methods This cross-sectional study involved a sample of 547 patients recruited from a specialised interdisciplinary treatment centre for vertigo/Dizziness. Diagnostic evaluation included standardised neurological examinations, structured clinical interview for major mental disorders (SCID-I) and self-report questionnaires regarding Dizziness, depression, anxiety, somatisation and quality of life. Results Neurological diagnostic workup revealed organic and non-organic vertigo/Dizziness in 80.8% and 19.2% of patients, respectively. In 48.8% of patients, SCID-I led to the diagnosis of a current psychiatric disorder, most frequently anxiety/phobic, somatoform and affective disorders. In the organic vertigo/Dizziness group, 42.5% of patients, particularly those with vestibular paroxysmia or vestibular migraine, had a current psychiatric comorbidity. Patients with psychiatric comorbidity reported more vertigo-related handicaps, more depressive, anxiety and somatisation symptoms, and lower psychological quality of life compared with patients without psychiatric comorbidity. Conclusions Almost half of patients with vertigo/Dizziness suffer from a psychiatric comorbidity. These patients show more severe psychosocial impairment compared with patients without psychiatric disorders. The worst combination, in terms of vertigo-related handicaps, is having non-organic vertigo/Dizziness and psychiatric comorbidity. This phenomenon should be considered when diagnosing and treating vertigo/Dizziness in the early stages of the disease.
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psychotherapy in Dizziness a systematic review
Journal of Neurology Neurosurgery and Psychiatry, 2011Co-Authors: Gabriele Schmid, Peter Henningsen, Marianne Dieterich, Heribert Sattel, Claas LahmannAbstract:Background About 30e50% of complex Dizziness disorders are organically not sufficiently explained or related to a psychiatric disorder. Of patients with such Dizziness disorders, 80% are severely impaired by Dizziness in their daily and working lives; nevertheless, they are often not diagnosed or treated adequately. Objectives This review aims to give a systematic overview of psychotherapeutic approaches and their efficacy regarding the treatment of Dizziness that is medically not sufficiently explained or related to a psychiatric disorder. Methods A systematic literature search was conducted in Medline, PSYNDEX and PsycINFO. Included in this systematic review were (randomised) controlled trials ((R)CTs) concerning psychotherapy in patients with Dizziness, medically not sufficiently explained or associated with a psychiatric disorder. If possible, Hedges’ g was used to express the effect sizes (ES) of the treatment. Heterogeneity was assessed using the Q statistic. In addition, the quality of the studies was rated. Results Three (R)CTs were included. All studies used cognitiveebehavioural treatment methods in combination with relaxation techniques or vestibular rehabilitation. All studies suggested that psychotherapy may provide improvement. The mean ES in the treatment groups was 0.46 (95% CI 0.05 to 0.88) for Dizziness related outcome, 0.10 (� 0.44 to 0.64) for anxiety and 0.17 (� 0.24 to 0.58) for depression whereas in the control groups the mean Dizziness related ES was � 0.04 (� 0.44 to 0.37), anxiety related ES was � 0.03 (� 0.43 to 0.38) and depression related ES was � 0.02 (� 0.42 to 0.38). The quality of the studies was average. Sample sizes were small, however, and there was a lack of long term studies. Conclusion This systematic review provides some preliminary evidence that psychotherapy may be effective in patients with Dizziness that is medically not sufficiently explained or due to a psychiatric disorder. The results should be replicated in larger samples and follow-up RCTs.
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Dizziness anxiety health care utilization and health behavior results from a representative german community survey
Journal of Psychosomatic Research, 2009Co-Authors: Jorg Wiltink, Marianne Dieterich, Annegret Eckhardthenn, Regine Tschan, Matthias Michal, Claudia Subicwrana, Manfred E BeutelAbstract:Background: Due to the lack of epidemiological data on the relation of Dizziness and anxiety, we investigated the prevalence of Dizziness and anxiety in a representative sample of the German population. We explored the consequences of comorbid anxiety for emotional distress, functional impairment, health care utilization, and health behavior in Dizziness. Methods: By the end of 2006, we surveyed a total of 1287 persons between 14 and 90 years of age in their homes by trained interviewers with standardized self-rating questionnaires on anxiety (Patient Health Questionnaire, Generalized Anxiety Disorder Scale, Mini-Social Phobia Inventory) and Dizziness (Vertigo Symptom Scale). The sample was representative for the German population in terms of age, sex, and education. Results: Symptoms of Dizziness were reported by 15.8% of the participants. Of the participants with Dizziness, 28.3% reported symptoms of at least one anxiety disorder (generalized anxiety, social phobia, panic). Persons with Dizziness reported more somatic problems such as hypertension, migraine, diabetes, etc. Comorbid anxiety was associated with increased health care use and impairment. Conclusion: Dizziness is a highly prevalent symptom in the general population. A subgroup with comorbid anxiety is characterized by an increased subjective impairment and health care utilization due to their Dizziness. Because treatment options for distinct neurotologic disorders are also known to reduce psychological symptoms, and in order to avoid unnecessary medical treatment, early neurologic and psychiatric/psychotherapeutic referral may be indicated.
Mun Young Chang - One of the best experts on this subject based on the ideXlab platform.
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can osteopenia induce residual Dizziness after treatment of benign paroxysmal positional vertigo
Otology & Neurotology, 2020Co-Authors: Seung Ri Oh, Hyunkyu Chae, Mun Young ChangAbstract:OBJECTIVE: This study aimed to determine whether there is an association between osteopenia and residual Dizziness after successful treatment of benign paroxysmal positional vertigo (BPPV). METHODS: In all, 62 patients with canalolithiasis-type BPPV were included in the study. Patients were divided into two groups according to the presence of residual Dizziness after resolution of BPPV. Univariate and multivariate analyses were performed to determine the factors associated with residual Dizziness. Patients were analyzed based on age, sex, affected semicircular canal, affected side, BPPV duration, and presence of hypertension, diabetes mellitus, hyperlipidemia, and osteopenia. RESULTS: In univariate analysis, BPPV duration and osteopenia showed a relatively significant association (p < 0.20) with the development of residual Dizziness. On subsequent multivariate analysis using these factors, osteopenia remained a statistically significant factor in association with residual Dizziness (p = 0.012, odds ratio, 9.916). CONCLUSION: Osteopenia is associated with the development of residual Dizziness. BPPV patients with osteopenia more frequently suffer from residual Dizziness after successful treatment of BPPV than those without osteopenia.
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clinical utility of cervical vestibular evoked myogenic potentials in predicting residual Dizziness after benign paroxysmal positional vertigo
Clinical Neurophysiology, 2019Co-Authors: Kyung Hyun Oh, Mun Young ChangAbstract:Abstract Objectives In the present study, the value of cervical vestibular-evoked myogenic potential (cVEMP) as a predictive factor for residual Dizziness after recovery of benign paroxysmal positional vertigo (BPPV) was evaluated. Methods The present study included 65 patients who had BPPV and underwent cVEMP testing. Patients were divided into two groups depending on the presence or absence of residual Dizziness after recovery of BPPV. Univariate and multivariate analyses were performed to determine the factors associated with residual Dizziness using age, gender, affected semicircular canal, affected side, BPPV duration, and cVEMP parameters. Results In univariate analysis, cVEMP-modified interaural amplitude difference (IAD) ratio and p13 latency showed a relatively significant association (p Conclusions Increased cVEMP-modified IAD ratio at the affected side is associated with residual Dizziness. BPPV patients with increased cVEMP-modified IAD ratio at the affected side are more likely to have residual Dizziness after recovery of BPPV. Significance cVEMP testing could be used for the prediction of residual Dizziness. An increased cVEMP-modified IAD ratio at the affected side may be used as a predictor of residual Dizziness.
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Prevalence of vestibular dysfunction and associated factors in South Korea
BMJ Open, 2015Co-Authors: Mun Young ChangAbstract:Objective To report the nationwide prevalence of Dizziness and vestibular dysfunction in the Korean population and determine the associated factors. Design Cross-sectional analysis of a nationwide health survey. Methods We obtained data from the 2009 to 2010 Korea National Health and Nutrition Examination Surveys, which were cross-sectional surveys of the South Korean civilian, non-institutionalised population aged 40 years and older (N=3267). A field survey team performed interviews and physical examinations. Structured questionnaires were handed out and balance function tests using the modified Romberg test of standing balance on firm and compliant support surfaces were performed on participants. Failure on the modified Romberg test was regarded to indicate vestibular dysfunction. Results The prevalence of Dizziness during the past year was 16.70% (95% CI 14.65% to 18.76%). The presence of vestibular dysfunction was noted in 1.84% (95% CI 1.18% to 2.51%). In addition, the prevalence of experiencing falls and positional Dizziness were 1.46% (95% CI 0.87% to 2.06%) and 1.73% (95% CI 1.17% to 2.29%), respectively. Multivariable analysis revealed that Dizziness was associated with increased age, female gender, hearing loss and stress. Vestibular dysfunction was associated with increased age, history of Dizziness and hearing loss. Conclusions Vertigo and Dizziness are the greatest contributors to the burden of disability in the aged population. Screening for Dizziness and vestibular dysfunction, and management of associated factors might be important for improving compromised quality of life due to postural imbalance caused by vestibular problems.