TY - JOUR
T1 - Online vestibular rehabilitation for chronic vestibular syndrome
T2 - 36-month follow-up of a randomised controlled trial in general practice
AU - van Vugt, Vincent A.
AU - Ngo, H. Tn
AU - van der Wouden, Johannes C.
AU - Twisk, Jos Wr
AU - van der Horst, Henriëtte E.
AU - Maarsingh, Otto R.
N1 - Funding Information: This study was funded by the Netherlands Organisation for Health Research and Development (ZonMw) (programme: Quality in health care; grant number: 839110015). The sponsors did not participate in the study design; data collection, analysis, and interpretation; or the preparation or submission of this report. Publisher Copyright: ©The Authors.
PY - 2023/9/1
Y1 - 2023/9/1
N2 - BACKGROUND: Vestibular rehabilitation (VR) is the preferred treatment for chronic vestibular symptoms such as dizziness and vertigo. An internet-based programme was developed to increase uptake of VR. The authors have previously reported that internet-based VR resulted in a clinically relevant decrease of vestibular symptoms for up to 6 months, compared with usual care. AIM: To evaluate long-term outcomes of internet-based VR in patients with chronic vestibular syndrome. DESIGN AND SETTING: A randomised controlled trial was conducted in Dutch general practice involving 322 participants aged ≥50 years with chronic vestibular syndrome. Participants were randomised to stand-alone VR, blended VR (with physiotherapy support), and usual care. Usual care participants were allowed to cross over to stand-alone VR 6 months after randomisation. METHOD: Participants were approached 36 months after randomisation. The primary outcome was the presence of vestibular symptoms as measured by the vertigo symptom scale-short form (VSS-SF). Secondary outcomes were dizziness-related impairment, anxiety, depressive symptoms, and healthcare utilisation. RESULTS: At 36-month follow-up, 65% of participants filled in the VSS-SF. In the usual care group, 38% of participants had crossed over to VR at 6 months. There were no significant differences in vestibular symptoms between VR groups and usual care (mean difference = -0.8 points, 95% confidence interval [CI] = -2.8 to 1.2, for stand-alone VR; -0.3, 95% CI = -2.2 to 1.7, for blended VR). In VR groups, clinically relevant improvement compared with baseline was maintained over time. CONCLUSION: Internet-based VR provides a maintained improvement of vestibular symptoms for up to 36 months in patients with chronic vestibular syndrome.
AB - BACKGROUND: Vestibular rehabilitation (VR) is the preferred treatment for chronic vestibular symptoms such as dizziness and vertigo. An internet-based programme was developed to increase uptake of VR. The authors have previously reported that internet-based VR resulted in a clinically relevant decrease of vestibular symptoms for up to 6 months, compared with usual care. AIM: To evaluate long-term outcomes of internet-based VR in patients with chronic vestibular syndrome. DESIGN AND SETTING: A randomised controlled trial was conducted in Dutch general practice involving 322 participants aged ≥50 years with chronic vestibular syndrome. Participants were randomised to stand-alone VR, blended VR (with physiotherapy support), and usual care. Usual care participants were allowed to cross over to stand-alone VR 6 months after randomisation. METHOD: Participants were approached 36 months after randomisation. The primary outcome was the presence of vestibular symptoms as measured by the vertigo symptom scale-short form (VSS-SF). Secondary outcomes were dizziness-related impairment, anxiety, depressive symptoms, and healthcare utilisation. RESULTS: At 36-month follow-up, 65% of participants filled in the VSS-SF. In the usual care group, 38% of participants had crossed over to VR at 6 months. There were no significant differences in vestibular symptoms between VR groups and usual care (mean difference = -0.8 points, 95% confidence interval [CI] = -2.8 to 1.2, for stand-alone VR; -0.3, 95% CI = -2.2 to 1.7, for blended VR). In VR groups, clinically relevant improvement compared with baseline was maintained over time. CONCLUSION: Internet-based VR provides a maintained improvement of vestibular symptoms for up to 36 months in patients with chronic vestibular syndrome.
KW - dizziness
KW - follow-up studies
KW - physiotherapy
KW - primary care
KW - vertigo
KW - vestibular diseases
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85169503535&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/37487644
U2 - https://doi.org/10.3399/BJGP.2022.0468
DO - https://doi.org/10.3399/BJGP.2022.0468
M3 - Article
C2 - 37487644
SN - 0960-1643
VL - 73
SP - e710-e719
JO - British journal of general practice
JF - British journal of general practice
IS - 734
ER -