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Profile of Patients Treated in Outpatient Vestibular Rehabilitation at a Hospital in São Paulo  [PDF]
Bárbara Vieira Coró, Miguel Angelo Hyppolito, Camila Giacomo Carneiro Barros, Ana Paula do Rego André
International Journal of Clinical Medicine (IJCM) , 2019, DOI: 10.4236/ijcm.2019.101002
Abstract: Introduction: Currently it is very common that the search for diagnosis and treatment for curing diseases can cause vertigo or dizziness. Objective: This study sought to characterize the profile of patients seen in the clinic for vestibular rehabilitation in a tertiary hospital in the last 10 years. Methods: Survey questionnaires of patients with dizziness. Results: The prevalence of treated subjects was female 65.3% (N = 439). The average age was 54.9 years old. Dizziness type roundabout was more prevalent 33.04% (N = 222). Tinnitus occurred in 58.33% of the population. The time of most observed dizziness was less than 5 years 70.68% (N = 475). Neurovegetative symptoms appeared in 63.98% (N = 430) of the population. The bilateral normal hearing was more standard 35.26% (N = 237). The topographic diagnosis of peripheral origin was the most usual 65.47% (N = 440). Conclusion: The peripheral otoneurologic involvement was more prevalent in this population, affecting more women at an average age of 54.9 years old. The most prevalent symptoms were vertigo, nausea, tachycardia, sweating, vomiting and tinnitus, characterizing the peripheral vestibular impairment. The time of dizziness was less than five years. Audiological standard normal curve was predominant and the symptom of tinnitus was the most reported. The most prevalent comorbidity was Hypertension.
Vertigo and vestibular rehabilitation.  [cached]
Konnur M
Journal of Postgraduate Medicine , 2000,
Abstract: The role of rehabilitation in the management of vertigo is limited to a very specific group of conditions. An Occupational therapist who is a part of the multidisciplinary team treating the vertiginous patient, with the knowledge of physiology and therapeutic benefit of vestibular rehabilitation can widen the rehabilitation spectrum for various diseases producing vertigo and dysequilibrium, to resolve or minimise these symptoms. The present article reviews the need for vestibular rehabilitation and the different conditions needing the same along with its characteristics, physiology and various exercises prescribed.
Vestibular Rehabilitation for the Patients with Intractable Vestibular Neuritis  [PDF]
Hiroaki Ichijo
International Journal of Otolaryngology and Head & Neck Surgery (IJOHNS) , 2018, DOI: 10.4236/ijohns.2018.76035
Abstract: Objective: To clarify whether vestibular rehabilitation is effective in improving spontaneous nystagmus in patients with intractable vestibular neuritis. Methods: The subjects were 8 patients (6 females and 2 males) with vestibular neuritis who revealed long-lasting (more than 2 months since the onset) horizontal spontaneous nystagmus toward the healthy side. We used thumbs-up head shaking for vestibular rehabilitation. This exercise involves active head shaking (1 Hz) while staring at one’s thumb nail. One set is 10 cycles. We asked the patient to do 3 sets (morning, afternoon, and night) every day. Results: The mean value of the slow-phase velocity of spontaneous nystagmus before treatment was 4.1°/s, and that 3 months after vestibular rehabilitation was 4.1°/s. No improvement was observed. Conclusion: Vestibular rehabilitation is not always effective in improving spontaneous nystagmus in patients with intractable vestibular neuritis. Therefore, clinicians should consider the possibility of long-term incomplete central compensation.
Quality of life of individuals submitted to vestibular rehabilitation
Patatas, Olívia Helena Gomes;Ganan?a, Cristina Freitas;Ganan?a, Fernando Freitas;
Brazilian Journal of Otorhinolaryngology , 2009, DOI: 10.1590/S1808-86942009000300014
Abstract: balance disorders affect social, family and professional activities. vestibular rehabilitation can reduce the impact of these disorders on the quality of life of individuals with vertigo. aim: to study the influence of vestibular rehabilitation on the quality of life of individuals, correlating it with gender, age, results from computerized vectoelectronystagmography and vertigo. study type: retrospective. materials and methods:twenty-two individuals were submitted to customized vestibular rehabilitation and the brazilian dizziness handicap inventory - dhi before and after vestibular rehabilitation. results from this questionnaire were correlated with gender, age, vestibular assessment and the presence of vertigo. results: all the dhi scores reduced significantly after vestibular rehabilitation. there were no differences among genders; adults and elderly patients; irritative peripheral vestibular syndromes; deficiency syndromes and normal exams; the presence or absence of vertigo. conclusion: all the individuals had improvements in their quality of life after customized vestibular rehabilitation.
Outpatient pulmonary rehabilitation – rehabilitation models and shortcomings in outpatient aftercare
Korczak, Dieter,Huber, Beate,Steinhauser, Gerlinde,Dietl, Markus
GMS Health Technology Assessment , 2010,
Abstract: Background: The chronic obstructive pulmonary disease (COPD) and the bronchial asthma are widespread diseases. They need long-lasting and sustainable rehabilitation. Objectives: The goal of this HTA is to describe the present supply and the economic relevance of out-patient pulmonary rehabilitation in conjunction with its social aspects. A further target is to derivate options for actions in the health-care system and possible research necessities. Methods: Relevant publications are identified by means of a structured search in 37 database accessed through the German Institute of Medical Documentation and Information (DIMDI). In addition a manual search of identified reference lists has been done. The present report includes German and English literature published from 2004 to 2009. The methodological quality was assessed by two independent researchers according to pre-defined quality criteria of evidence based medicine. Results: Among 860 publications 31 medical studies, four economic studies and 13 ethical studies meet the inclusion criteria. The studies cover rehabilitation programmes in 19 countries. The majority of them has a high level of evidence (1A to 2C). The pulmonary rehabilitation programmes differ by the setting (in-patient, out-patient, in-home, community-based), by the length of intervention (from two weeks to 36 months), by the way and the frequency of intervention and by the duration of the follow-up treatment. Overall out-patient rehabilitation programmes achieve the same positive effects for COPD patients as in-patient programmes do. This is especially true for physical performance and health related quality of life. There are only a few studies dealing with asthma. Therefore, valid statements cannot be given. The results for cost-effectiveness are not distinct enough. Discussion: Goals of pulmonary rehabilitation like prevention and adequate treatment of acute exacerbations, the minimisation of hospitalisation and the reduction of mortality are attained in out-patient as well as in in-patient pulmonary rehabilitation. Regarding the best frequency of training units per week or the duration and the content of a unit further research is needed. Final results for the ideal length of an in-patient rehabilitation are still missing. None of the studies deals with the analysis of the different treatment forms of a COPD which are frequently defined by an alteration of in-patient and out-patient treatments and participation in sports clubs or self-help groups. There are some other limitations of the studies. The results concerning self-manage
Vestibular rehabilitation: clinical benefits to patients with Parkinson's disease
Zeigelboim, Bianca Simone;Klagenberg, Karlin Fabianne;Teive, Hélio A. Ghizoni;Munhoz, Renato Puppi;Martins-Bassetto, Jackeline;
Arquivos de Neuro-Psiquiatria , 2009, DOI: 10.1590/S0004-282X2009000200009
Abstract: objective: to evaluate the effectiveness of the vestibular rehabilitation (vr) exercises by means of an assessment before and after the application of the brazilian version of the dizziness handicap inventory (dhi) questionnaire. method: twelve patients were studied, the following procedures were carried out: anamnesis, otorhinolaryngological and vestibular evaluation, and the application of the dhi before and after the vr. results: clinically resting tremors and subjective postural instability were the motor complaints most frequently associated with complaints of vertigo in 12 cases (100%); in the vestibular exam, all the patients presented abnormalities, frequently from the uni and bilateral peripheral vestibular deficiency syndromes in 10 cases (83.3%); there was significant improvement in the physical, functional and emotional aspects of the dhi after the completion of the vr. conclusion: the vr following the cawthorne and cooksey protocol were shown to be useful in managing subjective complaints of several aspects evaluated in this protocol.
Vestibular Rehabilitation In Unilateral Peripheral Vestibulopathy: A Preliminary Report  [PDF]
Birgul DONMEZ,Gulden AKDAL
Journal of Neurological Sciences , 2008,
Abstract: Vestibular rehabilitation was indicated for patients with vestibulopathy. We evaluated the effect of home supervised vestibular rehabilitation and visual feedback posturography training fourteen patients in a controlled study. Patients were assessed before and after rehabilitation by the Dynamic gait index, the Dizziness handicap inventory, the Berg balance scale and by static posturography. Supervised home program group significantly improved in Berg balance scale, dizziness handicap inventory and movement velocity (p<0.05). Visual feedback posturography group improved significantly in dizziness handicap inventory, reaction time, movement velocity and maximum excursion (p<0.05). But there were not significant differences between home supervised and visual feedback posturography group after treatment.
Manual therapy with and without vestibular rehabilitation for cervicogenic dizziness: a systematic review
Reidar P Lystad, Gregory Bell, Martin Bonnevie-Svendsen, Catherine V Carter
Chiropractic & Manual Therapies , 2011, DOI: 10.1186/2045-709x-19-21
Abstract: A comprehensive search was conducted in the databases Scopus, Mantis, CINHAL and the Cochrane Library for terms related to manual therapy, vestibular rehabilitation and cervicogenic dizziness. Included studies were assessed using the Maastricht-Amsterdam criteria.A total of fifteen articles reporting findings from thirteen unique investigations, including five randomised controlled trials and eight prospective, non-controlled cohort studies were included in this review. The methodological quality of the included studies was generally poor to moderate. All but one study reported improvement in dizziness following either unimodal or multimodal manual therapy interventions. Some studies reported improvements in postural stability, joint positioning, range of motion, muscle tenderness, neck pain and vertebrobasilar artery blood flow velocity.Although it has been argued that manual therapy combined with vestibular rehabilitation may be superior in the treatment of cervicogenic dizziness, there are currently no observational and experimental studies demonstrating such effects. A rationale for combining manual therapy and vestibular rehabilitation in the management of cervicogenic dizziness is presented.There is moderate evidence to support the use of manual therapy, in particular spinal mobilisation and manipulation, for cervicogenic dizziness. The evidence for combining manual therapy and vestibular rehabilitation in the management of cervicogenic dizziness is lacking. Further research to elucidate potential synergistic effects of manual therapy and vestibular rehabilitation is strongly recommended.Dizziness is a non-specific symptom that is commonly encountered by primary health care practitioners [1], and the prevalence has been reported to be between 11.1% and 28.9% [2-5]. It can be experienced as faintness, unsteadiness, perception of spinning and disorientation [6-8]. The mechanisms producing these symptoms are multiple and can involve several different organ system
Quality of life questionnaire application in patients before and after vestibular rehabilitation
Nishino, Lucia Kazuko,Granato, Lídio,Campos, Carlos Alberto Herrerias de
International Archives of Otorhinolaryngology , 2008,
Abstract: Introduction: Conventional vestibular tests are not efficient instruments to evaluate the level of commitment in the life quality of a patient with dizziness. The quality of life questionnaire specific for dizziness, the Dizziness Handicap Inventory, was translated and validated into Portuguese intending to get over this difficulty in quantifying the vertiginous patient symptoms. Objective: This study aims at comparing the Brazilian Dizziness Handicap Inventory results before and after personalized vestibular rehabilitation in patients diagnosed with chronic vertigo from benign paroxist positional vertigo and chronic vertigo from other causes. Method: Retrospective study of 30 medical records; all of which were submitted to the Brazilian Dizziness Handicap Inventory before and after the personalized vestibular rehabilitation treatment. Results: In the total scores average of vestibular pre-rehabilitation, the benign paroxist positional vertigo had a score of 47.93±24.46 and the chronic vertigo for other causes of 54.40±20.97. At discharge, the benign paroxist positional vertigo scores average was of 6.13±7.22 and in the chronic vertigo from other causes, the scores average was of 26.13±20.51. Conclusion: The commitment of the life quality of individuals with dizziness, both for chronic vertigo from other causes and benign paroxist positional vertigo, was very similar, confirming an important commitment. The vestibular rehabilitation effect for both cases was also efficient and the Dizziness Handicap Inventory was an efficient instrument to evaluate the vertiginous case evolution.
Vestibular rehabilitation with biofeedback in patients with central imbalance
Bittar, Roseli Saraiva Moreira;Barros, Camila de Giacomo Carneiro;
Brazilian Journal of Otorhinolaryngology , 2011, DOI: 10.1590/S1808-86942011000300014
Abstract: central nervous system disorders may cause important functional unbalance in the maintenance of balance and posture. there is no effective rehabilitation for these symptoms until now. objective: the aim of this paper is to evaluate the use of tongue electrotactile stimulation on patients with central imbalance using brainport. materials and methods: this is a prospective case series study. we evaluated 8 patients with central imbalance, 6 men and 2 women, with mean age of 67.75 years. the patients were submitted to computed dynamic posturography (cdp) and then received 18 sessions of electrotactile stimulation by brainport? device for 20 minutes, twice a day. then they were submitted to a new cdp test and to a self-perception scale to assess symptom remission, partial improvement and no improvement at all. results: 75% of the patients reported being more stable. there was no improvement in the balance control of the mass center in these patients. conclusion: the patients were able to use the electrotactile stimulus to improve their balance control.
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