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Recovery after early vestibular rehabilitation in patients with acute unilateral vestibular loss
Örebro University, School of Health and Medical Sciences.
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2006 (English)In: Audiological Medicine, ISSN 1651-386X, E-ISSN 1651-3835, Vol. 4, no 3, 117-123 p.Article in journal (Refereed) Published
Abstract [en]

The aims of this study were to follow the recovery process, and explore the disease impact on sick leave in patients with acute unilateral vestibular loss (AUVL). Another aim was to investigate whether initial signs of nystagmus, caloric response, and subjective symptoms of vertigo could predict the return to work. Recovery was followed through the reduction in spontaneous and head-shaking nystagmus, evaluated by Video-Frenzel examination, and by caloric response/asymmetry and spontaneous nystagmus, evaluated by bithermal binaural caloric testing. Information regarding employment, sick leave and subjective symptoms of vertigo was collected using a questionnaire. Twenty-seven patients with AUVL participated in a physiotherapy training programme, starting within 48 h of disease onset. Four assessments were performed: at disease onset, in the acute stage, and after one and six months. In most patients a very rapid cessation of spontaneous nystagmus could be observed (14/27 at a median time of two days after disease onset, a further 10 patients after one month and the remaining three patients after six months). A more prolonged persistence of head shaking nystagmus was observed (24/27, 14/27 and 5/21 of the patients showed head-shaking nystagmus at the three assessments). Caloric asymmetry was normalized after six months in 11/27 patients. A positive and significant correlation was observed between long-lasting sick leave and caloric asymmetry, sense of unsteadiness when standing and walking and older age. Unsteadiness when standing and walking, as well as existence of spontaneous nystagmus, were also positively and significantly correlated with the degree of caloric asymmetry. Spontaneous or head-shaking nystagmus, caloric asymmetry and subjective vertigo at disease onset did not, however, predict sick leave after one or six months. Recovery was excellent in most of the patients.

Place, publisher, year, edition, pages
2006. Vol. 4, no 3, 117-123 p.
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-10361DOI: 10.1080/16513860600933033OAI: oai:DiVA.org:oru-10361DiVA: diva2:310232
Available from: 2010-04-13 Created: 2010-04-13 Last updated: 2016-12-16Bibliographically approved
In thesis
1. Dizziness, balance and rehabilitation in vestibular disorders
Open this publication in new window or tab >>Dizziness, balance and rehabilitation in vestibular disorders
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Dizziness and balance problems are common symptoms at all ages. The aims were; to evaluate rehabilitation, static, dynamic balance and recovery in acute unilateral vestibular loss (AUVL), to evaluate the treatment of benign paroxysmal positional vertigo (BPPV) with assessment of static and dynamic balance and to evaluate the prevalence of dizziness and BPPV in a population of 75-year-olds.

Study 1: Twenty-seven patients (51years) with AUVL were included and the recovery was followed regarding vestibular function, dizziness, and sick-leave. The recovery was rapid, with disappearance of spontaneous nystagmus and rapid return to work.

Study II: Forty two patents (51 years) with AUVL were included and compared with a reference group. Static and dynamic balance were assessed after six months. Significant instability was found both in static and dynamic balance compared to a reference group.

Study III: Seventeen patients (52 years) with severe BPPV (> 3 months) were treated with Semonts´s manouver and/or Brandt-Daroff exercises. The recovery was evaluated by Dix-Hallpike test, subjective dizziness, unsteadiness and balance tests, after 1, 6 and 12 months. Semont´s maneouver resolved dizziness but the long term follow up showed impaired balance.

Study IV: A large cohort (675) of elderly was assessed regarding dizziness and BPPV. Side lying test and balance tests were applied. A high prevalence of dizziness (36%) and BPPV (11%) was found.

Conclusions: Patients with AUVL and BPPV have despite good symptomatic relief, still impaired static and dynamic balance at long term follow up. BPPV in elderly is common and should be examined since it can be treated.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2011. 78 p.
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 33
Keyword
benign paroxysmal positional vertigo, static balance, dynamic balance, unilateral vestibular loss, dizziness, walking, vestibular rehabilitation
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-15012 (URN)978-91-7668-797-0 (ISBN)
Public defence
2011-06-10, Arvid Carlssons föreläsningssal, Sahlgrenska akademin,Göteborgs universitet, Göteborg, 09:00 (Swedish)
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Available from: 2011-03-17 Created: 2011-03-17 Last updated: 2011-10-11Bibliographically approved

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Kollén, LenaMöller, Claes
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