None listed
Conditions
Brief summary
Brief summary: Between 10-30% of older community-living population report dizziness often leading to functional disability and psychological distress. The multifactorial aetiology of dizziness combined with a lack of validated diagnostic tests, and a tendency of clinicians to rely on poorly described symptoms and familiar assessments, are significant barriers to objectively establishing a successful diagnosis and implementing effective interventions. Thus, despite effective treatments being available, up to 40% of older people with reported dizziness remain undiagnosed and untreated. A multidisciplinary assessment battery, with new validated assessments of vestibular impairments is required for diagnosing and treating older people with dizziness. This project will aim to conduct a randomized control trial of a multifaceted dizziness intervention based on a multidisciplinary assessment. We hypothesize that a multidisciplinary assessment (tests of balance, inner ear function, blood pressure, mental health etc) followed by a tailored intervention (exercise program, vestibular rehabilitation, comprehensive geriatric assessment and medication review) will improve diagnosis, reduce self-reported dizziness, enhance postural stability and improve quality of life in older people suffering from dizziness.
Interventions
Multifaceted tailored intervention during a 6 month-period targeting the potential cause(s) of dizziness identified during a baseline multidisciplinary assessment. Established interventions will include the Otago home exercise program (strength and balance training exercises for 30min 3 times weekly and 2 walks of 30min weekly for 6 months; the program will involve home visits and phone contact with an exercise physiologist) to target poor balance, a vestibular rehabilitation program (over 8 wee
Multifaceted tailored intervention during a 6 month-period targeting the potential cause(s) of dizziness identified during a baseline multidisciplinary assessment. Established interventions will include the Otago home exercise program (strength and balance training exercises for 30min 3 times weekly and 2 walks of 30min weekly for 6 months; the program will involve home visits and phone contact with an exercise physiologist) to target poor balance, a vestibular rehabilitation program (over 8 weeks (within the 6months period) with a vestibular physiotherapist; the duration of the session will be about 30min) to target vestibular asymmetry, a booklet-based cognitive behavioral therapy (5 lessons including a weekly homework assignment (approximately 4 hours per week) over 8 weeks (within the 6-months intervention period) and telephone support by a clinical psychologist) to target depression disorders, comprehensive geriatric assessment and medication review with a geriatrician.
Sponsors
Prof Stephen Lord
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
50 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Having experienced one or more episode(s) of dizziness in the past year and not being currently treated for it; living independently in the community or retirement village; able to understand English.
Exclusion criteria
presence of a diagnosed degenerative neurological condition or severe cognitive impairment (GP-Cog score equal or below 4).
Outcome results
None listed