Acute Vestibular Syndrome
Conditions
Keywords
acute vestibular syndrome, vertigo, vestibular rehabilitation
Brief summary
Acute onset vertigo is common and entails much suffering with persisting symptoms at 3 months after onset in up to half of those afflicted. Vestibular rehabilitation to aid recovery is not readily available. The purpose of this study is to investigate the effects on vertigo symptoms of a 6-week online vestibular rehabilitation tool compared with standard care (written instructions leaflet) after acute onset vertigo.
Interventions
DEVICEOnline vestibular rehabilitation tool
For those randomized to the intervention group, a 6 weeks duration vestibular rehabilitation will be delivered using an online tool (YrselTräning)
OTHERStandard care (written instructions leaflet)
For those randomized to the control group, a 6 weeks duration standard vestibular rehabilitation will be delivered using a written instructions leaflet
Sponsors
University Hospital, Umeå
Sundsvall Hospital
Sahlgrenska University Hospital
Västernorrland County Council, Sweden
Södra Älvsborg Hospital
Karolinska University Hospital
University Hospital, Linkoeping
Sunderby Hospital
Capio Sankt Görans Hospital
Umeå University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* ≥18 years old; and * The subject has given written consent to participate in the study; and * New acute onset dizziness or vertigo since ≥24 hours with pathological spontaneous or gaze-evoked nystagmus (i.e. an acute vestibular syndrome, AVS). The nystagmus as described above must be present at investigation between 24 hours and 7 days from onset, spontaneously, gaze-evoked or head-shake evoked and documented; and * Screening and inclusion within 7 days of onset of continuous symptoms; and * Symptomatic at inclusion
Exclusion criteria
* Pre-existing vestibular disease or neurological disease anticipated to affect the ability to participate in the study or the effect of the intervention. N.B: Recurring AVS with no set diagnosis before inclusion is accepted, as is past transient neurological diseases such as TIA or migraine; or * Inability to use the online rehabilitation tool, e.g. due to not having access to a computer, tablet or smartphone, not having access to the internet or lacking in experience with such tools; or * Mental inability, reluctance or language difficulties that result in difficulty understanding the meaning of study participation; or * Medical and/or physical contraindications to making the required head movements (e.g. vertebral dissection) or otherwise participating in the training and testing exercises or data collection; or * Medication or other substance intake which can affect the ability to participate in the study or the reliability of the measurement methods. These medications include regular use of: Anticonvulsants, antiemetics/motion sickness medications, benzodiazepines, neuroleptics. Transient corticosteroid and/or antiemetic treatment related to the current vertigo is accepted.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The between group mean Vertigo Symptom Scale Short Form (VSS-SF) score difference | 6 weeks after vertigo onset | VSS-SF uses a five-point Likert scale: 0 (never), 1 (a few times), 2 (several times), 3 (quite often \[every week\]), and 4 (very often \[most days\]). The score ranges from 0 to 60. A higher score indicates worse symptoms. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The between groups mean Dizziness Handicap Inventory (DHI) score | 6 weeks and 3 months after vertigo onset | The Dizziness Handicap Inventory (DHI) uses a three-point scale to rate each item: 0 (no), 2 (sometimes), and 4 (always). The score ranges from 0 to 100. A higher overall score indicates more severe handicap. |
| The between groups changes in timed 25-foot walk test (T25-FW)); body sway during standing and walking; and the mobility | From baseline to 6 weeks and 3 months | — |
| The between groups changes in video head impulse test (vHIT, site-dependent) | 6 weeks and 3 months after vertigo onset | — |
| The between groups changes in video head impulse test (vHIT, site-dependent) measured lateral canal VOR gain and saccades | From baseline to 6 weeks and 3 months | — |
| The between groups mean vertigo symptom scale short form (VSS-SF) score | 12 months after vertigo onset | VSS-SF uses a five-point Likert scale: 0 (never), 1 (a few times), 2 (several times), 3 (quite often \[every week\]), and 4 (very often \[most days\]). The score ranges from 0 to 60. A higher score indicates worse symptoms. |
| The between group pedometer-derived mean weekly number of steps walked since last visit | 3 months after vertigo onset | — |
| The reliability of the Swedish VSS-SF translation | Six weeks after symptom onset | — |
| The frequency of BPPV at 6 weeks and 3 months after AVS onset using a BPPV specific questionnaire and positional nystagmus tests | 6 weeks and 3 months after vertigo onset | — |
| The between groups mean number of weekly training sessions | 6 weeks after vertigo onset | — |
| Register-based search for health economic effects on all levels of care (primary, specialized) and society (sick leave) | 12 months | — |
| The difference in kinematic output between measurement systems (i.e., multi-sensor and mobile app) | Three months after symptom onset | — |
Other
| Measure | Time frame |
|---|---|
| The proportion of participants who has experienced falls/fractures since study start | 6 weeks, 3 months and 12 months |
| The number of falls/fractures in each study arm | 6 weeks, 3 months and 12 months |
Countries
Sweden
Outcome results
None listed