Feasibility of integrating vestibular rehabilitation and cognitive behaviour therapy for people with persistent dizziness

Abstract

Purpose To evaluate the feasibility of integrating vestibular rehabilitation and cognitive behaviour therapy (VR-CBT) for people with persistent dizziness in primary care. Design Prospective single-group pre- and post-test study. Participants Adults (aged 18–70) with acute onset of dizziness and symptoms lasting a minimum 3 months, recruited from Bergen municipality. Methods Participants attended eight weekly group sessions of VR-CBT intervention. Feasibility outcomes consisted of recruitment and testing procedures, intervention adherence, and participant feedback, besides change in primary outcomes. The primary outcomes were Dizziness Handicap Inventory (DHI) and preferred gait velocity. Results Seven participants were recruited for the study. All participants completed the pre-treatment tests, five participants completed the intervention and answered post-treatment questionnaires, and three completed post-treatment testing. Of the five participants, three attended at least 75% of the VR-CBT sessions, and two 50% of the sessions. Participants reported that the VR-CBT was relevant and led to improvement in function. DHI scores improved beyond minimal important change in two out of five participants, and preferred gait velocity increased beyond minimal important change in two out of three participants. Conclusion The current tests and VR-CBT treatment protocols were feasible. Some changes are suggested to optimise the protocols, before conducting a randomised controlled trial. Trial registration NCT02655575 . Registered 14 January 2016—retrospectively registered

Primary or secondary chronic functional dizziness: does it make a difference? A DizzyReg study in 356 patients

“…Skills and vestibular function were more preserved in p-PPPD, but the subjective symptom burden remained high and remarkable differences between p-and s-PPPD in terms of life quality as assessed by EQ5D-3L were lacking. However, overall quality of life was significantly reduced in both groups (VAS 58%) compared to healthy subject collectives, which is in line with earlier reports [43,44]. The discrepancy between the high subjective burden in PPPD and the objective vestibular function is underlined by the lack of a significant correlation between DHI, VAP, and QoL scores and objective neurophysiological parameters (e.g., in vHIT and caloric testing).…”

Efficacy of integrating vestibular rehabilitation and cognitive behaviour therapy in persons with long-term dizziness in primary care– a study protocol for a randomised controlled trial

“…In addition, the study utilizes standardised testing procedures, evaluating both short-and long-term efficacy. Another strength is the initial feasibility study conducted, showing that test procedures and interventions were feasible and sage for the present population (27). To our knowledge, the current RCT study is the largest study to date, combining VR and CBT to treat persons with persistent dizziness.…”

“…The study is designed as a randomised controlled trial comparing two groups (BI-VR, and BI-VR with VR-CBT). To obtain a clinical important group difference in DHI of 11 points 38 based on drop-outs in the feasibility study (27), and in previous studies (18,20,57,58).…”

“…Further as none of the combined treatments included a focus on musculoskeletal complaints, there is a need to further develop the treatment combining VR and CBT, also targeting the musculoskeletal aspects, and afterward the effects of the program must be tested in an RCT. A recent feasibility study integrating VR and CBT with an additional focus on musculoskeletal effects showed that such treatment approach was feasible and safe (27). Therefore, this treatment is now ready to be evaluated in an RCT.…”

Efficacy of intergrating vestibular rehabilitation and cognitive behaviour therapy in persons with persistent dizziness in primary care- a study protocol for a randomised controlled trial

“…Further, as none of the combined treatments included a focus on musculoskeletal complaints, there is a need to further develop the treatment combining VR and CBT, also targeting the musculoskeletal aspects, and afterward the effects of the programme must be tested in a RCT. A recent feasibility study integrating VR and CBT with an additional focus on musculoskeletal effects showed that such a treatment approach was feasible and safe [27]. Therefore, this treatment is now ready to be evaluated in a RCT.…”