Patient trajectories and their impact on mobility, social participation and quality of life in patients with vertigo/dizziness/balance disorders and osteoarthritis (MobilE-TRA): study protocol of an observational, practice-based cohort study

Abstract

IntroductionMobility limitations have a multitude of different negative consequences on elderly patients including decreasing opportunities for social participation, increasing the risk for morbidity and mortality. However, current healthcare has several shortcomings regarding mobility sustainment of older adults, namely a narrow focus on the underlying pathology, fragmentation of care across services and health professions and deficiencies in personalising care based on patients’ needs and experiences. A tailored healthcare strategy targeted at mobility of older adults is still missing.ObjectiveThe objective is to develop multiprofessional care pathways targeted at mobility sustainment and social participation in patients with vertigo/dizziness/balance disorders (VDB) and osteoarthritis (OA).MethodsData regarding quality of life, mobility limitation, pain, stiffness and physical function is collected in a longitudinal observational study between 2017 and 2019. General practitioners (GPs) recruit their patients with VDB or OA. Patients who visited their GP in the last quarter will be identified in the practice software based on VDB and OA-related International Classification of Diseases 10th Revision. Study material will be sent from the practice to patients by mail. Six months and 12 months after baseline, all patients will receive a mail directly from the study team containing the follow-up questionnaire. GPs fill out questionnaires regarding patient diagnostics, therapy and referrals.Ethics and disseminationThe study was approved by the ethical committee of the Ludwig-Maximilians-Universität München and of the Technische Universität Dresden. Results will be published in scientific, peer-reviewed journals and at national and international conferences. Results will be disseminated via newsletters, the project website and a regional conference for representatives of local and national authorities.

Effectiveness of an evidence-based care pathway to improve mobility and participation in older patients with vertigo and balance disorders in primary care (MobilE-PHY2): study protocol for a multicentre cluster-randomised controlled trial

“…Sample size calculation was informed by data of a cohort study with the same population [ 32 ]. Data gave evidence of an ICC = 0.04 and an expected standard deviation of 25.…”

Referral trajectories in patients with vertigo, dizziness and balance disorders and their impact on health-related quality of life and functioning: results from the longitudinal multicenter study MobilE-TRA

“…Data for this research project emanated from the longitudinal multicenter study MobilE-TRA conducted in two German federal states (Bavaria and Saxony) from September 2017 until October 2019. A more detailed description of the study can be found elsewhere [ 18 ]. In brief, patients aged 65 years and older were included if they had consulted their PCP for an acute episode of VDB in the last quarter.…”

A Protocol on Effect of Gaze Exercises and Balance Regimen on Quality of Life of Patients with Peripheral-Vertigo

“…5 In the 5th decade following the 7th and 4th decades, incidence of vertigo found was more common in patient. Women (57.7%) were found to be more frequently affected than men (42.30%) in the 4:3 ratio 6 .…”

“…When testing horizontal semi-circular canals, the head is flexed 30 degree. In the case of a low amplitude (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) of either a moderate amplitude (approximately 200/sec) and high amplitude with an angular momentum (3000-4000/ sec), the eyes turn in a direction opposite to the head movement and the focus stays in a manual direction, while the Vestibular Reflex is working in a normal way. In a patient with a loss of vestibular function, the person will not move the eyes rapidly from the target as the head and eyes move away from target.…”