Clinical Trial: Vestibular Rehabilitation and Dizziness

Study Status: Active, not recruiting
Recruit Status: Active, not recruiting
Study Type: Interventional

Official Title: Vestibular Rehabilitation and Dizziness in Geriatric Patients

Brief Summary: The purpose of this study is to determine whether vestibular exercises provide added benefit to balance rehabilitation in older adults with dizziness and normal vestibular function.

Detailed Summary:

Dizziness is among the most prevalent complaints for which people seek medical help and the incidence increases with advancing age. Dizziness represents a diagnostic and treatment challenge because it is a subjective sensation, refers to a variety of symptoms (unsteadiness, spinning, sense of motion or lightheadedness), and has many potential contributory factors. Dizziness is often related to vestibular disease which is treated effectively with vestibular exercises. Successful management of dizziness is critical because dizziness is a major risk factor for falls in older adults.

There are parallels between the effects of age-related versus disease-related loss of vestibular function - in complaints of dizziness and increased risk for falls. The investigators' question, then, is whether the same exercises that are beneficial for patients with vestibular pathology are beneficial for older patients with dizziness but normal vestibular function.

Older adults with dizziness who have been referred to Audiology for vestibular evaluation will be randomized to receive either standard balance rehabilitation plus placebo eye exercises (CON) or standard balance rehabilitation plus vestibular-specific exercises (GS). Primary outcomes include symptoms, balance-related confidence, dynamic visual acuity, postural stability as measured by sensory organization test, fall risk as measured by dynamic gait index, and gait speed. Assessment will occur at baseline, discharge from physical therapy (PT), 1 and 6 months post-PT.


Sponsor: VA Office of Research and Development

Current Primary Outcome: symptoms of dizziness [ Time Frame: baseline, discharge from PT, 1 and 6 months post-PT ]

The subject's perception of dizziness and imbalance during ambulation and during sitting will be assessed using visual analogue scales.


Original Primary Outcome: symptoms of dizziness [ Time Frame: up to 6 months ]

The subject's perception of dizziness and imbalance during ambulation and during sitting will be assessed using visual analogue scales.


Current Secondary Outcome:

  • gaze stability [ Time Frame: baseline, discharge from PT, 1 and 6 months post-PT ]
    visual acuity during head movements
  • fall risk [ Time Frame: baseline, discharge from PT, 1 and 6 months post-PT ]
    fall risk is determined by dynamic gait index
  • Activities-specific balance confidence (ABC) [ Time Frame: baseline, discharge from PT, 1 and 6 months post-PT ]
    The ABC was developed to measure the subject's confidence with their balance across a continuum of activities.
  • Gait speed [ Time Frame: baseline, discharge from PT, 1 and 6 months post-PT ]
    Subjects are asked to walk at their preferred gait speed. The time it takes to walk 20 feet is recorded using a calibrated stopwatch and gait speed is calculated.


Original Secondary Outcome:

  • gaze stability [ Time Frame: baseline, discharge from PT, 1 and 6 months post-PT ]
    visual acuity during head movements
  • fall risk [ Time Frame: baseline, discharge from PT, 1 and 6 months post-PT ]
    fall risk is determined by dynamic gait index
  • Activities-specific balance confidence [ Time Frame: baseline, discharge from PT, 1 and 6 months post-PT ]
    The ABC was developed to measure the subject's confidence with their balance across a continuum of activities.
  • Gait speed [ Time Frame: baseline, discharge from PT, 1 and 6 months post-PT ]
    Subjects are asked to walk at their preferred gait speed. The time it takes to walk 20 feet is recorded using a calibrated stopwatch and gait speed is calculated.


Information By: VA Office of Research and Development

Dates:
Date Received: November 13, 2012
Date Started: November 1, 2012
Date Completion: April 2017
Last Updated: February 21, 2017
Last Verified: February 2017