Background

Chronic dizziness has a negative impact on emotional aspects, functional capacity, and quality of life of older people.

Objective

To compare the effects of the conventional Cawthorne & Cooksey and the multimodal Cawthorne & Cooksey protocols on patient-reported outcomes in older adults with vestibular disorders.

Methods

This is a single-blind, randomized controlled trial with three-months’ follow-up. Older adults with chronic dizziness were randomly assigned to conventional or multimodal protocols. The protocols were performed in individual 50-minute sessions, twice weekly, for two months. The primary outcome was the Dizziness Handicap Inventory (DHI) and the secondary outcomes were the Visual Analogue Scale, the Vestibular Disorders Activities of Daily Living Scale, the Geriatric Depression Scale, and the Activities-specific Balance Confidence Scale. Outcomes were collected at baseline, post-treatment and three-month follow-up; and analyzed on an intention-to-treat approach.

Results

Eighty-two patients were randomized into the conventional (n = 40) or multimodal (n = 42) protocols. There was no between-group difference on DHI at post-treatment (Mean Difference (MD): −0.7; 95% CI: −9.2, 7.8) and at three-month follow-up (MD: −1.6; 95% CI: −9.5, 6.2). No between-group difference was found for the secondary outcomes. All patient-reported outcomes in the within-group analysis showed significant improvement between baseline and post-treatment, and changes were maintained between post-treatment and follow-up. Following treatment, 55% of patients in the conventional and 57% in the multimodal protocol reached DHI clinical improvement (decrease ≥18).

Conclusions

The addition of multimodal exercises to the conventional Cawthorne & Cooksey protocol did not promote extra benefits on patient-reported outcomes in older adults with chronic dizziness.

Trial registration

Australian New Zealand Clinical Trials Registry-ANZCTR (ACTRN12610000018011), the trial was registered January 7, 2010 and the first participant was enrolled April 15, 2010. URL of the registry: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=334985.

中文翻译：

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前庭康复对患有前庭疾病的老年人患者报告的结果的益处：一项随机临床试验。

背景

慢性头晕对老年人的情绪、功能和生活质量产生负面影响。

客观的

比较传统 Cawthorne & Cooksey 方案和多模式 Cawthorne & Cooksey 方案对患有前庭疾病的老年人患者报告的结果的影响。

方法

这是一项单盲、随机对照试验，随访期为三个月。患有慢性头晕的老年人被随机分配到传统或多模式方案中。这些方案每周两次，每次 50 分钟，持续两个月。主要结果是头晕障碍量表（DHI），次要结果是视觉模拟量表、前庭障碍日常生活活动量表、老年抑郁量表和特定活动平衡信心量表。收集基线、治疗后和三个月随访的结果；并根据意向治疗方法进行分析。

结果

82 名患者被随机分为传统方案 ( n = 40) 或多模式方案 ( n = 42)。治疗后（平均差（MD）：-0.7；95% CI：-9.2，7.8）和三个月随访时（MD：-1.6；95% CI： −9.5, 6.2)。次要结果未发现组间差异。组内分析中所有患者报告的结果均显示基线和治疗后之间有显着改善，并且治疗后和随访之间保持了变化。治疗后，传统方案中 55% 的患者和多模式方案中 57% 的患者达到 DHI 临床改善（下降≥18）。

结论

在传统的 Cawthorne & Cooksey 方案中添加多模式锻炼并没有对患有慢性头晕的老年人患者报告的结果产生额外的好处。

试用注册

澳大利亚新西兰临床试验注册中心-ANZCTR（ACTRN12610000018011），该试验于2010年1月7日注册，第一位参与者于2010年4月15日入组。注册中心网址：https://www.anzctr.org.au/Trial/注册/TrialReview.aspx?id=334985。