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BMC Geriatrics Nov 2020Vertigo, dizziness and balance disorders (VDB) are among the most relevant contributors to the burden of disability among older adults living in the community and...
BACKGROUND
Vertigo, dizziness and balance disorders (VDB) are among the most relevant contributors to the burden of disability among older adults living in the community and associated with immobility, limitations of activities of daily living and decreased participation. The aim of this study was to identify the quality of evidence of physical therapy interventions that address mobility and participation in older patients with VDB and to characterize the used primary and secondary outcomes.
METHODS
A systematic search via MEDLINE (PubMed), Cochrane Library, CINAHL, PEDro, forward citation tracing and hand search was conducted initially in 11/2017 and updated in 7/2019. We included individual and cluster-randomized controlled trials and trials with quasi-experimental design, published between 2007 and 2017/2019 and including individuals ≥65 years with VDB. Physical therapy and related interventions were reviewed with no restrictions to outcome measurement. Screening of titles, abstracts and full texts, data extraction and critical appraisal was conducted by two independent researchers. The included studies were heterogeneous in terms of interventions and outcome measures. Therefore, a narrative synthesis was conducted.
RESULTS
A total of 20 randomized and 2 non-randomized controlled trials with 1876 patients met the inclusion criteria. The included studies were heterogeneous in terms of complexity of interventions, outcome measures and methodological quality. Vestibular rehabilitation (VR) was examined in twelve studies, computer-assisted VR (CAVR) in five, Tai Chi as VR (TCVR) in three, canal repositioning manoeuvres (CRM) in one and manual therapy (MT) in one study. Mixed effects were found regarding body structure/function and activities/participation. Quality of life and/or falls were assessed, with no differences between groups. VR is with moderate quality of evidence superior to usual care to improve balance, mobility and symptoms.
CONCLUSION
To treat older individuals with VDB, VR in any variation and in addition to CRMs seems to be effective. High-quality randomized trials need to be conducted to inform clinical decision making.
TRIAL REGISTRATION
PROSPERO 2017 CRD42017080291 .
Topics: Activities of Daily Living; Aged; Aged, 80 and over; Dizziness; Humans; Physical Therapy Modalities; Quality of Life; Vertigo
PubMed: 33228601
DOI: 10.1186/s12877-020-01899-9 -
MMW Fortschritte Der Medizin Oct 2021
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Otolaryngologic Clinics of North America Jun 2022Patients often report symptoms of headache and dizziness concomitantly. Symptoms of dizziness can be explored with a comprehensive vestibular assessment, allowing for... (Review)
Review
Patients often report symptoms of headache and dizziness concomitantly. Symptoms of dizziness can be explored with a comprehensive vestibular assessment, allowing for the investigation of central and peripheral vestibular system contributions to symptoms of dizziness. Patients who report both symptoms of headache and dizziness demonstrate abnormalities of the vestibular system which can be measured quantitatively. Completion of comprehensive vestibular testing can help to guide diagnosis and strategies for intervention.
Topics: Dizziness; Headache; Humans; Migraine Disorders; Vertigo
PubMed: 35490043
DOI: 10.1016/j.otc.2022.02.004 -
Otolaryngologic Clinics of North America Aug 2018Vertigo and dizziness are common conditions among older adults. They are closely associated with fall risk and portend major implications for geriatric injury and... (Review)
Review
Vertigo and dizziness are common conditions among older adults. They are closely associated with fall risk and portend major implications for geriatric injury and disability. Management can be particularly challenging, because symptoms are often nonspecific and may reflect multiple etiologies. Chronic dizziness can reflect dysfunction in the vestibular, somatosensory, or visual systems or in their central integration. Systemic processes, such as postural hypotension, arrhythmias, heart failure, medication use, and lower extremity weakness or frailty, also contribute. Management of acute vestibular syndrome requires ruling out dangerous causes, such as stroke. This article reviews relevant definitions, epidemiology, pathophysiology, diagnosis, and clinical management.
Topics: Accidental Falls; Aged; Aged, 80 and over; Dizziness; Humans; Risk Assessment; Vertigo; Vestibulocochlear Nerve Diseases
PubMed: 29803531
DOI: 10.1016/j.otc.2018.03.003 -
MMW Fortschritte Der Medizin Nov 2018
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Acta Neurologica Taiwanica Mar 2007Dizziness ranks among the most common complaints in medicine, affecting approximately 20% to 30% of the general population. However, the term dizziness encompasses a... (Review)
Review
Dizziness ranks among the most common complaints in medicine, affecting approximately 20% to 30% of the general population. However, the term dizziness encompasses a variety of different sensations each points in distinct diagnostic direction: rotational vertigo or other illusory sensation of motion indicates vestibular origin, whereas a sensation of light-headedness, giddiness, unsteadiness, drowsiness, or impending faint implies nonvestibular origin. Of patients older than 60 years, 20% have experienced dizziness severe enough to affect their daily activities. This article gives an overview of the historical and physical findings that help guiding to more specific diagnosis of vertigo and dizziness.
Topics: Diagnosis, Differential; Dizziness; Humans; Vertigo
PubMed: 17486734
DOI: No ID Found -
Praxis 2022Dizziness - What Next? Dizziness is a very common symptom with an extensive differential diagnosis that includes both benign and serious conditions. Acute care...
Dizziness - What Next? Dizziness is a very common symptom with an extensive differential diagnosis that includes both benign and serious conditions. Acute care physicians must be able to distinguish the majority of patients with self-limiting benign complaints from those with serious conditions. Our structured approach is intended to serve as a guide for acute medicine.
Topics: Diagnosis, Differential; Dizziness; Humans; Vertigo
PubMed: 36221966
DOI: 10.1024/1661-8157/a003895 -
Deutsche Medizinische Wochenschrift... Feb 2023Dizziness is a common symptom with many potential causes. Medical and especially cardiac aetiologies are associated with a poor overall prognosis such that...
Dizziness is a common symptom with many potential causes. Medical and especially cardiac aetiologies are associated with a poor overall prognosis such that identification of the underlying cause is essential. This article gives an overview of possible causes of dizziness, how the differential diagnoses should be investigated, and describes potential therapeutic approaches to the treatment of the most important underlying conditions.
Topics: Humans; Dizziness; Vertigo; Diagnosis, Differential; Physicians
PubMed: 36750126
DOI: 10.1055/a-1928-6142 -
South African Family Practice :... Apr 2023Dizziness is an extremely common, yet complex neurological symptom that reflects a disturbance of normal balance perception and spatial orientation. Dizziness is a...
Dizziness is an extremely common, yet complex neurological symptom that reflects a disturbance of normal balance perception and spatial orientation. Dizziness is a non-specific, catch-all term commonly used by patients to describe a wide array of symptoms, including a sensation of motion, weakness, light-headedness, unsteadiness, emotional upset and depression. The national 1-year prevalence of dizziness is around 50%, accounting for 4% of emergency department presentations and 1% of primary care consultations in South Africa. This article will focus on a diagnostic approach to the most common cause of dizziness (vertigo).
Topics: Humans; Dizziness; Vertigo; Space Perception; Orientation, Spatial; Primary Health Care
PubMed: 37132567
DOI: 10.4102/safp.v65i1.5712 -
Continuum (Minneapolis, Minn.) Oct 2012In 1986, the German neurologists Thomas Brandt and Marianne Dieterich described a syndrome of phobic postural vertigo (PPV) based on clinical observations of patients... (Review)
Review
PURPOSE OF REVIEW
In 1986, the German neurologists Thomas Brandt and Marianne Dieterich described a syndrome of phobic postural vertigo (PPV) based on clinical observations of patients with nonvertiginous dizziness that could not be explained by then-known neuro-otologic disorders. Subsequent research by an American team led by Jeffrey Staab and Michael Ruckenstein confirmed the core physical symptoms of PPV, clarified its relationship to behavioral factors, and streamlined its definition, calling the syndrome chronic subjective dizziness (CSD). This article reviews the 26-year history of PPV and CSD and places it within the context of current neurologic practice.
RECENT FINDINGS
Recent investigations in Europe, the United States, Israel, and Japan have validated the primary symptoms of CSD; identified its provoking factors and precipitants; elucidated its long-term clinical course, differential diagnosis, and common comorbidities; developed successful treatment strategies with serotonergic antidepressants, vestibular habituation, and possibly cognitive-behavioral therapy; and raised new hypotheses about pathophysiologic processes that initiate and maintain the disorder. In tertiary neuro-otology centers where it is recognized, CSD is the second most common diagnosis among patients presenting with vestibular symptoms.
SUMMARY
A quarter century of research has established CSD as a common clinical entity in neurologic and otorhinolaryngologic practice. Its identification and treatment offer relief to many patients previously thought to have enigmatic and unmanageable cases of persistent dizziness. Internationally sanctioned diagnostic criteria for CSD are under development for the first edition of the International Classification of Vestibular Disorders, scheduled for publication in early 2013.
Topics: Adult; Chronic Disease; Diagnosis, Differential; Dizziness; Female; Humans; Male; Middle Aged; Migraine Disorders; Panic Disorder; Physical Examination; Posture; Psychotherapy; Vertigo; Vestibular Neuronitis
PubMed: 23042063
DOI: 10.1212/01.CON.0000421622.56525.58