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Physical therapy outcomes for persons with bilateral vestibular loss.

Identifieur interne : 001312 ( Main/Exploration ); précédent : 001311; suivant : 001313

Physical therapy outcomes for persons with bilateral vestibular loss.

Auteurs : K E Brown [États-Unis] ; S L Whitney ; D M Wrisley ; J M Furman

Source :

RBID : pubmed:11801950

Descripteurs français

English descriptors

Abstract

OBJECTIVE

The purpose of the study was to assess the efficacy of physical therapy for patients with bilateral vestibular loss.

STUDY DESIGN

Retrospective case series.

METHODS

Twenty-four patients with a diagnosis of bilateral vestibular loss were identified by a retrospective chart review. Thirteen of the 24 patients met the inclusion criteria of having a moderate or greater loss of vestibular function bilaterally as rated by an otoneurologist based on the patient's vestibular function tests. These patients were treated with a custom-designed physical therapy program for a mean of 4.6 visits over an average period of 3.8 months. Patients completed the Dizziness Handicap Inventory and the Activities-specific Balance Confidence Scale at initial evaluation and discharge. Patients were asked to perform the balance and gait tasks of the Dynamic Gait Index, Sensory Organization Test of computerized dynamic posturography, and the Timed "Up and Go" test at their first and last physical therapy sessions. The number of falls in the previous 4 weeks and the use of an assistive device at initial evaluation and discharge were reported. Composite score, an overall score of clinical outcome, was calculated to determine clinically significant changes in physical performance and subjective information.

RESULTS

On a population basis, statistically significant improvement was observed after physical therapy for each of the outcome measures including the composite score (P < .05). Clinically significant changes were demonstrated by 33% to 55% of the patients on the various outcome measures. No change was noted in the patients' risk of falling, their number of falls, and the use of assistive devices.

CONCLUSION

Many patients with bilateral vestibular loss benefit from an individualized vestibular physical therapy exercise program based on improved physical function and reduced self-perceived levels of handicap.


DOI: 10.1097/00005537-200110000-00027
PubMed: 11801950


Affiliations:


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Le document en format XML

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<name sortKey="Brown, K E" sort="Brown, K E" uniqKey="Brown K" first="K E" last="Brown">K E Brown</name>
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<nlm:affiliation>Department of Physical Therapy, School of Health and Rehabilitation Sciences, School of Medicine, University of Pittsburgh, PA 15260, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
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<name sortKey="Whitney, S L" sort="Whitney, S L" uniqKey="Whitney S" first="S L" last="Whitney">S L Whitney</name>
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<name sortKey="Wrisley, D M" sort="Wrisley, D M" uniqKey="Wrisley D" first="D M" last="Wrisley">D M Wrisley</name>
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<name sortKey="Furman, J M" sort="Furman, J M" uniqKey="Furman J" first="J M" last="Furman">J M Furman</name>
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<term>Accidental Falls (MeSH)</term>
<term>Activities of Daily Living (classification)</term>
<term>Adult (MeSH)</term>
<term>Aged (MeSH)</term>
<term>Aged, 80 and over (MeSH)</term>
<term>Female (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Physical Therapy Modalities (MeSH)</term>
<term>Retrospective Studies (MeSH)</term>
<term>Treatment Outcome (MeSH)</term>
<term>Vestibular Diseases (etiology)</term>
<term>Vestibular Diseases (rehabilitation)</term>
<term>Vestibular Function Tests (MeSH)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr">
<term>Activités de la vie quotidienne (classification)</term>
<term>Adulte (MeSH)</term>
<term>Adulte d'âge moyen (MeSH)</term>
<term>Chutes accidentelles (MeSH)</term>
<term>Femelle (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Maladies vestibulaires (rééducation et réadaptation)</term>
<term>Maladies vestibulaires (étiologie)</term>
<term>Mâle (MeSH)</term>
<term>Résultat thérapeutique (MeSH)</term>
<term>Sujet âgé (MeSH)</term>
<term>Sujet âgé de 80 ans ou plus (MeSH)</term>
<term>Techniques de physiothérapie (MeSH)</term>
<term>Épreuves vestibulaires (MeSH)</term>
<term>Études rétrospectives (MeSH)</term>
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<term>Activities of Daily Living</term>
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<term>Vestibular Diseases</term>
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<keywords scheme="MESH" qualifier="rehabilitation" xml:lang="en">
<term>Vestibular Diseases</term>
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<term>Maladies vestibulaires</term>
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<term>Maladies vestibulaires</term>
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<term>Accidental Falls</term>
<term>Adult</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Physical Therapy Modalities</term>
<term>Retrospective Studies</term>
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<term>Adulte d'âge moyen</term>
<term>Chutes accidentelles</term>
<term>Femelle</term>
<term>Humains</term>
<term>Mâle</term>
<term>Résultat thérapeutique</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Techniques de physiothérapie</term>
<term>Épreuves vestibulaires</term>
<term>Études rétrospectives</term>
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<front>
<div type="abstract" xml:lang="en">
<p>
<b>OBJECTIVE</b>
</p>
<p>The purpose of the study was to assess the efficacy of physical therapy for patients with bilateral vestibular loss.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>STUDY DESIGN</b>
</p>
<p>Retrospective case series.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>METHODS</b>
</p>
<p>Twenty-four patients with a diagnosis of bilateral vestibular loss were identified by a retrospective chart review. Thirteen of the 24 patients met the inclusion criteria of having a moderate or greater loss of vestibular function bilaterally as rated by an otoneurologist based on the patient's vestibular function tests. These patients were treated with a custom-designed physical therapy program for a mean of 4.6 visits over an average period of 3.8 months. Patients completed the Dizziness Handicap Inventory and the Activities-specific Balance Confidence Scale at initial evaluation and discharge. Patients were asked to perform the balance and gait tasks of the Dynamic Gait Index, Sensory Organization Test of computerized dynamic posturography, and the Timed "Up and Go" test at their first and last physical therapy sessions. The number of falls in the previous 4 weeks and the use of an assistive device at initial evaluation and discharge were reported. Composite score, an overall score of clinical outcome, was calculated to determine clinically significant changes in physical performance and subjective information.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RESULTS</b>
</p>
<p>On a population basis, statistically significant improvement was observed after physical therapy for each of the outcome measures including the composite score (P < .05). Clinically significant changes were demonstrated by 33% to 55% of the patients on the various outcome measures. No change was noted in the patients' risk of falling, their number of falls, and the use of assistive devices.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>CONCLUSION</b>
</p>
<p>Many patients with bilateral vestibular loss benefit from an individualized vestibular physical therapy exercise program based on improved physical function and reduced self-perceived levels of handicap.</p>
</div>
</front>
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