Clinical effectiveness of a physiotherapy-led, hospital-based vestibular service

Journal article

Stewart, Vicky, Mendis, M. Dilani and Low Choy, Nancy. (2019). Clinical effectiveness of a physiotherapy-led, hospital-based vestibular service. Otorinolaringologia. 69(1), pp. 1-8. https://doi.org/10.23736/S0392-6621.18.02192-6
AuthorsStewart, Vicky, Mendis, M. Dilani and Low Choy, Nancy
Abstract

BACKGROUND: To investigate clinical effectiveness of a physiotherapy-led, hospital-based vestibular service by assessing initial and longer-term clinical outcomes, and to compare outcomes for immediate and delayed intervention pathways.
METHODS: Pragmatic, prospective, observational study reporting baseline, discharge and follow-up outcomes. Set in hospital-based vestibular rehabilitation service including emergency/acute settings and those referred to out-patients. Participants included adults (N.=193) presenting to hospital with non-emergent dizziness (mean age: 64.21±15.28 years; female 60%). Physiotherapy vestibular diagnostic tests categorized people as vestibular/non-vestibular. Vestibular rehabilitation commenced immediately (<48 hours of hospital presentation) or was delayed (referred and wait-listed for outpatient services, average 22 days). Vestibular rehabilitation, a program of exercises, consisting of eye/head movements integrated with balance and mobility exercises designed to promote adaptive vestibular system changes. Dizziness impairment, functional vestibular ocular reflex, static balance, gait velocity and functional gait were measured at initial presentation, discharge, and 3 months post-discharge.
RESULTS: Participants had significantly reduced dizziness and significantly improved functional gait at discharge, which was maintained 3 months post-discharge (P≤0.001). Both immediate and delayed intervention groups reported significantly reduced dizziness impairment (P≤0.001) but only the immediate group significantly improved in all mobility measures (P≤0.005). Resultant symptoms and functional impact of a vestibular disorder did not significantly subside to normal without vestibular rehabilitation, even 3 weeks after presenting to hospital.
CONCLUSIONS: Physiotherapy-led vestibular service was clinically effective in managing people presenting to hospital with suspected vestibular dysfunction with outcomes maintained in the longer term. Immediate intervention allows for quicker improvements in symptoms, and patients’ symptoms do not spontaneously resolve whilst waiting for intervention.

Keywordsvestibular diseases; vertigo; dizziness; treatment outcome; physical therapists
Year2019
JournalOtorinolaringologia
Journal citation69 (1), pp. 1-8
PublisherEdizioni Minerva Medica
ISSN0392-6621
Digital Object Identifier (DOI)https://doi.org/10.23736/S0392-6621.18.02192-6
Scopus EID2-s2.0-85060511533
Research or scholarlyResearch
Page range1-8
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication process dates
Deposited19 May 2021
Permalink -

https://acuresearchbank.acu.edu.au/item/8w195/clinical-effectiveness-of-a-physiotherapy-led-hospital-based-vestibular-service

Log in to edit

Restricted files

Publisher's version

  • 265
    total views
  • 0
    total downloads
  • 1
    views this month
  • 0
    downloads this month
These values are for the period from 19th October 2020, when this repository was created.

Export as

Related outputs

An audit of physiotherapists’ documentation on physical activity assessment, promotion and prescription to older adults attending out-patient rehabilitation
Paim, Tatiana, Low-Choy, Nancy, Dorsch, Simone and Kuys, Suzanne. (2022). An audit of physiotherapists’ documentation on physical activity assessment, promotion and prescription to older adults attending out-patient rehabilitation. Disability and Rehabilitation. 44(8), pp. 1537-1543. https://doi.org/10.1080/09638288.2020.1805644
Center-based group and home-based individual exercise programs have similar impacts on gait and balance in people with multiple sclerosis : A randomized trial
Williams, Katrina L., Low Choy, N. and Brauer, Sandy. (2021). Center-based group and home-based individual exercise programs have similar impacts on gait and balance in people with multiple sclerosis : A randomized trial. Physical Medicine and Rehabilitation. 13, pp. 9-18. https://doi.org/10.1002/pmrj.12377
A systematic review of patient-reported measures associated with vestibular dysfunction
Stewart, Vicky M., Mendis, M. Dilani and Low Choy, Nancy. (2018). A systematic review of patient-reported measures associated with vestibular dysfunction. The Laryngoscope. 128(4), pp. 971-981. https://doi.org/10.1002/lary.26641
Concurrent validity and responsiveness to change of the vestibular screening tool
Stewart, Vicky, Mendis, M. Dilani, Rowland, Jeffrey and Low Choy, Nancy. (2018). Concurrent validity and responsiveness to change of the vestibular screening tool. Otorinolaringologia. 68(4), pp. 124-131. https://doi.org/10.23736/S0392-6621.18.02164-1
Can a single session of motor imagery promote motor learning of locomotion in older adults? A randomized controlled trial
Nicholson, Vaughan P., Keogh, Justin W. L. and Low Choy, Nancy L.. (2018). Can a single session of motor imagery promote motor learning of locomotion in older adults? A randomized controlled trial. Clinical Interventions in Aging. 13, pp. 713 - 722. https://doi.org/10.2147/CIA.S164401
Improving Screening and Physiotherapy Management of Vestibular Disorders in the Hospital Setting
Stewart, Vicky. (2018). Improving Screening and Physiotherapy Management of Vestibular Disorders in the Hospital Setting [Thesis]. https://doi.org/10.26199/5b85d39599792
The patients’ perspective of sustaining a fall in hospital: A qualitative study
Gettens, Stephanie, Fulbrook, Paul, Jessup, Melanie and Low Choy, Nancy. (2018). The patients’ perspective of sustaining a fall in hospital: A qualitative study. Journal of Clinical Nursing. 27(3-4), pp. 743 - 752. https://doi.org/10.1111/jocn.14075
Self-reported concussion history and sensorimotor tests predict head/neck injuries
Hides, Julie Anne, Franettovich Smith, Melinda M., Mendis, M Dilani, Treleaven, Julia, Rotstein, Andrew H., Sexton, Christopher T., Low Choy, Nancy and McCrory, Paul. (2017). Self-reported concussion history and sensorimotor tests predict head/neck injuries. Medicine and Science in Sports and Exercise. 49(12), pp. 2385-2393. https://doi.org/10.1249/MSS.0000000000001372
A prospective investigation of changes in the sensorimotor following sports concussion: An exploratory study
Hides, Julie A., Franettovich Smith, Melinda M., Mendis, M. Dilani, Smith, Nigel, Cooper, Andrew J., Treleaven, Julia, Leung, Felix, Gardner, Andrew J., McCrory, Paul and Low Choy, Nancy L.. (2017). A prospective investigation of changes in the sensorimotor following sports concussion: An exploratory study. Musculoskeletal Science and Practice. 29, pp. 7 - 19. https://doi.org/10.1016/j.msksp.2017.02.003
Impacts of small vestibular schwannoma on community ambulation, postural, and ocular control
Low Choy, Nancy L., Lucey, Mary-Therese M., Lewandowski, Susan L. and Panizza, Benedict J.. (2017). Impacts of small vestibular schwannoma on community ambulation, postural, and ocular control. The Laryngoscope. 127(5), pp. 1147 - 1152. https://doi.org/10.1002/lary.26105
Frailty and mobility
Eeles, Eammon and Low Choy, Nancy. (2015). Frailty and mobility. In In Theou, Olga and Rockwood, Kenneth (Ed.). Frailty in aging : Biological, clinical and social implications pp. 107-120 S. Karger AG.
Use and validation of the balance outcome measure for elder rehabilitation in acute care
Kuys, Suzanne, Crouch, Tom, Dolecka, Urszula, Steele, Michael and Low Choy, Nancy. (2014). Use and validation of the balance outcome measure for elder rehabilitation in acute care. New Zealand Journal of Physiotherapy. 42(1), pp. 16 - 21.
Development and preliminary validation of the Acute Brain Injury Physiotherapy Assessment (ABIPA)
Gesch, Janelle, Low Choy, Nancy, Weeks, Benjamin, Passier, Leanne, Nascimento, Margarida, Haines, Terry and Kuys, Suzanne. (2014). Development and preliminary validation of the Acute Brain Injury Physiotherapy Assessment (ABIPA). Brain Impairment. 15(2), pp. 132 - 145. https://doi.org/10.1017/BrImp.2014.13
The effectiveness of quarter turn from prone in maintaining respiratory function in premature infants
Montgomery, Karly, Low Choy, Nancy, Steele, Michael and Hough, Judith. (2014). The effectiveness of quarter turn from prone in maintaining respiratory function in premature infants. Journal of Paediatrics and Child Health. 50(12), pp. 972 - 977. https://doi.org/10.1111/jpc.12689
Senior physiotherapy students as standardised patients for junior students enhances self-efficacy and satisfaction in both junior and senior students
Mandrusiak, Allison, Isles, Rosemary, Chang, Angela, Low Choy, Nancy, Toppenberg, Rowena, McCook, Donna, Smith, Michelle, O'Leary, Karina and Brauer, Sandy. (2014). Senior physiotherapy students as standardised patients for junior students enhances self-efficacy and satisfaction in both junior and senior students. BMC Medical Education. 14(105), pp. 1 - 7. https://doi.org/10.1186/1472-6920-14-105
Mobility has a non-linear association with falls risk among people in residential aged care : an observational study
Barker, Anna, Nitz, Jennifer, Low Choy, Nancy and Haines, Terry. (2012). Mobility has a non-linear association with falls risk among people in residential aged care : an observational study. Journal of Physiotherapy. 58(2), pp. 117 - 125. https://doi.org/10.1016/S1836-9553(12)70092-9
Sensory system function and postural stability in men aged 30-80 years
Illing, Sara, Low Choy, Nancy, Nitz, Jennifer and Nolan, Melissa. (2010). Sensory system function and postural stability in men aged 30-80 years. The Aging Male. 13(3), pp. 202 - 210. https://doi.org/10.3109/13685531003657826
Age-related changes in musculoskeletal function, balance and mobility measures in men aged 30-80 years
Nolan, Melissa, Nitz, Jennifer, Low Choy, Nancy and Illing, Sara. (2010). Age-related changes in musculoskeletal function, balance and mobility measures in men aged 30-80 years. The Aging Male. 13(3), pp. 194 - 201. https://doi.org/10.3109/13685531003657818
Linking stability to demographics, strength and sensory system function in women over 40 to support pre-emptive preventive intervention
Low Choy, Nancy, Brauer, Sandy and Nitz, Jennifer. (2008). Linking stability to demographics, strength and sensory system function in women over 40 to support pre-emptive preventive intervention. Climacteric. 11(2), pp. 144 - 154. https://doi.org/10.1080/13697130801931821
Age-related changes in strength and somatosensation during midlife: rationale for targeted preventive intervention programs
Low Choy, Nancy, Brauer, Sandy and Nitz, Jennifer. (2007). Age-related changes in strength and somatosensation during midlife: rationale for targeted preventive intervention programs. Annals of the New York Academy of Sciences. 1114(1), pp. 180 - 193. https://doi.org/10.1196/annals.1396.014
Timed stance performances reflect differences in age, prevalence of comorbidities, medication use, fall history and activity level: Early screening for balance loss is indicated
Low Choy, Nancy, Brauer, Sandy and Nitz, Jennifer. (2007). Timed stance performances reflect differences in age, prevalence of comorbidities, medication use, fall history and activity level: Early screening for balance loss is indicated. Australasian Journal on Ageing. 26(1), pp. 29 - 34. https://doi.org/10.1111/j.1741-6612.2007.00202.x
Balance, mobility and gaze stability deficits remain following surgical removal of vestibular schwannoma (acoustic neuroma): An observational study
Low Choy, Nancy, Johnson, Natalie, Treleaven, Julia, Jull, Gwendolen, Panizza, Ben and Brown-Rothwell, David. (2006). Balance, mobility and gaze stability deficits remain following surgical removal of vestibular schwannoma (acoustic neuroma): An observational study. Journal of Physiotherapy. 52(3), pp. 211 - 216.
The relationship of cervical joint position error to balance and eye movement disturbances in persistent whiplash
Treleaven, Julia, Jull, Gwendolen and Low Choy, Nancy. (2006). The relationship of cervical joint position error to balance and eye movement disturbances in persistent whiplash. Manual Therapy. 11, pp. 99 - 106.
Smooth Pursuit Neck Torsion test in whiplash-associated disorders: relationship to self-reports of neck pain and disability, dizziness and anxiety
Treleaven, Julia, Jull, Gwendolen and Low Choy, Nancy. (2005). Smooth Pursuit Neck Torsion test in whiplash-associated disorders: relationship to self-reports of neck pain and disability, dizziness and anxiety. Journal of Rehabilitation Medicine. 37, pp. 219 - 223.
The effect of depression on balance decline in mature women
Nitz, Jennifer, Low Choy, Nancy and Ogilvie, Meredith. (2005). The effect of depression on balance decline in mature women. Hong Kong Physiotherapy Journal. 23(1), pp. 27 - 35. https://doi.org/10.1016/S1013-7025(09)70056-9
Standing balance in persistent whiplash: a comparison between subjects with and without dizziness
Treleaven, Julia, Jull, Gwendolen and Low Choy, Nancy. (2005). Standing balance in persistent whiplash: a comparison between subjects with and without dizziness. Journal of Rehabilitation Medicine. 37, pp. 224 - 229.