A RANDOMIZED CONTROLLED TRIAL OF EXERCISE THERAPY FOR DIZZINESS AND VERTIGO IN PRIMARY-CARE

Background. 'Vestibular rehabilitation' (VR) is an increasingly popula r treatment option for patients with persistent dizziness. Previous cl inical trials have only evaluated the effects of specialist therapy pr ogrammes in small, selective, or uncontrolled patient samples. Aim. To determine the benefits of VR compared with standard medical care, usi ng a brief intervention for dirty patients in primary care. Method. Ad ults consulting their general practitioner (GP) with dizziness or vert igo were randomly assigned to treatment or control groups. Patients in both groups received the same evaluation at baseline, six-week follow -up, and six-month follow-up, comprising examination of nystagmus, pos tural control, and movement-provoked dizziness, and a questionnaire as sessment of subjective status, symptoms, handicap, anxiety, and depres sion. At baseline and six weeks later, the treatment group also receiv ed an individualized 30-minute therapy session, in which they were tau ght head, eye, and body exercises designed to promote vestibular compe nsation and enhance skill and confidence in balance. Results, The trea tment group (n = 67) improved on all measures, whereas the control gro up (n = 76) showed no improvement, resulting in a significant differen ce between the two groups an physical indices of balance and subjectiv e indices of symptoms and distress. Odds ratios for improvement in tre ated patients relative to untreated patients were 3.1 : 1 at six weeks (95% CI = 1.4-6.8) and 3.8: 1 at six months (95% CI = 1.6-8.7). Concl usion. VR is a simple, inexpensive, and beneficial treatment, and may be an appropriate first stage of management for many dizzy patients in primary care.