Summary of Search, “Best” Evidence’ Appraised, and Key Findings Strength of Recommendation: There is level 2 and level 3 evidence supporting the use of VRT to treat patients suffering from dizziness postconcussion. VRT is a relatively safe treatment option, with no adverse reactions or case reports. There is a decrease (improvement) in Dizziness Handicap Index scores across all 3 studies. Clinical Bottom Line: There is preliminary evidence suggesting that VRT can improve perceived disability in patients with postconcussion syndrome experiencing prolonged dizziness. All 3 studies found statistically significant decreases (improvements) in Dizziness Handicap Index scores. The exploratory study implemented VRT in conjunction with light aerobic exercise to improve perceived disability associated with dizziness postconcussion. The chart review explored VRT as a treatment for reducing dizziness and improving balance and gait dysfunction. The randomized control trial compared cervical spine therapy alone to cervical spine therapy in conjunction with VRT to obtain medical clearance for sport. Focused Clinical Question: Can VRT help postconcussion syndrome patients experiencing prolonged dizziness by improving their perceived disability? Summary of Key Findings: Three studies were included: 1 randomized control trial, 1 retrospective chart review, and 1 exploratory study. Clinicians are beginning to incorporate vestibular rehabilitation therapy (VRT) in their postconcussion treatment plan, in order to address the dysfunctional inner ear structures that could be causing this dizziness. Dizziness is the second most reported symptom associated with a concussion and may be a predictor of prolonged recovery. A significant portion of these people experience symptoms lasting longer than 10 days and are diagnosed with postconcussion syndrome. The instrument showed satisfactory test-retest reliability.Clinical Scenario: Every year, millions of people suffer a concussion. Satisfactory internal consistency was indicated, and the discriminative ability of the instruments was demonstrated. Evidence regarding a physical construct underlying the vertigo-balance sub-scale was provided. Using a Norwegian translated version of the VSS-SF, this is the first study to provide evidence of the construct validity of this instrument demonstrating a stable two factor structure of the scale, and the identified sub-dimensions of dizziness were related to vertigo-balance and autonomic-anxiety, respectively. High test-retest reliability was demonstrated (ICC VSS-SF: 0.88, VSS-V: 0.90, VSS-A: 0.90) and no systematic change was observed in the scores from test to retest after 2 days. The ability to discriminate between dizzy and not dizzy patients was excellent for the VSS-SF and sub-dimension VSS-V (area under the curve 0.87 and 0.91, respectively), and acceptable for the sub-dimension VSS-A (area under the curve 0.77). Construct validity was indicated by correlation between path length registered by platform posturography and the VSS-V (r = 0.52), but not with the VSS-A. Internal consistency of the VSS-SF was high (alpha = 0.90). Twelve of the items loaded clearly on either of the two dimensions, while three items cross-loaded. The factors were related to vertigo-balance (VSS-V) and autonomic-anxiety (VSS-A). The scree plot indicated a two factor structure accounting respectively for 41% and 12% of the variance prior to rotation. A cross-sectional pre-intervention design was used to examine the construct validity (sample II, n = 36) of the measure and a test-retest design was used to examine reliability (sub-sample of sample II, n = 28). The aim of the study was to examine the psychometric properties of the Vertigo symptom scale - short form (VSS-SF), a condition-specific measure of dizziness, following translation of the scale into Norwegian.Ī cross-sectional survey design was used to examine the factor structure, internal consistency and discriminative ability (sample I, n = 503).
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |