A professor from the University of Southampton has called on doctors around the world to give patients with persistent dizziness a booklet of simple exercises, after new research has shown that it is a very cost effective treatment for common causes of the condition.
Lucy Yardley, who has been researching dizziness for many years, will urge GPs at the international WONCA conference July 5 to ensure that the booklet is translated so that patients of all nationalities can benefit.
Professor Yardley’s urgent appeal comes after her study, funded by the National Institute for Health Research (NIHR) and published in the British Medical Journal, revealed that the exercises, such as turning your head right to left and back again or nodding your head up and down, led to reduced dizziness within a matter of weeks of starting, and the benefits lasted for at least a year.
Dizziness is a common condition, especially among older people, but it can affect any age. It can interfere with people’s daily activities and cause stress. It also increases the risk of falling and fear of falling, which in turn, can result in substantial further limitation of activity, injury, and healthcare costs.
Research has shown that an exercise-based treatment known as “vestibular rehabilitation” or “balance retraining” is the most effective means of treating dizziness related to inner ear problems (a very common cause of dizziness), however currently only about one in ten suitable patients are referred for this treatment.
During the study, which Professor Yardley is presenting at the WONCA conference, more than 300 participants were randomly allocated to receive either routine medical care (commonly just reassurance and medication to suppress dizziness symptoms), booklet based vestibular rehabilitation only, or booklet based vestibular rehabilitation with telephone support from a healthcare professional.
The majority of patients within the study, an NIHR Research for Patient Benefit project, suffered from dizziness due to an inner ear problem, however there were many patients who had undiagnosed dizziness.
Nearly twice as many patients who had the booklet and telephone support said they felt much better or totally well at the end of the study, compared with those who had routine care. Even without any support, getting the booklet led to better recovery than routine care. Only 5 per cent of patients receiving the booklet with support reported worse symptoms at the end of the study, compared with 15 per cent of those receiving usual care.
Professor Yardley says: “Dizziness can be a frustrating and sometimes frightening condition. Many people are undiagnosed, have no treatment for it and just learn to live with it. This leads to a low quality of life and can have high healthcare costs. By being given something as a simple as a booklet by their GP, that contains these simple head, neck and eye exercises, many patients will see real benefits in just a few weeks. These easy to understand exercises, which can be carried out at home, have the potential to improve the quality of life for thousands of people.”
The University of Southampton worked with the Ménière’s Society UK during the study. The Society supplied the exercise booklets used in the study and has been giving them to health professionals and members of the public for seven years.
Natasha Harrington-Benton, UK Director of the Society, comments: “Dizziness and balance disorders can be extremely debilitating and affect a person’s quality of life. This study demonstrates the benefits of vestibular rehabilitation in helping people to manage the symptoms of their condition. We are pleased to be able to provide access to the exercise booklets for both patients and health professionals and, to-date, we have distributed over 8,000 copies.”
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- L. Yardley, F. Barker, I. Muller, D. Turner, S. Kirby, M. Mullee, A. Morris, P. Little. Clinical and cost effectiveness of booklet based vestibular rehabilitation for chronic dizziness in primary care: single blind, parallel group, pragmatic, randomised controlled trial. BMJ, 2012; 344 (jun06 1): e2237 DOI: 10.1136/bmj.e2237