Effect of Vestibular Rehabilitation Therapy on the Daily Life Aspects of Military Men with Persistent Postural- Perceptual Dizziness: A Clinical Trial
-
Seyyed Mohammad Reza Taghavi
,
Farzad Mehrabi
,
Parsa Cheraghipour
,
Seyed Meead Mousavi
,
Akram Nezhadi
Abstract
Background and Aim: Persistent Postural-Perceptual Dizziness (PPPD) is a type of chronic dizziness without rotation, confusion, or unsteadiness, usually exacerbated by standing, active/passive movements, and complex or moving visual stimuli. Vestibular Rehabilitation Therapy (VRT) is an effective treatment for people with this disease. This study aimed to determine effect of VRT on the daily life aspects of military men with PPPD.
Methods: In this clinical trial, participants were 56 military men with PPPD. They underwent VRT that included exercises for gaze stabilization, adaptation, and habituation. The impact of balance problems caused by PPPD on different physical, emotional, and functional aspects of daily life was evaluated using the Dizziness Handicap Inventory (DHI) before and one month after the intervention.
Results: There was a significant decrease in functional, emotional, physical, and total scores on the DHI after VRT (p<0.001). The DHI scores at baseline showed a moderate handicap (48.64%) which decreased to a mild handicap (24.53%) after VRT. The lowest score at baseline was related to the functional aspect, which showed the highest improvement after VRT.
Conclusion: The VRT can improve all aspects (physical, emotional, and functional) of daily life in military men with PPPD and diminishes the severity of symptoms. Therefore, this treatment can be used as a suitable treatment for these patients.
IRCT Registration Number: IRCT20230520058237N1
[1] Staab JP, Eckhardt-Henn A, Horii A, Jacob R, Strupp M, Brandt T, et al. Diagnostic criteria for persistent postural-perceptual dizziness (PPPD): Consensus document of the committee for the Classification of Vestibular Disorders of the Bárány Society. J Vestib Res. 2017;27(4):191-208. [DOI:10.3233/VES-170622]
[2] Popkirov S, Staab JP, Stone J. Persistent postural-perceptual dizziness (PPPD): a common, characteristic and treatable cause of chronic dizziness. Pract Neurol. 2018;18(1):5-13. [DOI:10.1136/practneurol-2017-001809]
[3] Popkirov S, Stone J, Holle-Lee D. Treatment of Persistent Postural-Perceptual Dizziness (PPPD) and Related Disorders. Curr Treat Options Neurol. 2018;20(12):50. [DOI:10.1007/s11940-018-0535-0]
[4] Li L, He S, Liu H, Pan M, Dai F. Potential risk factors of persistent postural-perceptual dizziness: a pilot study. J Neurol. 2022;269(6):3075-85. [DOI:10.1007/s00415-021-10899-7]
[5] Zachou A, Anagnostou E. Diagnostic value of key signs in persistent postural-perceptual dizziness. J Neurol. 2020;267(6):1846-8. [DOI:10.1007/s00415-020-09820-5]
[6] Seemungal BM, Passamonti L. Persistent postural-perceptual dizziness: a useful new syndrome. J Psychosom Res. 2018;76:80-3.
[7] Siriwardhana R, Somarathna M, Sooriyaarachchi M, Subasinghe S, Sumanasekara H, Hapuarachchi C, et al. Prevalence of Paternal Postpartum Depression in Anuradhapura District in Sri Lanka and Its Association With Maternal Postpartum Depression as a Risk Factor. Journal of Family and Reproductive Health. 2022;13:239-42.
[8] Dieterich M, Staab JP, Brandt T. Functional (psychogenic) dizziness. Handb Clin Neurol. 2016;139:447-68. [DOI:10.1016/B978-0-12-801772-2.00037-0]
[9] Staab JP, Ruckenstein MJ, Solomon D, Shepard NT. Serotonin reuptake inhibitors for dizziness with psychiatric symptoms. Arch Otolaryngol Head Neck Surg. 2002;128(5):554-60. [DOI:10.1001/archotol.128.5.554]
[10] Honaker JA, Gilbert JM, Staab JP. Chronic subjective dizziness versus conversion disorder: discussion of clinical findings and rehabilitation. Am J Audiol. 2010;19(1):3-8. [DOI:10.1044/1059-0889(2009/09-0013)]
[11] Simon NM, Pollack MH, Tuby KS, Stern TA. Dizziness and panic disorder: a review of the association between vestibular dysfunction and anxiety. Ann Clin Psychiatry. 1998;10(2):75-80. [DOI:10.1023/a:1026167000066]
[12] Teh CS, Prepageran N. The impact of disease duration in persistent postural-perceptual dizziness (PPPD) on the quality of life, dizziness handicap and mental health. J Vestib Res. 2022;32(4):373-80. [DOI:10.3233/VES-210087]
[13] Spielberger CD, Reheiser EC. Job stress in university, corporate, and military personnel. Int J Stress Manage. 1994;1(1):19-31. [DOI:10.1007/BF01857281]
[14] Patatas OH, Ganança CF, Ganança FF. Quality of life of individuals submitted to vestibular rehabilitation. Braz J Otorhinolaryngol. 2009;75(3):387-94. [DOI:10.1016/S1808-8694(15)30657-1]
[15] Aratani MC, Ricci NA, Caovilla HH, Ganança FF. Brazilian version of the Vestibular Disorders Activities of Daily Living Scale (VADL). Braz J Otorhinolaryngol. 2013;79(2):203-11. [DOI:10.5935/1808-8694.20130036]
[16] Cawthorne T. The physiological basis for head exercises. The Journal of the Chartered Society of Physiotherapy. 1944;30:106.
[17] Waller B, Munukka M, Rantalainen T, Lammentausta E, Nieminen MT, Kiviranta I, et al. Effects of high intensity resistance aquatic training on body composition and walking speed in women with mild knee osteoarthritis: a 4-month RCT with 12-month follow-up. Osteoarthritis Cartilage. 2017;25(8):1238-46. [DOI:10.1016/j.joca.2017.02.800]
[18] Wainner RS, Fritz JM, Irrgang JJ, Boninger ML, Delitto A, Allison S. Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy. Spine (Phila Pa 1976). 2003;28(1):52-62. [DOI:10.1097/00007632-200301010-00014]
[19] Jafarzadeh S, Bahrami E, Pourbakht A, Jalaie S, Daneshi A.Validity and reliability of the Persian version of the dizziness handicap inventory. J Res Med Sci. 2014 Aug;19(8):769-75.
[20] Whitney SL, Wrisley DM, Brown KE, Furman JM. Is perception of handicap related to functional performance in persons with vestibular dysfunction? Otol Neurotol. 2004;25(2):139-43. [DOI:10.1097/00129492-200403000-00010]
[21] Gans RE, Vestibular rehabilitation: protocols and programs. San Diego: Singular Pub. Group; 1996. viii, 120.
[22] Hall CD, Gillig-Heusel L. Physical Therapy and Management of People with Non-Vestibular Dizziness. Vestibular Rehabilitation. In: Herdman SJ, Clendaniel RA, editors. Philadelphia, PA: F.A. Davis Company; 2014. p. 569-83.
[23] Staab JP. Behavioral aspects of vestibular rehabilitation. NeuroRehabilitation. 2011;29(2):179-83. [DOI:10.3233/NRE-2011-0693]
[24] Piker EG, Jacobson GP. Self-report symptoms differ between younger and older dizzy patients. Otol Neurotol. 2014;35(5):873-9. [DOI:10.1097/MAO.0000000000000391]
[25] Staab JP. Persistent Postural-Perceptual Dizziness. Semin Neurol. 2020;40(1):130-7. [DOI:10.1055/s-0039-3402736]
[26] Bittar RS, Lins EM. Clinical characteristics of patients with persistent postural-perceptual dizziness. Braz J Otorhinolaryngol. 2015;81(3):276-82. [DOI:10.1016/j.bjorl.2014.08.012]
[27] Huppert D, Strupp M, Rettinger N, Hecht J, Brandt T. Phobic postural vertigo--a long-term follow-up (5 to 15 years) of 106 patients. J Neurol. 2005;252(5):564-9. [DOI:10.1007/s00415-005-0699-x]
[28] Kapfhammer HP, Mayer C, Hock U, Huppert D, Dieterich M, Brandt T. Course of illness in phobic postural vertigo. Acta Neurol Scand. 1997;95(1):23-8. [DOI:10.1111/j.1600-0404.1997.tb00063.x]
[29] Steensnaes MH, Knapstad MK, Goplen FK, Berge JE. Persistent Postural-Perceptual Dizziness (PPPD) and quality of life: a crosssectional study. Eur Arch Otorhinolaryngol. 2023. [DOI:10.1007/s00405-023-08040-7]
[30] Van De Wyngaerde KM, Lee MK, Jacobson GP, Pasupathy K, Romero-Brufau S, McCaslin DL. The Component Structure of the Dizziness Handicap Inventory (DHI): A Reappraisal. Otol Neurotol. 2019;40(9):1217-23. [DOI:10.1097/MAO.0000000000002365]
[31] Nada EH, Ibraheem OA, Hassaan MR. Vestibular Rehabilitation Therapy Outcomes in Patients With Persistent Postural-Perceptual Dizziness. Ann Otol Rhinol Laryngol. 2019;128(4):323-9. [DOI:10.1177/0003489418823017]
[32] Holmberg J, Karlberg M, Harlacher U, Rivano-Fischer M, Magnusson M. Treatment of phobic postural vertigo. A controlled study of cognitive-behavioral therapy and self-controlled desensitization. J Neurol. 2006;253(4):500-6. [DOI:10.1007/s00415-005-0050-6]
[33] Heinrichs N, Edler C, Eskens S, Mielczarek MM, Moschner C. Predicting continued dizziness after an acute peripheral vestibular disorder. Psychosom Med. 2007;69(7):700-7. [DOI:10.1097/PSY.0b013e318151a4dd]
[2] Popkirov S, Staab JP, Stone J. Persistent postural-perceptual dizziness (PPPD): a common, characteristic and treatable cause of chronic dizziness. Pract Neurol. 2018;18(1):5-13. [DOI:10.1136/practneurol-2017-001809]
[3] Popkirov S, Stone J, Holle-Lee D. Treatment of Persistent Postural-Perceptual Dizziness (PPPD) and Related Disorders. Curr Treat Options Neurol. 2018;20(12):50. [DOI:10.1007/s11940-018-0535-0]
[4] Li L, He S, Liu H, Pan M, Dai F. Potential risk factors of persistent postural-perceptual dizziness: a pilot study. J Neurol. 2022;269(6):3075-85. [DOI:10.1007/s00415-021-10899-7]
[5] Zachou A, Anagnostou E. Diagnostic value of key signs in persistent postural-perceptual dizziness. J Neurol. 2020;267(6):1846-8. [DOI:10.1007/s00415-020-09820-5]
[6] Seemungal BM, Passamonti L. Persistent postural-perceptual dizziness: a useful new syndrome. J Psychosom Res. 2018;76:80-3.
[7] Siriwardhana R, Somarathna M, Sooriyaarachchi M, Subasinghe S, Sumanasekara H, Hapuarachchi C, et al. Prevalence of Paternal Postpartum Depression in Anuradhapura District in Sri Lanka and Its Association With Maternal Postpartum Depression as a Risk Factor. Journal of Family and Reproductive Health. 2022;13:239-42.
[8] Dieterich M, Staab JP, Brandt T. Functional (psychogenic) dizziness. Handb Clin Neurol. 2016;139:447-68. [DOI:10.1016/B978-0-12-801772-2.00037-0]
[9] Staab JP, Ruckenstein MJ, Solomon D, Shepard NT. Serotonin reuptake inhibitors for dizziness with psychiatric symptoms. Arch Otolaryngol Head Neck Surg. 2002;128(5):554-60. [DOI:10.1001/archotol.128.5.554]
[10] Honaker JA, Gilbert JM, Staab JP. Chronic subjective dizziness versus conversion disorder: discussion of clinical findings and rehabilitation. Am J Audiol. 2010;19(1):3-8. [DOI:10.1044/1059-0889(2009/09-0013)]
[11] Simon NM, Pollack MH, Tuby KS, Stern TA. Dizziness and panic disorder: a review of the association between vestibular dysfunction and anxiety. Ann Clin Psychiatry. 1998;10(2):75-80. [DOI:10.1023/a:1026167000066]
[12] Teh CS, Prepageran N. The impact of disease duration in persistent postural-perceptual dizziness (PPPD) on the quality of life, dizziness handicap and mental health. J Vestib Res. 2022;32(4):373-80. [DOI:10.3233/VES-210087]
[13] Spielberger CD, Reheiser EC. Job stress in university, corporate, and military personnel. Int J Stress Manage. 1994;1(1):19-31. [DOI:10.1007/BF01857281]
[14] Patatas OH, Ganança CF, Ganança FF. Quality of life of individuals submitted to vestibular rehabilitation. Braz J Otorhinolaryngol. 2009;75(3):387-94. [DOI:10.1016/S1808-8694(15)30657-1]
[15] Aratani MC, Ricci NA, Caovilla HH, Ganança FF. Brazilian version of the Vestibular Disorders Activities of Daily Living Scale (VADL). Braz J Otorhinolaryngol. 2013;79(2):203-11. [DOI:10.5935/1808-8694.20130036]
[16] Cawthorne T. The physiological basis for head exercises. The Journal of the Chartered Society of Physiotherapy. 1944;30:106.
[17] Waller B, Munukka M, Rantalainen T, Lammentausta E, Nieminen MT, Kiviranta I, et al. Effects of high intensity resistance aquatic training on body composition and walking speed in women with mild knee osteoarthritis: a 4-month RCT with 12-month follow-up. Osteoarthritis Cartilage. 2017;25(8):1238-46. [DOI:10.1016/j.joca.2017.02.800]
[18] Wainner RS, Fritz JM, Irrgang JJ, Boninger ML, Delitto A, Allison S. Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy. Spine (Phila Pa 1976). 2003;28(1):52-62. [DOI:10.1097/00007632-200301010-00014]
[19] Jafarzadeh S, Bahrami E, Pourbakht A, Jalaie S, Daneshi A.Validity and reliability of the Persian version of the dizziness handicap inventory. J Res Med Sci. 2014 Aug;19(8):769-75.
[20] Whitney SL, Wrisley DM, Brown KE, Furman JM. Is perception of handicap related to functional performance in persons with vestibular dysfunction? Otol Neurotol. 2004;25(2):139-43. [DOI:10.1097/00129492-200403000-00010]
[21] Gans RE, Vestibular rehabilitation: protocols and programs. San Diego: Singular Pub. Group; 1996. viii, 120.
[22] Hall CD, Gillig-Heusel L. Physical Therapy and Management of People with Non-Vestibular Dizziness. Vestibular Rehabilitation. In: Herdman SJ, Clendaniel RA, editors. Philadelphia, PA: F.A. Davis Company; 2014. p. 569-83.
[23] Staab JP. Behavioral aspects of vestibular rehabilitation. NeuroRehabilitation. 2011;29(2):179-83. [DOI:10.3233/NRE-2011-0693]
[24] Piker EG, Jacobson GP. Self-report symptoms differ between younger and older dizzy patients. Otol Neurotol. 2014;35(5):873-9. [DOI:10.1097/MAO.0000000000000391]
[25] Staab JP. Persistent Postural-Perceptual Dizziness. Semin Neurol. 2020;40(1):130-7. [DOI:10.1055/s-0039-3402736]
[26] Bittar RS, Lins EM. Clinical characteristics of patients with persistent postural-perceptual dizziness. Braz J Otorhinolaryngol. 2015;81(3):276-82. [DOI:10.1016/j.bjorl.2014.08.012]
[27] Huppert D, Strupp M, Rettinger N, Hecht J, Brandt T. Phobic postural vertigo--a long-term follow-up (5 to 15 years) of 106 patients. J Neurol. 2005;252(5):564-9. [DOI:10.1007/s00415-005-0699-x]
[28] Kapfhammer HP, Mayer C, Hock U, Huppert D, Dieterich M, Brandt T. Course of illness in phobic postural vertigo. Acta Neurol Scand. 1997;95(1):23-8. [DOI:10.1111/j.1600-0404.1997.tb00063.x]
[29] Steensnaes MH, Knapstad MK, Goplen FK, Berge JE. Persistent Postural-Perceptual Dizziness (PPPD) and quality of life: a crosssectional study. Eur Arch Otorhinolaryngol. 2023. [DOI:10.1007/s00405-023-08040-7]
[30] Van De Wyngaerde KM, Lee MK, Jacobson GP, Pasupathy K, Romero-Brufau S, McCaslin DL. The Component Structure of the Dizziness Handicap Inventory (DHI): A Reappraisal. Otol Neurotol. 2019;40(9):1217-23. [DOI:10.1097/MAO.0000000000002365]
[31] Nada EH, Ibraheem OA, Hassaan MR. Vestibular Rehabilitation Therapy Outcomes in Patients With Persistent Postural-Perceptual Dizziness. Ann Otol Rhinol Laryngol. 2019;128(4):323-9. [DOI:10.1177/0003489418823017]
[32] Holmberg J, Karlberg M, Harlacher U, Rivano-Fischer M, Magnusson M. Treatment of phobic postural vertigo. A controlled study of cognitive-behavioral therapy and self-controlled desensitization. J Neurol. 2006;253(4):500-6. [DOI:10.1007/s00415-005-0050-6]
[33] Heinrichs N, Edler C, Eskens S, Mielczarek MM, Moschner C. Predicting continued dizziness after an acute peripheral vestibular disorder. Psychosom Med. 2007;69(7):700-7. [DOI:10.1097/PSY.0b013e318151a4dd]
| Files | ||
| Issue | Vol 33 No 1 (2024) | |
| Section | Research Article(s) | |
| DOI | https://doi.org/10.18502/avr.v33i1.14270 | |
| Keywords | ||
| Persistent postural-perceptual dizziness dizziness handicap inventory vestibular rehabilitation military | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Taghavi SMR, Mehrabi F, Cheraghipour P, Mousavi SM, Nezhadi A. Effect of Vestibular Rehabilitation Therapy on the Daily Life Aspects of Military Men with Persistent Postural- Perceptual Dizziness: A Clinical Trial. Aud Vestib Res. 2023;33(1):20-27.
