Proposed Topic (Most preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for 10 years or less)
Authors (including presenting author) :
Wong MC(1), Law YF(1), Chow TH(1), Kwan MY(2), Cheung YW(1), Au TK(1)
Affiliation :
(1)Physiotherapy Department, Tseung Kwan O Hospital
(2)Department of ENT, KEC cluster
Introduction :
Chronic vestibular dysfunction is often a frustrating problem and can have a tremendous impact on one’s quality of life. VRE has been proposed in order to reduce the dizziness symptoms and improve body balance of individuals with vestibular dysfunction. There is also moderate to strong evidence showing that it is a safe and effective treatment. In view of this, a VRE class was developed in hospital setting in the hope of providing favorable treatment as well as peer support to patients.
Objectives :
To assess the efficacy of the structured physiotherapy VRE class with Home Based Exercise in patients with dizziness/vertigo
Methodology :
Patients referred by ENT doctors to physiotherapy for dizziness/vertigo in Tseung Kwan O Hospital were recruited to a 45-minute VRE class consisting of 3 sessions in 9 weeks, with components of Cawthorne-Cooksey exercise, TaiChi exercise, balance training and various adaptation, substitution and habituation exercises. The maximum number of patients was six in each class. In the first session, patient underwent pre-assessment and then attended the exercise class with self-management education. Subsequently, patients continued to perform the vestibular exercises at home independently for 4 weeks and then attended the second session for review. Finally, patients attended the third session after another 4 weeks of home exercise with post-assessment.
Result & Outcome :
From Jun 2021 to Sep 2023, 106 patients (26 males and 80 females) with mean age 59.1±13.4 completed the program, with 64% of patients were diagnosed with unilateral/bilateral vestibular weakness. The mean dizziness intensity measured in Visual Analogue Scale (VAS) was significantly decreased from 4.67 to 2.26 (p<0.05). Self-perceived impact of dizziness on daily life measured by Dizziness Handicap Inventory (DHI) was decreased from 37.0 to 28.8 (p<0.05). Static balance also improved as represented by Single Leg Stand Test from 17.7 to 21.0 seconds (p<0.05) and 19.9 to 22.2 seconds (p<0.05) for left and right leg respectively. In addition, Sharpened Romberg Test with eyes closed improved from 9.5 to 13.6 seconds (p<0.05). Subjectively, over 90% of patients are satisfactory with the VRE class overall.
Conclusion:
The Physiotherapy VRE Class with Home Based Exercise was effective for patients with dizziness or vertigo in terms of improvement in symptoms, balance and quality of life.
