N/A
N=17
"Can A Prescribed Walking Program With or Without Monitoring Impact Dizziness in the Older Adults?"
Dizziness
Bottom Line
View on ClinicalTrials.gov: NCT03403400 ↗Enrolled (actual)
17
Serious AEs
0.0%
Results posted
Jul 2020
Primary outcome: Primary: Modified Clinical Test of Sensory Integration for Balance (mCTSIB) — 115.98; 97.4; 110.15; 107.23 seconds — p=.640
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- VRWP Group (Behavioral); VRW Group (Behavioral)
- Age
- Older Adult · 65+ yrs
- Sex
- All
- Sponsor
- AdventHealth
- Primary completion
- Sep 2019
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Modified Clinical Test of Sensory Integration for Balance (mCTSIB) |
115.98; 97.4; 110.15; 107.23; 120; 111.17 | .640 |
| PRIMARY Timed Up and Go (TUG) Test |
10; 12.73; 12.42; 12.54; 7.80; 10 | .67 |
| PRIMARY Dynamic Gait Index |
20; 19.5; 20.67; 20.2; 22.80; 22 | .67 |
| PRIMARY Dizziness Handicap Inventory (DHI) |
16; 38.5; 23.67; 29.6; 13.2; 11.5 | .11 |
| SECONDARY Total Number of Visits |
5.6; 6.75; 7.33; 7.04 | — |
| SECONDARY Length of Interventions in Weeks |
8.5; 9.25; 8.5; 8.88 | — |
Summary
Dizziness is a common complaint reported by 30% of people above 65 years of age and by more than 50% of those 90 years of age and older.(1) Age-related decline in vestibular, musculoskeletal, and neurologic performances compounded by a vestibular pathology can result to debilitating physical and psychological consequences. Dizziness is associated with falls,(2) disability (3) and physical inactivity.(4) Walking for endurance is cited as one of the components of vestibular rehabilitation (VR) in the "Clinical Practice Guideline for Peripheral Vestibular Hypofunction".(5) Although walking can offset the avoidance of physical activity from symptom provocation, no direct evidence has been found to support the effect of walking on postural and dynamic stability, function, and participation in people with dizziness.
The primary purpose of this study is to evaluate the impact of walking as an exercise component of VR on both primary and secondary vestibular-specific outcome measures. The primary outcomes are mCTSIB, TUG test, DGI, and DHI, while the secondary outcomes are the total number of visits and length of interventions (in weeks). The second purpose is to evaluate whether pedometers increase the adherence of older adults with vestibular issues to a walking program. This will be measured by change in physical activity, as represented by International Physical Activity Questionnaire (IPAQ) Walking Metabolic Equivalent of Task (MET)-minutes/week and IPAQ Total Physical Activity MET-minutes/week scores from the IPAQ short form during the episode of care (admission and discharge) and on four-weeks follow-up compared to those patients who only received instructions to walk without a pedometer. The third purpose of this study is to establish test-retest reliability of the TUG test on older adults with dizziness. Lastly, the fourth purpose of this study to investigate if the TUG, DGI, and mCTSIB are significant and strong predictors of the DHI in older adults with dizziness. Protocol #1365169 "Predictors of Disability in the Older Adults" is being performed to supplement the number of subjects for the fourth objective of this study.
Eligibility Criteria
Inclusion Criteria
- Age 65 years or older referred for physical therapy evaluation for symptoms of dizziness, postural instability, or both
- Able to walk without the physical help of another person, with or with no assistive device
- Able to follow commands and execute the examination and intervention instructions in the English language
- Willing to participate in a phone interview four weeks after discharge
- Able to provide informed consent
Exclusion Criteria
- Unstable medical issues, such as unstable or uncontrolled cardiovascular conditions, elevated blood pressure (Systolic greater than or equal to 140mmHg and diastolic greater than or equal to 90mmHg), orthostatic hypotension (a fall in systolic blood pressure of at least 20mmHg or diastolic blood pressure of at least 10mmHg when a person stands from a sitting or lying down position), uncontrolled metabolic disease, as determined by the evaluating physical therapist, documented in the Functional Comorbidity Index, vital signs and assessment portion of the initial evaluation.
- History of falls from syncopal origin
- Dizziness of central origin, such as stroke, head injuries, MS or PD;
- Active BPPV (patients with positive dix hallpike and/or roll test)
- Inability to walk without physical assistance.
Data sourced from ClinicalTrials.gov (NCT03403400). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.