Factors Associated With Rehabilitation Outcomes in Patients With Unilateral Vestibular Hypofunction: A Prospective Cohort Study
Autor: | Courtney D. Hall, Lisa Heusel-Gillig, Susan J. Herdman |
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Rok vydání: | 2020 |
Předmět: |
Male
medicine.medical_specialty Visual acuity medicine.medical_treatment Physical Therapy Sports Therapy and Rehabilitation Logistic regression Dizziness 03 medical and health sciences 0302 clinical medicine Quality of life medicine Humans Prospective Studies 030223 otorhinolaryngology Prospective cohort study Balance (ability) Rehabilitation Depression business.industry Middle Aged Treatment Outcome Vestibular Diseases Head Movements Quality of Life Physical therapy Anxiety Accidental Falls Female medicine.symptom business 030217 neurology & neurosurgery Patient education |
Zdroj: | Physical Therapy. 100:2009-2022 |
ISSN: | 1538-6724 0031-9023 |
DOI: | 10.1093/ptj/pzaa138 |
Popis: | Objective The purpose of this study was to determine factors associated with rehabilitation outcomes following vestibular rehabilitation (VR). Methods In this prospective cohort study, 116 patients who completed at least 2 supervised sessions participated. Patient characteristics and comorbidities were recorded. Initial and discharge measures included symptom intensity, balance confidence, quality of life, percent of time symptoms interfere with life, perceived benefits of VR, gait speed, fall risk, visual acuity during head movement, and anxiety/depression. Intention-to-treat analyses were performed to determine outcomes at discharge. Bivariate correlations between independent (group characteristics and baseline measures) and dependent (discharge measures) variables were determined. Logistic regressions were performed to identify factors associated with whether a patient would have a normal score or meaningful change at discharge. Results There was a large effect of VR with significant improvement for the group as a whole on each outcome measure. For each outcome measure, most patients improved. Based on preliminary logistic regression, 2 patient characteristics were associated with outcome: number of therapy visits predicted meaningful improvement in gait speed, and falls after the onset of the unilateral vestibular hypofunction (UVH) predicted meaningful change in the percent of time symptoms interfered with life. Initial Activities-Specific Balance Confidence Scale (ABC) and Dynamic Gait Index scores predicted normal ABC scores at discharge, and initial ABC scores predicted recovery of Dynamic Gait Index scores. Preliminary prediction models were generated for balance confidence, impact of dizziness on life, dynamic visual acuity, gait speed, and fall risk. Conclusions Therapists may use these findings for patient education or to determine the need for adjunct therapy, such as counseling. Impact Not all people with UVH improve following VR, but there is little research examining why. This study looked at multiple factors and identified number of visits and falls after onset of UVH as patient characteristics associated with outcomes following VR; these findings will help therapists create better predictive models. |
Databáze: | OpenAIRE |
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