Vestibular rehabilitation in Europe: a survey of clinical and research practice

• DOI: 10.1007/s00415-020-10228-4
• Publication Date: 2020-10-13T14:02:39Z
• Authors: Dara Meldrum; Lisa Burrows; Ondrej Cakrt; Hassen Kerkeni; Christophe Lopez; Frederik Tjernstrom; Luc Vereeck; Oz Zur; Klaus Jahn
• Keywords: Posturography; Demographics; Thematic Analysis

Abstract Vestibular rehabilitation (VR) is practiced across Europe but little in this area has been quantified. The aim of study was to investigate current VR assessment, treatment, education, and research practices. This an online, cross-sectional survey with 39 specific questions four sections: demographics, practice, research. disseminated through the Dizzynet network individual therapists country-specific special interest groups. Results were analysed descriptively. A thematic approach taken analyse open questions. total 471 individuals (median age 41, range 23 − 68 years, 73.4% women), predominately physiotherapists (89.4%) from 20 European countries responded survey. They had worked for a median 4 years (range < 1 35) VR. majority (58.7%) hospital in-patient or out-patient settings 21.4% dedicated services. Most respondents specialized neurology, care elderly (geriatrics), otorhinolaryngology. reported as hard/very hard access by 48%, main barriers identified lack knowledge health professionals (particularly family physicians), trained therapists, local know treat benign paroxysmal positional vertigo (BPPV 87.5%), unilateral vestibular hypofunction (75.6%), cervicogenic dizziness (63%). use assessment equipment varied widely. Over 70% used high-density foam objective gait speed testing. 50% dynamic visual acuity equipment. Infrared systems, Frenzel lenses, posturography not commonly employed (< 20%). most frequently physical outcome measures Clinical Test Sensory Interaction Balance, Functional Gait Assessment/Dynamic Index, Romberg/Tandem Romberg. Dizziness Handicap Inventory, Visual Analogue Scale, Falls Efficacy Vertigo Symptom Scale patient measures. Adaptation, balance, habituation exercises (> 80%), virtual reality 15.6%. knowledge/use Semont, Epley Barbeque-Roll manoeuvres treatment BPPV. education regarding obtained at post-registration level (89.5%) only 19% reporting pre-registration education. There strong (78%) agreement that should have professionally accredited postgraduate certification VR, blended learning popular mode. Three major priority: management conditions, effectiveness mechanisms/factors influencing compensation In summary, quantified clinical practice Europe. Knowledge common diseases high, published subjective well results stress need improving both training standards care. approach, taking advantage best practices some countries, seems reasonable approach.