Study strengths & weaknesses - The Effect Yoga Has In Treating Vertigo

G. Schmid, P. Henningsen, M. Dieterich, H. Sattel, and C. Lahmann (January 01, 2011). A systematic review of psychotherapy for dizziness. 82, 6, 601-606, Journal of Neurology, Neurosurgery, and Psychiatry.

The paper provides an overview of psychotherapy treatments for treating dizziness in vertigo patients.

A search was conducted in Medline, PSYNDEX, and PsycINFO.

The study comprised randomized controlled trials (RCTs) focusing on psychotherapy in dizzy individuals.

Overall number of papers: 1278 Randomized controlled trials, follow-up, psychotherapy, and case reports: 17

Three randomized controlled trials were included.

Psychotherapy provides improvement for vertigo patients with dizziness. In the treatment groups, the mean ES for outcome related to dizziness was 0.46. Outcomes related to anxiety was 0.10 and for depression the outcome was found to be 0.17. In the control groups, the ES related to dizziness was found to be 0.04. On the other hand, anxiety related ES was 0.03 while depression related ES was 0.02.

Strengths: the study has an average quality.

Weaknesses: The size of the sample used in the study were small.

The study is significant as it shows that psychotherapy is effective for vertigo patients with dizziness. Dizziness is a leading cause of falls. Therefore, psychotherapy is important to reduce the number of falls.

Tsukamoto HF, Costa Vde S, Silva RA Jr, Pelosi GG, Marchiori LL, Vaz CR, Fernandes KB. The effectiveness of a vestibular rehabilitation protocol to improve the health-related quality of life and postural balance in patients with vertigo. Int Arch Otorhinolaryngol 2015; 19:238-247.

The study aims to analyze the impact of vestibular rehabilitation treatment protocol on patients with vertigo and compare it to the patients taking or not taking anti-vertigo drugs.

The study had a nonrandomized controlled trial. The trial was conducted on subjects that were previously identified to have vertigo. The evidence on the symptoms of vertigo was evaluated through the Dizziness Handicap Inventory. The patients through a custom protocol underwent treatment for 12 weeks.

N= 20, and was divided into two groups. The control group, n = 11 and the medicated group, n = 9.

Dependent: Vertigo symptoms

The study noted an improvement in the quality of life (p < 0.001). The effects of dizziness also decreased (p = 0.003). Also, there was progress in the postural balance.

The samples used were of good quality for the study.

The intervention is significant as it improves both the quality of life and postural balance.

Minguez-Zuazo, A., Grande-Alonso, M., Saiz, B. M., Touche, R. L., & Lara, S. L. (June 28, 2016). Therapeutic patient education and exercise therapy in patients with cervicogenic dizziness: a prospective case series clinical study. Journal of Exercise Rehabilitation, 12, 3, 216-225.

The study aimed at evaluating the effectiveness of therapeutic exercise and education in the treatment of dizziness for vertigo patients.

Questionnaires were distributed containing questions, body chart, and demographic data about pain. The subjects were studied for postural control and a cervical range of motion. The study on the subjects was done pre and post intervention.

The subjects underwent eight treatment sessions that were performed twice a week.

N=7 (five females and two males) aged 38.43± 14.10. The subjects had cervicogenic dizziness.

Independent:

Treatment procedure

Dependent: Number of days in cognitive rehabilitation (CR) and in control group.

In the majority of the subjects, there was a great improvement. Dizziness disability (mean change, 9.71± 6.96; 95% CI, 3.26–16.15; d= 1.01), neck disability (mean change, 5.14± 2.27.28; 95% CI, 3.04–7.24; d= 1.32), and Catastrophism (95% confidence interval [CI], 4.96–18.17; d= 1.60); mean change, 11.57± 7.13. In addition to these, they improved motion on both the right and left side.

Strengths:

There is comparison of subjects in CR and control group

The study has shown the effectiveness of therapeutic education and exercise treatment to patients.

Liu, X. M., Pan, F. M., Yong, Z. Y., Ba, Z. Y., Wang, S. J., Liu, Z., Zhao, W. D., ... Wu, D. S. (January 01, 2017). Does the longus colli have an effect on cervical vertigo?: A retrospective study of 116 patients. Medicine, 96, 12.)

The study was focused on the evaluation of Longus Colli muscles and their role in cervical vertigo.

The subjects were grouped into vertigo group or non-vertigo group, and Anterior cervical discectomy and fusion (ACDF) performed on them. In the study, measurement of inner distance and cross-sectional area of longus colli were performed.

N=116, where n=44 were placed in the vertigo group while n=72 were placed in the non-vertigo group.

The subjects in both groups were found to have similar demographic data.

The study is significant in cervical vertigo as inner distance and cross-sectional area of longus are associated closely with the condition.

Liu, X. M., Pan, F. M., Yong, Z. Y., Ba, Z. Y., Wang, S. J., Liu, Z., Zhao, W. D., ... Wu, D. S. (January 01, 2017). Does the longus colli have an effect on cervical vertigo?: A retrospective study of 116 patients. Medicine, 96, 12.)

The study was focused on the evaluation of Longus Colli muscles and their role in cervical vertigo.

The subjects were grouped into vertigo group or non-vertigo group, and Anterior cervical discectomy and fusion (ACDF) performed on them. In the study, measurement of inner distance and cross-sectional area of longus colli were performed.

N=116, where n=44 were placed in the vertigo group while n=72 were placed in the non-vertigo group.

The subjects in both groups were found to have similar demographic data.

The study is significant in cervical vertigo as inner distance and cross-sectional area of longus are associated closely with the condition.

Synthesis

This paper has focused on five articles that assess different treatment procedures for vertigo. One study by Amini et al., (2015) on the use of histamine in peripheral vertigo treatment researched on the reduction of the duration, severity, and frequency of dizziness attacks in patients with vertigo. The researchers defined vertigo as a hallucination of movement that a person experiences regarding themselves or the surrounding. This condition they state can affect the quality of life for the patient. In the study, a meta-analysis on clinical practices that utilized medications that were efficient and had minimal adverse effects were done. A review of several articles helped towards the study of treatment of peripheral vertigo as it was found histamine antagonist to be effective. Another case study by Minguez-Zuazo et al. (2016), specifically focused on the treatment of patients with cervocogenic dizziness using therapeutic patient education and exercise therapy. The study had the treatment programs performed on patients through sessions conducted twice a week. Before the start of the treatment programs, the patients were examined for postural control and cervical range of motion. These conditions were also assessed at the end of a four-week period. There was an improvement in the patient conditions by reduction of some falls since their motions had improved. Therefore, for vertigo patients, therapeutic education and therapeutic exercise are effective.

A study researched the role longus colli muscles have on patients with cervical vertigo (Liu et al., 2017). The researchers used coronal magnetic resonance imaging (MRI) to measure the cross-sectional area and the inner distance of the longus colli. The study showed that the measurements of the longus colli are related to cervical vertigo. The patients in the study also underwent anterior cervical discectomy and fusion (ACDF) that was shown to be useful for the patients with cervical vertigo. Schmid et al. (2011) focused on dizziness a condition that is common among vertigo patients. Dizziness is one of the leading causes of falls as about 80 percent of the patients experience dizziness in their work and daily lives. According to the study, dizziness has not been explained sufficiently and has not also been related to any psychiatric disorder. The study aimed to investigate the effectiveness of psychotherapeutic approaches in the treatment of the dizziness condition. The study found that psychotherapy is effective in patients with vertigo and having the dizziness condition as it helps reduce the number of falls significantly. Tsukamoto et al. (2015) studied the improvement of the quality of life in patients with vertigo using vestibular rehabilitation protocol. To improve the lives of vertigo patients, it is important to solve the hallucination feeling in the affected individual. They analyzed the effect of completion of the procedure on patients under antivertigo drugs and those not taking the drugs. The patients underwent the treatment for 12 weeks with proprioceptive and balance training, cawthorne-Cooksey protocol exercises, shoulder girdle exercises, and cervical manual therapy practice. The vestibular rehabilitation protocol caused improved postural balance and therefore reduced the number of falls for the patients with vertigo. However, the pharmacologic treatment did not improve patient condition. All the articles focused on this report have yielded valid results for therapy treatment of vertigo. Therapeutic yoga has been shown to be effective in reducing the number of falls when it is compared to use of pharmaceutical therapy.

References

Amini, A., Heidari, K., Kariman, H., Taghizadeh, M., Hatamabadi, H., Shahrami, A., Derakhshanfar, H., Asadollahi, S. (January 01, 2015). Histamine Antagonists for Treatment of Peripheral Vertigo: A Meta-Analysis. The Journal of International Advanced Otology, 11, 2, 138-42

Minguez-Zuazo, A., Grande-Alonso, M., Saiz, B. M., Touche, R. L., & Lara, S. L. (June 28, 2016). Therapeutic patient education and exercise therapy in patients with cervicogenic dizziness: a prospective case series clinical study. Journal of Exercise Rehabilitation, 12, 3, 216-225.

Liu, X. M., Pan, F. M., Yong, Z. Y., Ba, Z. Y., Wang, S. J., Liu, Z., Zhao, W. D., ... Wu, D. S. (January 01, 2017). Does the longus colli have an effect on cervical vertigo? A retrospective study of 116 patients. Medicine, 96, 12.)

Schmid, G., Henningsen, P., Dieterich, M., Sattel, H., & Lahmann, C. (January 01, 2011). Psychotherapy in dizziness: a systematic review. Journal of Neurology, Neurosurgery, and Psychiatry, 82, 6, 601-606.

Tsukamoto HF, Costa Vde S, Silva RA Jr, Pelosi GG, Marchiori LL, Vaz CR, Fernandes KB. The effectiveness of a vestibular rehabilitation protocol to improve the health-related quality of life and postural balance in patients with vertigo. Int Arch Otorhinolaryngol 2015; 19:238-247.