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DOI: 10.1055/s-0040-1718956
Lian gong as a Therapeutic Treatment Option in Primary Care for Patients with Dizziness: A Randomized Controlled Trial
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Abstract
Introduction Dizziness is one of the most common reasons for seeking primary health care. Vestibular rehabilitation (VR) is a conventional treatment method for peripheral balance disorders that effectively decreases symptoms. Lian gong [LG] is believed to benefit patients with dizziness and to reduce the impact of the condition on quality of life by stimulating visual fixation, attention, body balance, and neuroplasticity.
Objective The present study aimed to evaluate the effects of LG on the impact of dizziness on quality of life and fear of falling in primary health care patients.
Methods This was a two-arm, parallel randomized clinical trial that included 36 patients with dizziness not caused by central changes. After specific medical evaluations and indications for treatment, the participants were randomly assigned to 3 groups: the LG group (n = 11), the VR group (n = 11), and the control group (n = 14). The interventions were conducted collectively over a period of 12 weeks.
Results Lian gong reduced the influence of dizziness on quality of life in physical (1.8 points, 95% confidence interval [CI]: 0.2–3.4), functional (4.0 points, 95% CI: 2.1–5.9), and emotional domains of quality of life (4.4 points, 95% CI: 1.7–7.2), with no differences compared with VR. There were similar concerns among the groups about the risk of falling.
Conclusion Lian gong was shown to be an effective balance rehabilitation strategy to reduce the impact of dizziness on quality of life, with similar results to those of VR.
Keywords
Dizziness - primary health care - complementary therapies - speech therapy - clinical trialPublication History
Received: 12 February 2020
Accepted: 23 August 2020
Article published online:
08 December 2020
© 2020. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Villalón TA, García ML, Landrean AS. Enfoque clínico del vértigo desde la Atención Primaria de Salud. Rev Habanera Cienc Méd 2014; 13: 394-405
- 2 Alyono JC. Vertigo and dizziness: understanding and managing fall risk. Otolaryngol Clin North Am 2018; 51 (04) 725-740
- 3 Neuhauser HK. The epidemiology of dizziness and vertigo. Handb Clin Neurol 2016; 137: 67-82 DOI: 10.1016/B978-0-444-63437-5.00005-4.
- 4 Iwasaki S, Yamasoba T. Dizziness and imbalance in the elderly: age-related decline in the vestibular system. Aging Dis 2014; 6 (01) 38-47
- 5 Bittar RSM, Oiticica J, Bottino MA, Ganança FF, Dimitrov R. Population epidemiological study on the prevalence of dizziness in the city of São Paulo. Rev Bras Otorrinolaringol (Engl Ed) 2013; 79 (06) 688-698
- 6 Omron R. Peripheral Vertigo. Emerg Med Clin North Am 2019; 37 (01) 11-28
- 7 Whitman GT. Dizziness. Am J Med 2018; 131 (12) 1431-1437
- 8 Yardley L, Barker F, Muller I. et al. Clinical and cost effectiveness of booklet based vestibular rehabilitation for chronic dizziness in primary care: single blind, parallel group, pragmatic, randomised controlled trial. BMJ 2012; 344: e2237
- 9 Geraghty AW, Kirby S, Essery R. et al. Internet-based vestibular rehabilitation for adults aged 50 years and over: a protocol for a randomised controlled trial. BMJ Open 2014; 4 (07) e005871
- 10 Barin K, Dodson EE. Dizziness in the elderly. Otolaryngol Clin North Am 2011; 44 (02) 437-454 , x
- 11 Gardiner S, Glogowska M, Stoddart C, Pendlebury S, Lasserson D, Jackson D. Older people's experiences of falling and perceived risk of falls in the community: A narrative synthesis of qualitative research. Int J Older People Nurs 2017; 12 (04) 10111-12151
- 12 Kovacs E, Wang X, Grill E. Economic burden of vertigo: a systematic review. Health Econ Rev 2019; 9 (01) 37
- 13 Patatas OHG, Ganança CF, Ganança FF. Qualidade de vida de indivíduos submetidos à reabilitação vestibular. Rev Bras Otorrinolaringol (Engl Ed) 2009; 75: 387-394
- 14 Lopes AL, Lemos SMA, Chagas CA, Araújo SG, Santos JN. Evidências científicas da reabilitação vestibular na atenção primária à saúde: uma revisão sistemática. Audiol Commun Res 2018; 23: e2032
- 15 Pereira PC, Oliveira LHS, Souza VV, Silva AS. Eficácia da reabilitação vestibular em idosos com tontura. RUVRD 2013; 11: 371-378
- 16 Hånsson EE, Månsson NO, Håkansson A. Effects of specific rehabilitation for dizziness among patients in primary health care. A randomized controlled trial. Clin Rehabil 2004; 18 (05) 558-565
- 17 Yardley L, Donovan-Hall M, Smith HE, Walsh BM, Mullee M, Bronstein AM. Effectiveness of primary care-based vestibular rehabilitation for chronic dizziness. Ann Intern Med 2004; 141 (08) 598-605
- 18 Yardley L, Beech S, Zander L, Evans T, Weinman J. A randomized controlled trial of exercise therapy for dizziness and vertigo in primary care. Br J Gen Pract 1998; 48 (429) 1136-1140
- 19 Hånsson EE, Månsson NO, Ringsberg KA, Håkansson A. Falls among dizzy patients in primary healthcare: an intervention study with control group. Int J Rehabil Res 2008; 31 (01) 51-57
- 20 Peixoto MCC. A viabilidade e efetividade de um Programa de Reabilitação Vestibular na Atenção Primária à Saúde [dissertação]. Minas Gerais: Faculdade de Medicina-UFMG; 2015
- 21 Brasil, Ministério da Saúde, Secretaria de Atenção à Saúde, Departamento de Atenção Básica. Política Nacional de Práticas Integrativas e Complementares no SUS - PNPIC-SUS. Brasília: Ministério da Saúde; 2006
- 22 Zhong D, Xiao Q, Xiao X. et al. Tai Chi for improving balance and reducing falls: An overview of 14 systematic reviews. Ann Phys Rehabil Med 2020; S1877-0657 (20)30028-2. Doi: 10.1016/j.rehab.2019.12.008
- 23 Prado ET, Raso V, Scharlach RC, Kasse CA. Hatha yoga on body balance. Int J Yoga 2014; 7 (02) 133-137
- 24 Zhao L, Liu J, Zhang F. et al. Effects of long-term acupuncture treatment on resting-state brain activity in migraine patients: a randomized controlled trial on active acupoints and inactive acupoints. PLoS One 2014; 9 (06) e99538
- 25 Lopes AL, Lemos SMA, Figueiredo PHS, Santos JN. Impacto do lian gong na qualidade de vida de indivíduos com tontura na atenção primária. Rev Saude Publica 2019; 53: 73
- 26 Ming ZY. LG Shi Ba Fa: Liang gong em 18 terapias. São Paulo: Pensamento. 2004
- 27 Correia DS, Cardoso GMC, Cardoso DM, Fernandes RRO, Soares WD. Uso do LG na estratégia de saúde da família: tratamento da dor crônica. Rev enferm UFPE on line, Recife 2016; 10: 1600-1605
- 28 Norré ME, De Weerdt W. Vestibular habituation training. Technique and first results. Preliminary report. Acta Otorhinolaryngol Belg 1979; 33 (03) 347-364
- 29 Cawthorne T. The physiological basis for head exercises. Journal of Chartered Society of Physiotherapy 1944; 30: 106
- 30 Cooksey FS. Physical medicine. Practitioner 1945; 155: 300-305
- 31 Herdman SJ. Vestibular Rehabilitation. Contemporary Perspectives in Rehabilitation. 3rd ed. Philadelphia: FA Davis Co; 2007
- 32 Castro ASOD, Gazzola JM, Natour J, Ganança FF. Versão brasileira do dizziness handicap inventory. Pro Fono 2007; 19 (01) 97-104 , 27
- 33 Camargos FFO, Dias RC, Dias JMD, Freire MTF. Adaptação transcultural e avaliação das propriedades psicométricas da Fall Efficacy Scale- International em idosos brasileiros (FES-I). Rev Bras Fisoter 2010; 14: 237-243
- 34 Manfroi MN, Correia PMS, Franzoni WCC, Moraes LB, Stein F, Marinho A. Dor: o impulso na busca pela saúde por meio de práticas integrativas e complementares. BrJP 2019; 2 (04) 316-320
- 35 Aratani MC, Ricci NA, Caovilla HH, Ganança FF. Benefits of vestibular rehabilitation on patient-reported outcomes in older adults with vestibular disorders: a randomized clinical trial. Braz J Phys Ther 2020; S14133555 (19) 30025-5
- 36 Peluso ÉT, Quintana MI, Ganança FF. Anxiety and depressive disorders in elderly with chronic dizziness of vestibular origin. Rev Bras Otorrinolaringol (Engl Ed) 2016; 82 (02) 209-214
- 37 PNUD, IPEA, FJP. Atlas of Human Development in Brazil [Internet]. [cited 2020 Jan 23]. Available from: http://www.atlasbrasil.org.br