Vestibular Rehabilitation Therapy: A Treatment Option for Seniors with Benign

Monday, 22 July 2013

Christi S. Weems, BSN, RN
Health Services, Lubbock Independent School District, Lubbock, TX
JoAnn D. Long, RN, PhD, NEA-BC
Department of Nursing, Lubbock Christian University, Lubbock, TX

Learning Objective 1: Discuss the safety, effectiveness and time constraints of vestibular rehabilitation therapy for elderly patients with benign paroxysmal positional vertigo and the implications of treatment.

Learning Objective 2: The learner will be able to discuss the nursing role in assessing for and treating benign paroxysmal positional vertigo with vestibular rehabilitation therapy.

Purpose: Dizziness is the leading cause of falls in the US, resulting in 80,000 hospitalizations and 16,000 deaths annually and is a prominent external cause of unintentional global injury.  The purpose of this study is to explore the effectiveness and safety of vestibular rehabilitation therapy (VRT) for elderly patients with benign paroxysmal positional vertigo (BPPV) and, to determine if performing VRT is within the scope of nursing practice.

Methods: This evidence-based comprehensive literature review used peer-reviewed articles published from 1993 through 2012, using Medline, CINHAL, PubMed databases and government aging websites searching BPPV, VRT, and effective treatment in the elderly.  The research questions were: 1) Is VRT a safe, effective form of treatment for seniors diagnosed with BPPV?   2) Is performing VRT within the scope of nursing practice?

 Results: Seniors were more likely to experience vestibular disorders due to the natural ageing process and the majority of patients are managed in primary care. Seniors with BPPV have a 12% increased risk of falling, depression, and altered mental status.  Approximately 70% of patients seeking help for dizziness receive medications that suppress the natural vestibular compensation process causing side effects that lead to falls and complications. VRT has a 65%-95% success rate in reliving symptoms of BPPV in as little as one or two treatments.  VRT is safe, effective, non-invasive, and quick. Exercises can be taught so that patients can continue them on their own.  VRT is well-tolerated and is the only treatment that has helped improve balance function and performance in patients with chronic balance issues, when compared to medical therapy.  

Conclusion: VRT is a simple, non-invasive therapeutic treatment that can be performed safely on seniors.  Nurses who are willing to work with medical colleagues, to define role boundaries and learn new skills can perform VRT safely and effectively.