Influência do tratamento com fármacos antivertiginosos sobre o equilíbrio postural e qualidade de vida de indivíduos com queixas de tontura / Influence of antivertigo drugs on postural balance and health-related quality of life of individuals with dizziness complaints

Resumo:OBJETIVO:avaliar a influência do tratamento com fármacos antivertiginosos sobre a qualidade de vida e o equilíbrio postural de adultos e idosos com queixas de tontura.MÉTODOS:estudo transversal, com amostra de 51 indivíduos portadores de queixas de tontura, divididos em dois grupos, de acordo com o uso (grupo medicado, n=25) ou não (grupo não medicado, n=26) de fármacos antivertiginosos. Foram coletadas informações sobre: caracterização dos sintomas (ficha elaborada pelos pesquisadores), autopercepção de qualidade de vida (Dizziness Handicap Inventory),intensidade de tontura (escala visual analógica de tontura) e equilíbrio postural (plataforma de força).RESULTADOS:verificou-se intensidade moderada de tontura (Média: 4,6 ± 2,8) e impacto negativo das vestibulopatias sobre a qualidade de vida (Média: 47,3 ± 22,4) na amostra total. Quando comparados os dois grupos, não houve diferença estatisticamente significante na intensidade da tontura (p=0,74) ou qualidade de vida (p=0,79), e também, nos parâmetros da estabilometria, em quatro tarefas (teste t independente, p>0,05). Contudo, após a inclusão do tempo de utilização de fármacos antivertiginosos como uma covariável do estudo, foi verificado pior desempenho nas diferentes tarefas da estabilometria no grupo medicado (ANCOVA, p<0,05).CONCLUSÃO:o uso de fármacos antivertiginosos não melhora a qualidade de vida de indivíduos com queixas de tontura e o equilíbrio postural esteve alterado no grupo medicado.

Abstract:PURPOSE:this study aimed to identify the influence of anti-vertigo drugs on the health-related quality of life and balance in adults and elder individuals with dizziness complaints.METHODS:51 individuals with dizziness complaints were enrolled at this cross-sectional study. The sample was divided into two groups according to chronic use of antivertigo drugs (medicated group, n=25 or non-medicated group, n=26). Information regarding vertigo-related symptoms, health-related quality of life (through Dizziness Handicap Inventory), dizziness intensity (measured by dizziness visual analogue scale) and postural balance (using a force platform) were assessed in all subjects recruited.RESULTS:a moderate intensity of dizziness was observed (Mean: 4.6 ± 2.8) as well as negative impact on health-related quality of life (Mean: 47.3 ± 22.4) at this sample. When medicated and non-medicated groups were compared, no statistically differences were observed concerning dizziness intensity (p=0.74) and health-related quality of life (p=0.79). Similar results were observed regarding balance parameters (Unpaired t test, p > 0.05). However, after including the time duration of antivertigo drugs' use as a covariable of this study, a worse balance in different balance tasks was observed at the medicated group (ANCOVA, p<0.05).CONCLUSION:no benefits concerning the symptoms or health-related quality of life were observed after chronic treatment with anti-vertigo drugs. On the other hand, worse balance control was observed in medicated group.

Effectiveness of a vestibular rehabilitation protocol to improve the health-related quality of life and postural balance in patients with vertigo

Introduction Dizziness can be characterized as a balance disorder that causes discomfort, leading to several functional limitations. Currently, vestibular rehabilitation has been highlighted as a possible treatment. Objective Analyze the effects of completing a vestibular rehabilitation treatment protocol on quality of life and postural balance in patients with vestibular complaints, as well as to compare these effects between the patients taking or not taking antivertigo drugs. Methods A nonrandomized controlled trial was performed with 20 patients previously diagnosed with vestibular diseases. Information regarding vertigo symptoms, quality of life as assessed through the Dizziness Handicap Inventory, visual analog scale of dizziness, and stabilometry using force platform was collected. Patients were treated for 12 weeks by a customprotocol. The sample was divided into two groups according to the use (medicated group, n = 9) or not (control group, n = 11) of antivertigo drugs. Results There was improvement in quality of life (p < 0.001) and intensity of dizziness (p = 0.003) with the intervention. An improvement of postural balance was observed through functional tests. However, no statistically significant difference was noted in stabilometry. When both groups were compared, no statistically significant differences between the variations of the variables analyzed were found in the re-evaluation session. Conclusion Quality of life and postural balance are improved with intervention. However, this improvement is not associated with pharmacologic treatment.

Effectiveness of a Vestibular Rehabilitation Protocol to Improve the Health-Related Quality of Life and Postural Balance in Patients with Vertigo.

Introduction Dizziness can be characterized as a balance disorder that causes discomfort, leading to several functional limitations. Currently, vestibular rehabilitation has been highlighted as a possible treatment. Objective Analyze the effects of completing a vestibular rehabilitation treatment protocol on quality of life and postural balance in patients with vestibular complaints, as well as to compare these effects between the patients taking or not taking antivertigo drugs. Methods A nonrandomized controlled trial was performed with 20 patients previously diagnosed with vestibular diseases. Information regarding vertigo symptoms, quality of life as assessed through the Dizziness Handicap Inventory, visual analog scale of dizziness, and stabilometry using force platform was collected. Patients were treated for 12 weeks by a custom protocol. The sample was divided into two groups according to the use (medicated group, n = 9) or not (control group, n = 11) of antivertigo drugs. Results There was improvement in quality of life (p < 0.001) and intensity of dizziness (p = 0.003) with the intervention. An improvement of postural balance was observed through functional tests. However, no statistically significant difference was noted in stabilometry. When both groups were compared, no statistically significant differences between the variations of the variables analyzed were found in the re-evaluation session. Conclusion Quality of life and postural balance are improved with intervention. However, this improvement is not associated with pharmacologic treatment.

Análise da independência funcional, qualidade de vida, força muscular respiratória e mobilidade torácica em pacientes hemiparéticos submetidos a um programa de reabilitação: estudos de caso / Analysis of functional independence, quality of life, respiratory muscle strength and thoracic mobility in hemiparetic patients submitted to a rehabilitation program: case studies

O acidente vascular encefálico (AVE) tem grande impacto sobre a saúde da população. A hemiparesia é um dos sinais clínicos mais óbvios da doença e os indivíduos acometidos apresentam tendência em manter-se em uma posição de assimetria postural, com função respiratória prejudicada. O objetivo deste estudo foi avaliar os efeitos de um Programa de Reabilitação na independência funcional, qualidade de vida, força muscular respiratória e mobilidade torácica em pacientes hemiparéticos, após AVE. Participaram do estudo quatro indivíduos hemiparéticos, com idades entre 53 e 78 anos. Para a mensuração das variáveis, foram utilizadas as Escalas PASS e IBm, o questionário SF-36, e testes específicos de manovacuometria e cirtometria. Após a avaliação inicial, foi aplicado um Programa de Reabilitação do Tronco, com duração de 50 minutos. Ao término de 20 sessões, todos os indivíduos foram reavaliados, utilizando-se os mesmos instrumentos. Não foram encontrados resultados estatisticamente significantes (p > 0,05), porém se observou melhora nos índices de independência funcional, qualidade de vida, força muscular respiratória e mobilidade torácica. Sugere-se que a aplicação de exercícios, direcionados ao restabelecimento da função do tronco, em um programa de reabilitação para o indivíduo hemiparético é satisfatória. Faz-se necessária a realização de novos estudos com uma amostra maior.

Stroke has a major impact on public health. Hemiplegia is one of the most obvious clinical signs of the disease, and individuals tend to keep themselves in an asymmetric postural position, with impaired respiratory function. The purpose of this study was to evaluate the effects of a rehabilitation project on functional independence, quality of life, respiratory muscle strength and mobility chest in hemiplegic patients. The study was based on four hemiplegic subjects, aged between 53 and 78 years. Outcomes were measured using PASS and IBm Scales, a SF-36 questionnaire, and specific manometry and mobility chest tests. After the initial assessment, the Trunk Rehabilitation Program was used for 50 minutes. At the end of 20 sessions, all subjects were reassessed, using the same instruments. There were no statistically significant results (p > 0,05), however, an improvement was observed in levels of functional independence, quality of life, respiratory muscle strength and mobility chest. It is suggested that the implementation of exercises, aimed at restoring the function of the trunk, in a rehabilitation program for the hemiplegic subject, is satisfactory. Further studies with a larger sample is recommended.