title: Internet-based vestibular rehabilitation for adults aged 50 years and over: a protocol for a randomised controlled trial.
abstract: BACKGROUND
  Dizziness is highly prevalent in older adults and can lead to falls, fear of falling, loss of confidence, anxiety and depression. Vestibular rehabilitation (VR) exercises are effective in reducing dizziness due to vestibular dysfunction, but access to trained therapists is limited. Providing dizzy patients with booklets teaching them how to carry out VR exercises has been shown to be a cost-effective way of managing dizziness in primary care. Internet-based intervention delivery has many advantages over paper-based methods, including the provision of video instructions, automated tailoring and symptom-related feedback. This trial will examine whether an internet-based VR intervention is (1) effective in reducing dizziness and (2) a cost-effective primary care treatment option.
  
  
  METHODS
  This will be a single blind, randomised controlled trial carried out in UK primary care. A stand-alone internet-based VR intervention will be compared with routine care in 262 dizzy patients aged 50 years and over. Measures will be taken at baseline, 3 and 6 months. Our primary outcome measure will be the effectiveness of the intervention in reducing dizziness symptoms compared with routine care at 6 months. Cost-effectiveness will be examined along with the effect of the intervention on dizziness-related disability and symptoms of depression and anxiety. Psychological process variables including expectancy, self-efficacy and acceptance will be explored in relation to adherence and symptom reduction.
  This trial has undergone ethical scrutiny and been approved by an NHS Research Ethics Committee, Southampton A REC Reference: 13/SC/0119. The findings of this trial will be disseminated to the scientific community through presentations at national and international conferences, and by publishing in peer review journals. Findings will be disseminated to the public through targeted press releases. This trial will provide valuable information on the role of internet interventions in facilitating self-management in older adults.
  86912968.
authors: Primary Care and Population Sciences Division, University of Southampton, Southampton, Hampshire, UK.
authors: Adam W A
authors: AW
authors: Geraghty
authors: Academic Unit of Psychology, University of Southampton, Southampton, UK.
authors: Sarah
authors: S
authors: Kirby
authors: Academic Unit of Psychology, University of Southampton, Southampton, UK.
authors: Rosie
authors: R
authors: Essery
authors: Primary Care and Population Sciences Division, University of Southampton, Southampton, Hampshire, UK.
authors: Paul
authors: P
authors: Little
authors: Neuro-otology Unit, Imperial College London, London, UK.
authors: Adolfo
authors: A
authors: Bronstein
authors: Norwich Medical School, University of East Anglia, Norwich, UK.
authors: David
authors: D
authors: Turner
authors: Primary Care and Population Sciences Division, University of Southampton, Southampton, Hampshire, UK.
authors: Beth
authors: B
authors: Stuart
authors: Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
authors: Gerhard
authors: G
authors: Andersson
authors: Department of Psychology, Stockholm University, Stockholm, Sweden.
authors: Per
authors: P
authors: Carlbring
authors: Academic Unit of Psychology, University of Southampton, Southampton, UK.
authors: Lucy
authors: L
authors: Yardley
mesh_terms: D000368:Aged; D003362:Cost-Benefit Analysis; D004244:Dizziness / Q000191:economics / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000191:economics; D017048:Health Care Costs; D006801:Humans; D020407:Internet; D008875:Middle Aged; D010353:Patient Education as Topic; D012107:Research Design; D016037:Single-Blind Method
keywords: Otolaryngology