title: Effects of Nonpharmacological Interventions for Dizziness in Older People: Systematic Review.
abstract: BACKGROUND
  Nonpharmacological interventions have been shown to have some effectiveness in adults with dizziness; however, the effectiveness of these interventions in older people is unknown.
  
  
  OBJECTIVE
  The aim of this study was to determine the effects of conservative nonpharmacological interventions for dizziness in older people.
  
  
  METHODS
  The Cochrane Central Register of Controlled Trials, PubMed, EMBASE, SCOPUS, CINAHL, AMED, Index to Chiropractic Literature, PsycINFO, and MANTIS were searched from inception to May 2014.
  
  
  METHODS
  Two investigators independently screened controlled trials with participants who were more than 60 years old and experienced dizziness. Studies of participants with dizziness from a specific diagnosis, such as Ménière disease and benign paroxysmal positional vertigo, were excluded. Outcome measures from the selected studies included self-reported dizziness and postural balance.
  
  
  METHODS
  Two investigators independently extracted data on participants, interventions, comparison group, outcome measures, and results. The risk of bias of the included studies was assessed with Cochrane guidelines.
  
  
  RESULTS
  Seven articles consisting of 7 controlled trials were included. All studies involved some form of exercise, including vestibular rehabilitation exercises, postural balance exercises, and tai chi exercise, as the main intervention. The studies had a high risk of bias because of the lack of adequate randomization and allocation concealment, the lack of reporting on cointerventions, the lack of reporting on reasons for dropouts, and the lack of reporting on participant adherence.
  
  
  CONCLUSIONS
  Heterogeneity among the included studies in interventions and outcome measures prohibited a meta-analysis. Only 2 studies reported a significant difference between the intervention group and the comparison group for self-reported dizziness.
  
  
  CONCLUSIONS
  There is insufficient evidence to determine the effectiveness of nonpharmacological treatments for dizziness in older people. Current evidence is hampered by a high risk of bias, and well-designed trials with adequate masking, randomization, and adherence are needed.
authors.affiliation: J.C. Kendall, BAppSc(ComplMed), MClinChiro, Discipline of Chiropractic, School of Health Sciences, RMIT University, Melbourne, Victoria, Australia.
authors.forename: Julie C
authors.initials: JC
authors.lastname: Kendall
authors.affiliation: J. Hartvigsen, PhD, DC, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark, and Nordic Institute of Chiropractic and Clinical Biomechanics, University of Southern Denmark.
authors.forename: Jan
authors.initials: J
authors.lastname: Hartvigsen
authors.affiliation: M.F. Azari, PhD, BSc(Hons), BAppSc(Chiro), Discipline of Chiropractic, School of Health Sciences, RMIT University, and Health Innovations Research Institute, RMIT University.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Azari
authors.affiliation: S.D. French, PhD, MPH, BAppSc(Chiro), School of Rehabilitation Therapy, Queens University, Louise D. Acton Building, 31 George St, Kingston, Ontario, Canada. simon.french@queensu.ca.
authors.forename: Simon D
authors.initials: SD
authors.lastname: French
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000072700:Conservative Treatment; D004244:Dizziness / Q000628:therapy*; D005081:Exercise Therapy / Q000379:methods; D006801:Humans; D008875:Middle Aged; D004856:Postural Balance; D057566:Self Report; D016896:Treatment Outcome