title: STEADFAST: Psychotherapeutic Intervention Improves Postural Strategy of Somatoform Vertigo and Dizziness.
abstract: Patients with somatoform vertigo and dizziness (SVD) disorders often report instability of stance or gait and fear of falling. Posturographic measurements indeed indicated a pathological postural strategy. Our goal was to evaluate the effectiveness of a psychotherapeutic and psychoeducational short-term intervention (PTI) using static posturography and psychometric examination. Seventeen SVD patients took part in the study. The effects of PTI on SVD were evaluated with quantitative static posturography. As primary endpoint a quotient characterizing the relation between horizontal and vertical sway was calculated (Q H/V ), reflecting the individual postural strategy. Results of static posturography were compared to those of age- and gender-matched healthy volunteers (n = 28); baseline measurements were compared to results after PTI. The secondary endpoint was the participation-limiting consequences of SVD as measured by the Vertigo Handicap Questionnaire (VHQ). Compared to the healthy volunteers, the patients with SVD showed a postural strategy characterized by stiffening-up that resulted in a significantly reduced body sway quotient before PTI (patients: Q H/V = 0.31 versus controls: Q H/V = 0.38; p = 0.022). After PTI the postural behavior normalized, and psychological distress was reduced. PTI therefore appears to modify pathological balance behaviour. The postural strategy of patients with SVD possibly results from anxious anticipatory cocontraction of the antigravity muscles.
authors: Department of Neurology, Vestibular Research Unit, Philipps-University, Baldingerstrasse, 35043 Marburg, Germany; Department of Neurology, University Medical Center, Johannes Gutenberg University, Langenbeckstrasse 1, 55101 Mainz, Germany.
authors: Christoph
authors: C
authors: Best
authors: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University, Langenbeckstrasse 1, 55101 Mainz, Germany.
authors: Regine
authors: R
authors: Tschan
authors: Department of Neurology, University Medical Center, Johannes Gutenberg University, Langenbeckstrasse 1, 55101 Mainz, Germany.
authors: Nikola
authors: N
authors: Stieber
authors: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Johannes Gutenberg University, Langenbeckstrasse 1, 55101 Mainz, Germany.
authors: Manfred E
authors: ME
authors: Beutel
authors: Department of Psychosomatic Medicine, Bürgerhospital, Tunzhofer Strasse 14-16, 70191 Stuttgart, Germany.
authors: Annegret
authors: A
authors: Eckhardt-Henn
authors: Department of Neurology, Ludwig-Maximilians-University, Marchioninistrasse 15, 81377 Munich, Germany; German Center for Vertigo and Balance Disorders (IFB) (DSGZ), Ludwig-Maximilians-University, Marchioninistrasse 15, 81377 Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), 81377 Munich, Germany.
authors: Marianne
authors: M
authors: Dieterich
mesh_terms: D000328:Adult; D000368:Aged; D004244:Dizziness / Q000175:diagnosis / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D004856:Postural Balance / Q000502:physiology*; D011613:Psychotherapy / Q000379:methods*; D016896:Treatment Outcome; D014717:Vertigo / Q000175:diagnosis / Q000534:rehabilitation*