Physical findings in patients with dizziness undergoing a group exercise programme

Background and purpose: Although there have been studies on patients with persistent dizziness, physical findings have not been formerly focused. The aim of this study was to investigate localization and extent of physical dysfunctions in patients with long-lasting dizziness. To investigate physical change, we re-examined patients who had completed a vestibular rehabilitation (VR) programme.

Methods: A longitudinal design was used. Patients with peripheral vestibular dysfunction were examined with the Global Physiotherapy Examination (GPE-52) and the Vertigo Symptom Scale-short form (VSS-SF). The GPE-52 consists of 52 standardized items within posture, respiration, movement, muscle and skin. Initially, 32 patients were included; 20 completed the VR programme. The programme, based upon traditional VR exercises combined with a body awareness approach, was administered as group sessions taking place once weekly for nine weeks.

Results: The majority of patients had a flexed head posture, and their respiration was restricted. Reduced flexibility, reduced ability to relax, measured with passive movements, and restricted range of motion (ROM) were found in about half of the patients in the neck, jaw, shoulder girdle and thorax. On palpation of muscles, 70-94% of the patients had reduced stretch in the abdominals/diaphragm, upper trapezius, sternocleidomastoid and medial gastrocnemius muscles. After the VR programme, significant improvements (p < 0.05) were shown in the following areas: respiration, flexibility and passive movement tests in the shoulder and cervical region, and ROM in the neck and jaw. Significant improvement (p < 0.05) was also reported in the balance subscale of the VSS-SF.

Conclusions: This study documents that postural changes, restricted respiration, lack of flexibility, ability to relax and reduced muscular stretch seem quite common in patients with dizziness. A modified VR comprising body awareness significantly improved respiration and movements in the upper body as well as self-reported balance.