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Objective: Persistent postural-perceptual dizziness (PPPD) is a chronic functional disorder where treatment should be tailored to the individual needs. While customized therapy with a physiotherapist has evidence-based benefits, it comes at a cost and the facility may not be available to some, especially in rural areas. An alternative option is a home-based treatment called MEND (Move, Eye, Neck stretching, and Deep breathing exercises) therapy. This study aimed to assess the efficacy of MEND therapy in PPPD compared to the hospital-based vestibular rehabilitation therapy (VRT). Methods: 59 PPPD patients completed the randomized-controlled study comparing MEND therapy (intervention) and hospital-based VRT (control). EuroQOL Group quality of life questionnaire (EQ-5D), Dizziness Handicap Inventory (DHI), and 21-question Depression, Anxiety, and Stress Scale (DASS-21) were monitored at baseline, 4 weeks, and 12 weeks. Results: At the end of the study, 100% patients on MEND therapy found it beneficial compared to 79.3% in the control group. The MEND therapy provided significant improvements in the physical (P = .007), functional (P = .0006), emotional (P = .0003), and total DHI (P = .0003) with a medium to large effect size. The control group showed significant improvement only in the functional elements of DHI (P = .04), and total DHI (P = .04) with a small to medium effect size. Conclusion: The MEND therapy is an effective option that incorporates all elements of therapy for PPPD. [ABSTRACT FROM AUTHOR]

Introduction: Persistent postural-perceptual dizziness (PPPD) is a chronic functional vestibular disorder where there is persistent dizziness or unsteadiness occurring on most days for more than 3 months duration. Treatment recommendations for PPPD include vestibular rehabilitation therapy (VRT) with or without medications and/or cognitive behavioral therapy. Objectives: This paper is a pilot study designed to compare the effects of Bal Ex as a home-based VRT on the quality of life (EQ-5D), dizziness handicap (DHI) and mental health (DASS-21) against hospital-based VRT. Design: This was an assessor-blinded, randomized controlled pilot study where PPPD patients were randomly selected to undergo Bal Ex, the home-based VRT (intervention group) or hospital-based (control group) VRT. The participants were reviewed at 4 weeks and 12 weeks after the start of therapy to assess the primary endpoints using the subjective improvement in symptoms as reported by patients, changes in DHI scores, DASS-21 scores and EQ5D VAS scores. Results: Thirty PPPD patients successfully completed the study with 15 in each study group. Within 4 weeks, there were significant improvements in the total DHI scores as well as anxiety levels. By the end of 12 weeks, there were significant improvements in the DHI, DASS-21 and EQ5D. The degree of improvement between Bal Ex and the control was comparable. Conclusion: VRT is an effective modality in significantly improving quality of life, dizziness handicap, depression, and anxiety levels within 3 months in PPPD. Preliminary results show Bal Ex is as effective as hospital-based VRT and should be considered as a treatment option for PPPD. [ABSTRACT FROM AUTHOR]

Objective: To investigate the association between GMlFCS level, hours of standing, and hip subluxation/dislocation. Method: A cross sectional study was done at the tertiary centre in Malaysia. Hip migration percentage (MP) and acetabular index (Al) were measured from plain radiographs of the pelvis (AP view). Results: A total of 36 bilateral spastic CP patients who were compliant to physiotherapy sessions, seating management, and standing were included in this study. The subjects were between 6 and 12 years old with GMFCS III-V. All subjects stood a minimum of 1 hour to a maximum of ≥3 hours. All patients practiced standing from a minimum of 4 years to a maximum of 10 years. A statistically significant association was found between the GMFCS level and the severity of MP (p = 0.01) and the Al (p = 0.01). MP was maintained at 10% and 20-30% in CP children who stood 3 or more hours and 2 hours, respectively. However, the results were not statistically significant (p = 0.24). The Al of CP children was 20 degrees in all groups which demonstrated that even an hour of standing in children who were compliant to physiotherapy and postural care helps to reduce the Al. However, the results were not significant (p = 0.43). Implications/Impact on Rehabilitation: The GMFCS level impacts the MP and Al. A standing duration of 3 hours or more in a day in CP children for minimum of 4 years showed promising effects on MP and Al; however, a future large scale study is recommended. [ABSTRACT FROM AUTHOR]