Scientific Research Journal of India Volume: 3, Issue: 1, Year: 2014

41






PHYSIOTHERAPY INTERVENTION IN MANAGEMENT OF DIZZINESS

* Shahanawaz SD



ABSTRACT
Purpose: The aim of the study is to know the efficacy of exercise protocol in treating the patients with
dizziness. Design: Pilot study. Setting: RK Physiotherapy Department ,Rajkot, Gujarat, India; Madhuram
Hospital, Rajkot Methodology: Patients had evaluated by physician, Hall pike dix test, caloric test, postural
nyastagmography, Dizziness handicap inventory. Before the treatment patient had an outcome measured
with Dizziness handicap inventory, and Hall pike dix test. After that patient received design treatment
protocol for seven days. And after that all subject has to outcome measure with dizziness handicap
inventory, and Hall pike dix test. Results: Fifteen patients had at least one complication. 56 had myofascial
pain syndrome, 39 patients had post-operative joint stiffness, 23 had osteoporosis, 12 sustained path

KEYWORDS: Dizziness, DHI, Physiotherapy, Protocol

INTRODUCTION
The brain coordinates information from the
eye, the inner ear, and the bodys senses to
maintain balance. If any of these information
sources is disrupted, the brain may not be
able to compensate. Which results in
dizziness. Dizziness is one of the geriatric
problem.
1
According to studies, thirty
percent of older population suffer with
dizziness and this percentage will increases
at the age of 85 years.
2
For physicians
dizziness for older age group became
challenge as it is associated with multicausal.
The vestibular system is integral to balance
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42
control. The paired vestibular organs, housed
within the temporal bone, include 3
orthogonal semicircular canals (superior,
posterior, and horizontal) and 2 otolish
organs (utricle and saccule). Together, the
semicircular canals and otolish organs
provides continues input to the brain about
rotational and translationl head motion and
the heads orientation relative to the gravity
This information from the vestibular organs
and their central pathways allows for the
maintenance of gaze and postural stability
via the vestibular ocular reflex and vestibulo
spinal reflex, respectively. Dysfunction of
the peripheral vestibular structures cannot be
directly observed but can be inferred from
assessment of these reflexes.

Background of study:
Dizziness is one of the geriatric problems.
According to studies, thirty percent of older
population suffers with dizziness and this
percentage will increases at the age of 65
years. For physicians dizziness became
challenge as it is associated with multiple
causes. According to National Institutes of
Health 54% of people experience feeling
dizzy at least once during life time.

Aim of study:
The purpose of this study was to Know the
efficacy of exercise protocol in treating the
patients with dizziness.

Hypothesis:
There is significant difference in treating the
patients with designed exercise protocol and
were assessed on Dizziness Handicap
Inventory (DHI) ,
Null Hypothesis:
There is no significant difference in treating
the patients with designed exercise protocol
and were assessed on Dizziness Handicap
Inventory (DHI)

Material:
Couch, stop watch, Goniometre.

Study design:
Pilot study.

Study area:
RK Physiotherapy Department ,Rajkot,
Gujarat, India. Madhuram Hospital ,Rajkot

Population:
Subjects having dizziness.

Inclusion criteria:-
Age group is 18-65
Both Males and Females
Able to experiencing symptoms for longer
period of 3 months
Able to transfer from sitting to standing and
move independently
Able to tolerate the exercise.
1) Physician diagnosed dizziness
2) Hall pike dix test (+ve)
3) Dizziness handicap inventory
4) caloric test (+ve)
Scientific Research Journal of India Volume: 3, Issue: 1, Year: 2014
43
5) Nyastagmography.

METHODOLOGY
All subjects were explained about the study.
Informed consent forms had sign. Subjects
were examined thoroughly with assessment
format. Assessment format is given in the
annexure. Patients had evaluated by
physician, Hall pike dix test.
3
caloric test,
postural nyastagmography, Dizziness
handicap inventory
4
. Patient who had fulfill
any three inclusion criteria included in the
study. Before the treatment patient had an
outcome measured with Dizziness handicap
inventory, and Hall pike dix test. After that
patient received design treatment protocol
for seven days. And after that all subject has
to outcome measure with dizziness handicap
inventory, and Hall pike dix test.

RESULTS
The mean value of pre treatment is 48.00 and
post treatment is 38.14 .and statistically
assessed by using the Wilcoxon signed ranks
test the table value T=2.7831 and p value is
0.018 .hence it shows a significant
difference.

Findings: Patient with dizziness shown the
significant changes in pre and post DHI
outcome
measured.

Wilcoxon Signed Ranks Test

CONCLUSION
Patient with dizziness shows significant
improvement post exercise protocol .Hence
the null hypothesis is rejected and Alternate
hypothesis is accepted.

DISCUSSION
In this study it has observed that the pre
treatment and post treatment values for the
subject 1 is 60 and 36 which were assessed
by using DHI ,when compare to the other
subjects .It shows the Subject 1 has practiced
more times /day.

Funding:
Self Funding

Conflict of Interest:
My interest is to set a exercise protocol on
dizziness which is cost effective and helpful to
the Indian society.


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44
ANNEXURE - 1
PROTOCOL FOR DIZZINESS PATIENTS
No. TASK Repetition Time
1 straight head 3 times 30second
2 Turn your ahead 60 degrees towards right 3 times 30 second
3 Turn your ahead 60 degrees towards left 3 time 30second
4 Close your eyes and imagine blank back ground 1time 30second
5 Close Your Eyes Busy back ground (Checker
Board)
1 time 30 second
6 Single Leg Stance -Right Side 1 time 30 second
7 Single Leg Stance - Left Side 1 time 30second
8 Heel and Toe raises 1 time 30second
9 Perturbation training 1 time 30secomd
10 Hip marching 1 time 30 second
11 Lift up your right knee as high as comfortable.
(Lower your leg,
Alternate lifting your knees)
10,lifts(each
leg)
30 second
12 Sit and straight your right knee 6 times 30second

Scientific Research Journal of India Volume: 3, Issue: 1, Year: 2014
45

DIZZINESS HANDICAP QUESTIONNAIRE
1). Does looking up increase your problem?
(- ?)
o Yes ()
o Sometimes
( )
o No ()
2). Because of your problem, do you feel frustrated?
( l- l?)
o Yes ()
o Sometimes
( )
o No ()
3). Because of your problem, do you restrict your travel for business or recreation?
(l- , , ?)

o Yes ()
o Sometimes
( )
o No ()
4) Does walking down the aisle of a supermarket increase your problems?
( l- .
o Yes ()
o Sometimes
( )
o No ()
5). Because of your problem, do you have difficulty getting into or out of bed?
(l- ?)
o Yes ()
o Sometimes
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( )
o No ()
6). Does your problem significantly restrict your participation in social activities
such asgoing out to dinner, the movies, dancing or to parties?
( | ,= ,5= ,= r
?)
o Yes ()
o Sometimes
( )
o No ()
7). Because of your problem, do you have difficulty reading?
( .)
o Yes ()
o Sometimes
( )
o No ()
8). Does performing more ambitious activities such as sports or dancing or
household choressuch as sweeping or putting dishes away increase your problem?
( ,= r , , ?)
o Yes ()
o Sometimes
( )
o No ()
9). Because of your problem, are your afraid to leave your home without having
someoneaccompany you?
(l | ?)
o Yes ()
o Sometimes
( )
o No ()
10). Because of your problem have you been embarrassed in front of others?
o Yes ()
Scientific Research Journal of India Volume: 3, Issue: 1, Year: 2014
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( l ?)
o Sometimes
( )
o No ()
11). Do quick movements of your head increase your problem?
(|= l ?)
o Yes ()
o Sometimes
( )
o No ()
12). Because of your problem, do you avoid heights?
(l?)
o Yes ()
o Sometimes
( )
o No ()
13)Does turning over in bed increase your problem?
( l ?)
o Yes ()
o Sometimes
( )
o No ()
14). Because of your problem, is it difficult for you to do strenuous homework or
yard
work?
(l , ?)
o Yes ()
o Sometimes
( )
o No ()
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15). Because of your problem, are you afraid people may think you are
intoxicated?
(l l?)
o Yes ()
o Sometimes
( )
o No ()
16). Because of your problem, is it difficult for you to go for a walk by yourself?
( ?)

o Yes ()
o Sometimes
( )
o No ()
17). Does walking down a sidewalk increase your problem?
( | ?)

o Yes ()
o Sometimes
( )
o No ()
18). Because of your problem, is it difficult for you to concentrate?
(l|\ - ?)
o Yes ()
o Sometimes
( )
o No ()
19) Because of your problem, is it difficult for you to walk around the house in the
dark?
(l ~ ?
o Yes ()
o Sometimes
( )
Scientific Research Journal of India Volume: 3, Issue: 1, Year: 2014
49
o No ()
20). Because of your problem, are you afraid to stay at home alone?
(l | ?)
o Yes ()
o Sometimes
( )
o No ()
21). Because of your problem, do you feel handicapped?
( , ?)
o Yes ()
o
Sometimes
)
o No ()
22). Has your problem placed stress on your relationship with members of your
family orfriends?
(l | ? ~ - ?)
o Yes ()
o Sometimes
( )
o No ()
23). Because of your problem, are you depressed?
(l?)
o Yes ()
o Sometimes
( )
o No ()
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24). Does your problem interfere with your job or household responsibilities?
( lll, l - ?)
o Yes ()
o Sometimes
( )
o No ()
25). Does bending over increase your problem?
( l ?)
o Yes ()
o Sometimes
( )
o No ()

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CORRESPONDENCE
* M.P.T. (Neurology), Ph.D, Assistant Professor, RK University, Rajkot