2023-09-28 14:46:10 +00:00
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abstract: 'BackgroundTraumatic brain injury (TBI) is the leading cause of long-term
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disability in working age adults. Recent studies show that most acute
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TBI patients demonstrate vestibular features of dizziness and imbalance,
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often from combined peripheral and central vestibular dysfunction.
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Effective treatment for vestibular impairments post-TBI is important
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given its significant adverse impact upon quality of life and employment
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prospects. The most frequent peripheral vestibular disorder in acute TBI
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is benign paroxysmal positional vertigo (BPPV), affecting approximately
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half of acute cases. Although there is effective treatment for
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idiopathic BPPV, there are no high-quality clinical data for post-TBI
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BPPV regarding its prevalence, natural history, which treatment is most
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effective and when is the best time to treat. In particular,
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observational studies suggest post-TBI BPPV may be recurrent, indicating
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that hyperacute treatment of BPPV may be futile. Given the potential
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hurdles and the lack of accurate post-TBI BPPV data, the current study
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was designed to provide information regarding the feasibility and
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optimal design of future large-scale prospective treatment studies that
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would compare different interventions and their timing for post-TBI
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BPPV.MethodA multi-centre randomised mixed methods feasibility study
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design was employed. We aim to recruit approximately 75 acute TBI
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patients across a range of clinical severities, from three major trauma
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centres in London. Patients will be randomised to one of three treatment
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arms: (1) therapist-led manoeuvres, (2) patient-led exercises and (3)
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advice. Participants will be re-assessed by blinded outcome assessors at
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4 and 12weeks. Acceptability of the intervention will be obtained by
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patient interviews at the end of their treatment and therapist
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interviews at the end of the study. Primary outcomes relate to
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feasibility parameters including recruitment and retention rates,
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adverse events and intervention fidelity. We will also aim to provide a
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more accurate estimate of the prevalence of BPPV in TBI cases on the
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trauma ward.DiscussionThe multi-centre nature of our feasibility study
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will inform the design of a future prospective treatment trial of BPPV
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in acute TBI. Important parameters we will obtain from this study, key
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for designing a future prospective treatment study, include estimating
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the prevalence of BPPV in TBI patients admitted to UK major trauma
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wards, and elucidating both patient and care-provider barriers in
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delivering BPPV treatment.Trial registrationISRCTN, ISRCTN91943864.
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Registered on 10 February 2020.'
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affiliation: 'Smith, RM; Seemungal, BM (Corresponding Author), Imperial Coll London,
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Dept Brain Sci, Neurootol Unit, Brain \& Vestibular Grp BAVG, London, England.
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Smith, Rebecca M.; Tahtis, Vassilios; Seemungal, Barry M., Imperial Coll London,
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Dept Brain Sci, Neurootol Unit, Brain \& Vestibular Grp BAVG, London, England.
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Marroney, Natalie; Beattie, Jenna; Seemungal, Barry M., Imperial Coll Healthcare
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NHS Trust, London, England.
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Newdick, Abby, St Georges Univ Hosp NHS Fdn Trust, London, England.
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Tahtis, Vassilios, Kings Coll Hosp NHS Fdn Trust, London, England.
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Burgess, Caroline, Kings Coll London, Populat Hlth Sci, London, England.
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Marsden, Jonathan, Univ Plymouth, Sch Hlth Profess, Plymouth, Devon, England.'
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article-number: '130'
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author: Smith, Rebecca M. and Marroney, Natalie and Beattie, Jenna and Newdick, Abby
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and Tahtis, Vassilios and Burgess, Caroline and Marsden, Jonathan and Seemungal,
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Barry M.
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author-email: 'rmsmi15@ic.ac.uk
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bmseem@ic.ac.uk'
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author_list:
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- family: Smith
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given: Rebecca M.
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- family: Marroney
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given: Natalie
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- family: Beattie
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given: Jenna
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- family: Newdick
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given: Abby
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- family: Tahtis
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given: Vassilios
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- family: Burgess
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given: Caroline
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- family: Marsden
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given: Jonathan
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- family: Seemungal
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given: Barry M.
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da: '2023-09-28'
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doi: 10.1186/s40814-020-00669-z
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eissn: 2055-5784
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files: []
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journal: PILOT AND FEASIBILITY STUDIES
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keywords: 'Feasibility study; Traumatic brain injury; Benign paroxysmal positional
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vertigo; Rehabilitation'
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keywords-plus: 'QUALITY-OF-LIFE; CLINICAL-TRIAL; RISK-FACTORS; DIZZINESS; FALLS; SCALE;
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DISABILITY; COMMUNITY; VALIDITY; OUTCOMES'
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language: English
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number: '1'
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number-of-cited-references: '58'
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orcid-numbers: 'Smith, Rebecca/0000-0003-2628-9861
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Seemungal, Barry/0000-0002-6578-0904'
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papis_id: 967a445ccd2525f24d245b7777c146ba
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ref: Smith2020mixedmethods
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times-cited: '1'
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title: A mixed methods randomised feasibility trial investigating the management of
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benign paroxysmal positional vertigo in acute traumatic brain injury
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000729238200130
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usage-count-last-180-days: '0'
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usage-count-since-2013: '0'
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volume: '6'
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web-of-science-categories: Medicine, Research \& Experimental
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year: '2020'
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