Introduction
Methods
Survey instrument
Data analysis
Results
Demographics
Median | Min–Max | |
---|---|---|
Age (years) | 41 | 23–68 |
Gender | n | % |
Male | 125 | (26.5) |
Female | 345 | (73.3) |
Not given | 1 | (0.21) |
Highest qualification | n | % |
BSc | 132 | 28.0 |
Diploma | 95 | 20.2 |
MSc | 127 | 27.0 |
PhD | 15 | 3.2 |
DPT | 8 | 1.7 |
Other (not specified) | 94 | 20.0 |
Profession | n | % |
Physiotherapist | 421 | 89.4 |
Occupational therapist | 34 | 7.2 |
Orthoptist | 5 | 1.1 |
Audiological scientist | 1 | 0.2 |
Chiropractor | 3 | 0.6 |
Medical doctor | 3 | 0.6 |
Therapist | 2 | 0.4 |
Naturopath | 1 | 0.2 |
RGN | 1 | 0.2 |
Job environmenta | n | % |
Private practice | 252 | 53.5 |
Hospital in-patient | 140 | 29.7 |
Hospital out-patient | 134 | 28.5 |
Specialist VR service | 101 | 21.4 |
Rehabilitation centre | 59 | 12.5 |
Academic institution (research) | 40 | 8.5 |
Academic institution (teaching) | 40 | 8.5 |
Residential care | 19 | 4.0 |
Community/primary care | 12 | 2.5 |
Other | 5 | 1.1 |
No answer | 2 | 0.4 |
All (n = 471) | Novice (n = 171) | Competent (n = 239) | Expert (n = 61) | |||||
---|---|---|---|---|---|---|---|---|
Median (IQR) | Min–max | Median (IQR) | Min–max | Median (IQR) | Min–max | Median (IQR) | Min–max | |
Years post registration | 16 (16) | < 1–47 | 13 (15) | < 1–40 | 17.5 (15.5) | 1–47 | 17.5 (12) | 4–42 |
Years in VR | 4 (4) | < 1–35 | 1 (1) | < 1–30 | 5 (7) | < 1–35 | 14 (11) | 2–32 |
% of working time in VR | 15 (25) | 0.01–100 | 10 (10) | < 1–100 | 20 (30) | 1–100 | 70 (58) | 5–100 |
Number of VR patients per week | 4 (8) | 0.05–150 | 2 (2) | 0.05–30 | 5 (8) | 1–150 | 20 (38) | 1–150 |
Work environments and specialities
VR practice
Equipment | No. responding | Always | Never | No access | Sometimes | Would use if I had access |
---|---|---|---|---|---|---|
Infrared goggles with recording | 408 | 10.0 | 19.6 | 64.7 | 4.9 | 16.2 |
Infrared goggles, no recording | 398 | 12.1 | 45.0 | 37.9 | 7.0 | 8.5 |
Balance: Equitest | 394 | 0.8 | 21.3 | 74.4 | 4.1 | 12.9 |
Balance: Balance master | 396 | 1.0 | 21.2 | 74.7 | 5.6 | 12.1 |
Static force plate | 405 | 8.9 | 18.5 | 62.0 | 11.9 | 9.1 |
Dynamic force plate | 396 | 5.8 | 19.9 | 66.2 | 8.6 | 12.4 |
Frenzel lenses | 415 | 9.9 | 24.8 | 44.1 | 20.0 | 14.2 |
Subjective visual vertical (bucket test) | 398 | 12.3 | 23.1 | 41.2 | 25.4 | 6.5 |
ETDRS | 272 | 7.4 | 37.5 | 48.2 | 8.5 | 5.1 |
Snellen | 416 | 18.5 | 21.4 | 37.0 | 26.2 | 3.6 |
Computerised gaze stabilisation test | 279 | 5.1 | 29.7 | 56.5 | 6.5 | 18.8 |
Video head impulse test | 409 | 10.5 | 20.5 | 55.3 | 19.3 | 8.8 |
Treadmill DVA | 391 | 2.3 | 27.9 | 60.1 | 10.2 | 11.5 |
Optokinetic drum | 405 | 9.1 | 24.7 | 56.3 | 13.3 | 7.2 |
Computerized optokinetic test | 275 | 5.5 | 29.8 | 57.1 | 7.3 | 14.9 |
High-density foam | 435 | 45.3 | 9.0 | 17.0 | 31.0 | 0.7 |
Computerised gait analysis | 393 | 5.6 | 24.7 | 58.8 | 12.0 | 11.2 |
Known and marked out gait test | 431 | 45.2 | 10.4 | 13.0 | 33.4 | 1.6 |
Known and marked out Fukuda test | 441 | 37.6 | 18.1 | 13.4 | 30.4 | 2.3 |
Rotatory chair | 416 | 15.9 | 23.6 | 35.6 | 25.2 | 7.2 |
Conditions treated
Condition | Know% | Treat% | Do not know% | Do not treat% |
---|---|---|---|---|
BPPV | 98.9 | 87.5 | 1.3 | 3.0 |
Vestibular neuritis | 93.3 | 66.2 | 4.4 | 14.0 |
Cervicogenic dizziness | 93.3 | 63.0 | 4.7 | 13.6 |
Unilateral vestibular hypofunction | 92.8 | 75.6 | 5.1 | 9.8 |
Multiple sclerosis | 90.0 | 61.9 | 6.8 | 20.1 |
Traumatic brain injury | 89.8 | 59.2 | 5.6 | 21.8 |
Vestibular migraine | 89.2 | 51.5 | 7.9 | 21.7 |
Functional dizziness | 88.9 | 61.7 | 9.0 | 30.6 |
Presbystasis | 85.0 | 70.2 | 13.4 | 16.2 |
PPPD | 84.8 | 64.7 | 13.8 | 19.4 |
Meniere’s disease | 82.7 | 54.4 | 1.8 | 18.0 |
Post-concussion | 78.2 | 49.5 | 18.6 | 26.2 |
Cerebrovascular accident | 76.8 | 17.5 | 3.2 | 16.1 |
Mal de Debarquement | 57.6 | 27.7 | 38.5 | 34.3 |
Perilymphatic fistula | 56.1 | 14.5 | 37.2 | 49.1 |
Vestibular paroxysmia | 52.0 | 7.3 | 37.8 | 40.0 |
Types of VR exercises
Type of exercise | Percentage of respondents | ||||
---|---|---|---|---|---|
Very frequently | Frequently | Sometimes | Rarely | Never | |
Balance | 65.6 | 26.1 | 5.7 | 0.7 | 2.0 |
Adaptation | 60.5 | 29.4 | 6.7 | 1.7 | 1.7 |
Habituation | 54.5 | 29.3 | 12.1 | 2.0 | 2.0 |
Gait retraining | 47.0 | 27.9 | 14.3 | 3.1 | 7.7 |
Substitution | 40.2 | 28.5 | 17.2 | 6.9 | 7.2 |
Muscle strength | 18.0 | 24.1 | 34.7 | 12.2 | 10.9 |
Optokinetic stimulation | 15.2 | 23.2 | 26.0 | 13.8 | 21.8 |
Breathing/relaxation | 14.4 | 28.2 | 31.6 | 15.5 | 10.3 |
Brandt–Daroff | 7.3 | 12.6 | 25.5 | 24.5 | 30.1 |
Virtual reality | 5.5 | 10.0 | 21.1 | 11.4 | 51.9 |
Visual (pencil push ups) | 5.5 | 15.9 | 17.6 | 16.6 | 43.9 |
Physical and patient-reported outcome measures
Access to VR
Education in VR
Research activity and priorities
Research priorities themes | Counts | |
---|---|---|
1. Management of dizziness/vertigo in specific conditions | 317 | |
Chronic dizziness/vertigo | 62 | |
Chronic dizziness/vertigo | 10 | |
Persistent Perceptual Postural Dizziness (PPPD) | 35 | |
Visual vertigo/Visually Induced Dizziness | 8 | |
Mal de Debarquement syndrome (MdDS) | 6 | |
Motion sickness | 3 | |
Benign Paroxysmal Positional Vertigo (BPPV) | 45 | |
Recurrent BPPV | 10 | |
Other | 35 | |
Vestibular migraine | 42 | |
Ageing and falls (presbyvestibulopathy, multiple sensory deficit) | 35 | |
Menière’s disease/hydrops | 23 | |
Unilateral vestibular hypofunction (vestibular neuritis) | 21 | |
Cervicogenic dizziness | 19 | |
Central nervous disease (stroke, multiple sclerosis) | 18 | |
Traumatic Brain Injury (TBI, concussion, commotion) | 16 | |
Bilateral vestibular hypofunction | 14 | |
Other (children, orthostatic, vestibular paroxysmia) | 14 | |
2. Evaluating effectiveness of vestibular rehabilitation (VR) | 246 | |
Efficacy of different VR protocols in different diseases | 61 | |
Outcome measures | 49 | |
Vestibular function (caloric testing) | 5 | |
Balance | 6 | |
Impact of disease (quality of life, work) | 5 | |
To monitor compensation/progress | 3 | |
Other (best?, subjective or objective?, oculomotor testing) | 30 | |
Optimal parameters for VR (frequency/duration/length/dosage) | 26 | |
VR-setting (self/individual/group/telerehabilitation/on line) | 24 | |
Incorporation of rehabilitation technology (virtual reality, OKS) | 24 | |
Efficacy of VR compared to other treatments | 16 | |
Psychological treatment in VR (cognitive behavioral therapy, mindfulness) | 15 | |
Timing of VR | 11 | |
Other (medication, multidisciplinary care, different models of care, holistic) | 20 | |
3. Understanding vestibular compensation and dizziness | 206 | |
Models and mechanisms (psychological factors, sensory reweighting, etiology) | 83 | |
Education of physiotherapist (PT) | 26 | |
Care pathways (and how to improve them) | 24 | |
Developing of diagnostic algorithms | 18 | |
Factors influencing compensation | 18 | |
Epidemiology (prevalence of, frequency of) | 11 | |
Role of PT in diagnostics | 10 | |
Other | 16 | |
4. Other (remuneration, artificial labyrinth, differences between countries…) | 7 | |
5. No answer (blank, do not know) | 182 |