Musculoskeletal Pain in Long-term Dizziness (MUPID)

This project is aimed at patients with dizziness believed to be due to conditions in the balance organ in the inner ear (vestibular diseases). Dizziness can be bothersome and influence postural control negatively, and can cause secondary musculoskeletal disorders. Dizziness can also result in reduced work capacity. The purpose of the project is to strengthen the knowledge base regarding symptom burden, prognosis and treatment of prolonged dizziness. The hypothesis is that musculoskeletal pain at baseline is a prognostic factor for prolonged dizziness.

Patients referred to an tertiary otorhinolarynglogical clinic due to dizziness will be invited to participate in the study. The aims are to examine the prevalence, extent and distribution of musculoskeletal pain in patients with prolonged dizziness, and to investigate the associations between musculoskeletal pain, dizziness symptoms, psychological and physical function and health-related quality of life. Furthermore, the aim is to monitor the natural course of the dizziness symptoms and functional status in these patients, and examine risk factors for prolonged disability after 6 and 12 months. The hypothesis is that muscle pain and distress at baseline may be independently associated with prolonged complaints at follow-up. Finally, patients who still are dizzy and have pain after 12 months will be invited to participate in one of two group interventions a) modified vestibular rehabilitation and b) virtual reality / exergaming. The interventions will be feasibility studies with a pre-post design.

After 1 year participants who still have dizziness complaints will be offered one of two interventions: Group-based vestibular rehabilitation combining cognitive intervention, vestiular exercises and body awareness therapy Exergaming intervention with virtual reality exercises using data games and videos, and other balance exercises.

The intervention is in groups of 8-10 patients. The interventions consists of cognitive therapy, vestibular exercises and body awareness therapy, 8 group sessions

The intervention is individual and consist of non-immersive virtual reality exercises to improve balance

The intervention is group based and is a combination of information/education, vestibular exercises (head movements and gaze stability exercises) body awareness exercises and cognitive therapy

Inclusion Criteria: Patients referred to an otorhinolaryngological university clinic due to suspected vestibular disorders (dizziness) Patients must be bothered with dizziness at the time of consultation Exclusion Criteria: Patients uable to fill in questionnaires due language barriers Patients not able to undergo diagnostic and testing procedures Patients with vestibular Schwannoma Patients with diving-related inner ear injuries