{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:45:23Z","timestamp":1790837123771,"version":"4.1.0"},"reference-count":33,"publisher":"Royal College of General Practitioners","issue":"734","license":[{"start":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T00:00:00Z","timestamp":1549929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Gen Pract"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Vestibular rehabilitation (VR) is the preferred treatment for chronic vestibular symptoms such as dizziness and vertigo. An internet-based programme was developed to increase uptake of VR. The authors have previously reported that internet-based VR resulted in a clinically relevant decrease of vestibular symptoms for up to 6 months, compared with usual care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate long-term outcomes of internet-based VR in patients with chronic vestibular syndrome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and setting<\/jats:title><jats:p>A randomised controlled trial was conducted in Dutch general practice involving 322 participants aged \u226550 years with chronic vestibular syndrome. Participants were randomised to stand-alone VR, blended VR (with physiotherapy support), and usual care. Usual care participants were allowed to cross over to stand-alone VR 6 months after randomisation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Participants were approached 36 months after randomisation. The primary outcome was the presence of vestibular symptoms as measured by the vertigo symptom scale\u2014short form (VSS\u2013SF). Secondary outcomes were dizziness-related impairment, anxiety, depressive symptoms, and healthcare utilisation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At 36-month follow-up, 65% of participants filled in the VSS\u2013SF. In the usual care group, 38% of participants had crossed over to VR at 6 months. There were no significant differences in vestibular symptoms between VR groups and usual care (mean difference = \u22120.8 points, 95% confidence interval [CI] = \u22122.8 to 1.2, for stand-alone VR; \u22120.3, 95% CI = \u22122.2 to 1.7, for blended VR). In VR groups, clinically relevant improvement compared with baseline was maintained over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Internet-based VR provides a maintained improvement of vestibular symptoms for up to 36 months in patients with chronic vestibular syndrome.<\/jats:p><\/jats:sec>","DOI":"10.3399\/bjgp.2022.0468","type":"journal-article","created":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T16:30:14Z","timestamp":1683304214000},"page":"e710-e719","source":"Crossref","is-referenced-by-count":5,"title":["Online vestibular rehabilitation for chronic vestibular syndrome: 36-month follow-up of a randomised controlled trial in general practice"],"prefix":"10.3399","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2746-4820","authenticated-orcid":false,"given":"Vincent A","family":"van Vugt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e0 TN","family":"Ngo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6639-6050","authenticated-orcid":false,"given":"Johannes C","family":"van der Wouden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos WR","family":"Twisk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henri\u00ebtte E","family":"van der Horst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3747-9217","authenticated-orcid":false,"given":"Otto R","family":"Maarsingh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1987","published-online":{"date-parts":[[2023,5,5]]},"reference":[{"key":"2023090614550715000_73.734.e710.1","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-017-0695-0"},{"key":"2023090614550715000_73.734.e710.2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-63437-5.00005-4"},{"key":"2023090614550715000_73.734.e710.3","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000691"},{"issue":"1","key":"2023090614550715000_73.734.e710.4","doi-asserted-by":"crossref","first-page":"47","DOI":"10.3233\/VES-2004-14105","article-title":"Prevalence of dizziness and vertigo in an urban elderly population","volume":"14","author":"Jonsson","year":"2004","journal-title":"J Vestib Res"},{"key":"2023090614550715000_73.734.e710.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2015.04.010"},{"key":"2023090614550715000_73.734.e710.6","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j3727"},{"key":"2023090614550715000_73.734.e710.7","doi-asserted-by":"publisher","DOI":"10.1080\/02813432.2017.1288683"},{"key":"2023090614550715000_73.734.e710.8","doi-asserted-by":"publisher","DOI":"10.1258\/002221503768199915"},{"key":"2023090614550715000_73.734.e710.9","doi-asserted-by":"publisher","DOI":"10.1007\/s004150070146"},{"key":"2023090614550715000_73.734.e710.10","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-005871"},{"key":"2023090614550715000_73.734.e710.11","doi-asserted-by":"publisher","DOI":"10.1370\/afm.2070"},{"key":"2023090614550715000_73.734.e710.12","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-015479"},{"key":"2023090614550715000_73.734.e710.13","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l5922"},{"key":"2023090614550715000_73.734.e710.14","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-63437-5.00006-6"},{"key":"2023090614550715000_73.734.e710.15","unstructured":"Bakker-Mutsaerts M Dros J Schep-Akkerman AE (2017) [Summary of the Dutch College of General Practitioners\u2019 practice guideline \u2018Dizziness\u2019]. 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