SHORT COMMUNICATION DIZZINESS AMONG PATIENTS WITH WHIPLASH-ASSOCIATED DISORDER: A RANDOMIZED CONTROLLED TRIAL Eva Ekvall Hansson, RPT, MSc, Nils-Ove Ma ˚ nsson, MD, PhD , Karin A.M. Ringsberg, RPT, PhD and Anders Ha ˚ kansson, MD, PhD From the University of Lund, Department of Clinical Sciences, Family Medicine, Malmo ¨ University Hospital, Malmo ¨, Sweden Objective: To investigate whether vestibular rehabilitation for patients with whiplash-associated disorder and dizziness had any effect on balance measures and self-perceived handicap. Design: Randomized, controlled trial. Subjects: Twenty-nine patients, 20 women and 9 men, age range 22  76 years. Methods: The patients were randomized to an intervention group or a control group. The intervention comprised vesti- bular rehabilitation. All patients were assessed at baseline, after 6 weeks and after 3 months with 4 different balance measures and the Dizziness Handicap Inventory. Results: After 6 weeks, the intervention group showed statistically significant improvements compared with the control group in the following measures: standing on one leg eyes open (p  /0.02), blindfolded tandem stance (p  /0.045), Dizziness Handicap Inventory total score (p  /0.047), Dizzi- ness Handicap Inventory functional score (p  /0.005) and in Dizziness Handicap Inventory physical score (p  /0.033). After 3 months, the intervention group showed statistically significant improvements compared with the control group in the following measures: standing on one leg eyes open (p  /0.000), tandem stance (p  /0.033) and Dizziness Handi- cap Inventory physical score (p  /0.04). Conclusion: Vestibular rehabilitation for patients with whip- lash-associated disorder can decrease self-perceived handicap and increase postural control. Key words: balance, dizziness, physiotherapy, postural control, rehabilitation. J Rehabil Med 2006; 38: 387  390 Correspondence address: Eva Ekvall Hansson, University of Lund, Department of Clinical Sciences, Family Medicine, Malmo ¨ University Hospital, Entrance 59, SE-205 02 Malmo ¨, Sweden. E-mail:eva.ekvall-hansson@med.lu.se Submitted September 13, 2005; accepted April 18, 2006 INTRODUCTION Approximately 28% of people involved in road traffic collisions will develop whiplash, or whiplash-associated disorders (WAD) (1). Approximately 15  25% of these persons suffer from dizziness (2). Dysfunction in cervical mechanoreceptors and instability in the neck may cause dizziness among persons with WAD (3, 4). Abnormal electronystagmographic findings have been reported (5) and persons with WAD can exhibit dis- turbances in postural control (6). Current research has focused on vestibular rehabilitation for different causes of dizziness and shows evidence of cure and relief of symptoms (7  9). When treating dizziness among persons with WAD, the vestibular organ should be considered as well as postural control (10). Thus, it is of interest to examine whether it is possible to treat dizziness related to WAD with vestibular rehabilitation. The aim of this study was to investigate whether vestibular rehabilitation has an effect on clinical balance measures and self-perceived handicap among patients with dizziness asso- ciated with WAD. MATERIAL AND METHODS Patients Patients were recruited from general practitioners and physiotherapists in primary healthcare, orthopaedic physicians in private practice, administrators of rehabilitation at the regional social insurance office and the orthopaedic hospital clinic, all in Malmo ¨, Sweden. Criteria for inclusion in the study were a diagnosis of WAD with dizziness reported as a symptom. After initial assessment, the patients were randomized by an independent person using a random number table, into intervention or control groups. The same independent person also carried out the intervention. All assessments (at baseline and after 6 weeks and 3 months) were performed by 1 of the authors (EEH), who was blind to the randomization. Recruitment started in March 2002 and was, for practical and economic reasons, terminated in December 2004. Measures Four different balance measures were used; tandem standing was performed with eyes open for 30 seconds and with eyes closed for 30 seconds (11). Standing on one leg eyes open (SOLEO) and eyes closed (SOLEC) respectively were also performed for 30 seconds (12). In SOLEO and SOLEC, both left and right legs were tested and the results were summed up and then divided by 2. In tandem standing, SOLEO and SOLEC, 3 trials were allowed and the best result was used. In walking in a figure of eight (13), and in walking heel to toe on a 5-meter-long line (11), steps outside the figure and steps outside the line were counted. To establish the level of self-perceived handicap experienced by the patients, the Dizziness Handicap Inventory (DHI) was used (14). The inventory comprises 25 different items, organized in 3 different dimen- sions: functional, emotional and physical. The total maximum score is 100 points. J Rehabil Med 2006; 38: 387  390 # 2006 Taylor & Francis. ISSN 1650-1977 DOI: 10.1080/16501970600768992 J Rehabil Med 38