Please select the eligibility criteria that correspond to the clinical trial below.
Title: Effectiveness of Computer Assisted Training in Vestibular Rehabilitation for Older Patients With Vestibular Dysfunction
Brief Summary: BACKGROUND A Cochrane review from 2003 found that about 30% of people 65 years or older each year fall and that number is even higher for elder people living in institutions. Falls are the cause of 95% of all hip fractures, resulting in prolonged hospitalization and prolonged disability. In patients who are referred to the emergency room after unexplained fall, a study of 564 patients showed that 80% of the patients had vestibular symptoms characterized by balance problems, nausea, impairment, vomiting, and dizziness. 41% of the patients had dizziness suggesting a dysfunctional vestibular system called vestibular dysfunction. In patients with vestibular dysfunction, vestibular rehabilitation (VR) can reduce fall risk. Several studies show however that the elderly has a decreased compliance in relation to the performance of home exercise.

A solution to support the older vestibular rehabilitation process and to maintain the achieved level of functionality after the rehabilitation process is the computer-training program "Move It To Improve It" (MITII). Based on individual studies and tests therapists develop a personalized rehabilitation program permanently corrected, modified and adjusted. The system generates feedback to the therapists at hospital with information about the person's daily training and scores of individual exercises. The Web cam makes it possible to make video footage and pictures to be used in the feedback information. The system also establish direct communication between users and therapists. The web community provide the framework for a telerehabilitation system, which means that the hospital can service more users in the same period.

The ph.d. consist of three studies which has the purposes:

To compare a computer exercise program (Mitii) with conservative home-training according to printed instructions in the rehabilitation of patients with vistibular dysfunction in an outpatient clinic To investigate whether the effect of vestibular rehabilitation is preserved three months after the completion of supervised training in an outpatient clinic for specific vestibular rehabilitation and whether a computer assisted home training program (Mitii) is superior to printed instructions in this respect To evaluate patient experience and barriers for the use fo the computer assisted rehabilitation of patients with vestibular dysfunction


Options:
A: Inclusion Criteria:

* The dizziness is provoked or aggravated by head movements, more than 3 months duration og symptoms, the dizziness started acute, understand Norwegian

Exclusion Criteria:

* Dizziness no longer a problem, other known reasons, than vestibular, for the dizziness (neurological, psychological, or cancer), fluctuating vestibular disease (e.g, ménières disease), scheduled for treatment of/ have had treatment for benign paroxysmal positional vertigo within one month,conditions where fast head movements are contraindicated (e.g. osteoporosis of the neck, whiplash associated injuries), participated in group therapy for dizziness within the past year, unable to attend test and treatment locations
B: Inclusion Criteria:

* SVD diagnosis
* Clinically relevant SVD (VHQ sum score \> 45)
* Informed consent

Exclusion Criteria:

* Insufficient German language ability
* Insufficient cognitive abilities (Mini Mental State Test (MMST) ≤ 27)
* Severe and chronic comorbid somatic or mental disease (e.g., suicidality, severe depression, drug addiction)
* Current psychotherapeutic treatment
* Living \> 50 km away from Munich
C: Inclusion Criteria:

* Be 18 years or over
* Be registered with a participating GP
* Must have visited their GP for dizziness in the last 2 years
* Must complete the consent form, and baseline questionaire indicating they are still suffering from dizziness and that quick head movements make them dizzy.

Exclusion Criteria:

* Non-Labyrinthe cause of dizziness identified by GP
* Medical contraindications from making normal head movements
* Serious co-morbidity
* Moved away from practice
* Recently deceased
* Non-English speakers, and unable to read/write in English.
D: Inclusion Criteria:

* Patient Acceptance
* 65 years old or older
* Peripheral vestibular dysfunction, stable (ie no inflammatory processes ie neuronitis vestibulitis and/or fluctuations symptoms ie Meniere)
* Central vestibular dysfunction without other co-morbidities (eg. Parkinson's, Stroke)
* Mixed peripheral and central vestibular dysfunction without other co-morbidity

Exclusion Criteria:

* Lack of vision
* If exercise therapy is contraindicated
* Significant cardiac problems
* Taking medicine with risk of vestibular side effects (benzodiazepines, sedatives)
* Dementia (MMSE test \<27 or an anamnesis suggesting dementia)
* Stroke within the past 6 months
* Other cognitive dysfunction
* Operation of hip fractures within the last 3 months

Answer: D