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Trial registered on ANZCTR
Registration number
ACTRN12612000379819
Ethics application status
Approved
Date submitted
30/03/2012
Date registered
3/04/2012
Date last updated
21/01/2024
Date data sharing statement initially provided
21/01/2024
Date results provided
21/01/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Treating dizziness in older people
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Scientific title
A randomised controlled trial of dizziness interventions based on a multidisciplinary assessment in older people: towards the development of a multiple profile assessment of dizziness – the MPA-D
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Secondary ID [1]
280230
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nil
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Universal Trial Number (UTN)
nil
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
dizziness in older people
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Condition category
Condition code
Neurological
286372
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0
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Other neurological disorders
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Cardiovascular
286425
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0
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Other cardiovascular diseases
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Mental Health
286426
286426
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0
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Anxiety
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Multifaceted tailored intervention during a 6 month-period targeting the potential cause(s) of dizziness identified during a baseline multidisciplinary assessment. Established interventions will include the Otago home exercise program (strength and balance training exercises for 30min 3 times weekly and 2 walks of 30min weekly for 6 months; the program will involve home visits and phone contact with an exercise physiologist) to target poor balance, a vestibular rehabilitation program (over 8 weeks (within the 6months period) with a vestibular physiotherapist; the duration of the session will be about 30min) to target vestibular asymmetry, a booklet-based cognitive behavioral therapy (5 lessons including a weekly homework assignment (approximately 4 hours per week) over 8 weeks (within the 6-months intervention period) and telephone support by a clinical psychologist) to target depression disorders, comprehensive geriatric assessment and medication review with a geriatrician.
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Intervention code [1]
284563
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Treatment: Other
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Intervention code [2]
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Rehabilitation
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Intervention code [3]
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Behaviour
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Intervention code [4]
285448
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Other interventions
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Comparator / control treatment
the control group will receive no intervention. However, as part of our duty of care, if significant vestibular, postural hypotension, mental illness or high-fall risk problems are identified in control group participants at the fortnightly case conference meetings we will immediately provide the control participants (and their GPs with participant permission) with reports of these findings
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Control group
Active
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Outcomes
Primary outcome [1]
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Frequency and duration of dizziness episodes experienced in the 6-months period between baseline and re-test - using the Vertigo Symptom Scale
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Assessment method [1]
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Timepoint [1]
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at baseline and 6 months post baseline (i-e at the end of the intervention period)
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Primary outcome [2]
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dizziness-related quality of life recorded using a validated questionnaire, the Dizziness Handicap Inventory
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Assessment method [2]
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Timepoint [2]
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at baseline and 6 months post baseline (i-e at the end of the intervention period)
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Primary outcome [3]
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Choice stepping reaction time, a composite measure of reaction time, strength and balance. This is measured using a 'dance-mat' which displays 4 pressure-sensitive arrows (front left, front right, left, right) and is connected to a computer screen displaying the same arrows' arrangement. In this test the participant is required to step as fast as possible on the arrow on the mat which corresponds to the arrow lighting up on the computer screen. The participant performs 20 trials with the arrows displayed in a random order.
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Assessment method [3]
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Timepoint [3]
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at baseline and 6 months post baseline (i-e at the end of the intervention period)
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Secondary outcome [1]
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Tilt table test of orthostatic hypotension: a decrease in systolic blood pressure greater than 20 mmHg, or a decrease in diastolic blood pressure greater than 10 mmHg or a decrease of systolic blood pressure to less than 90 mmHg after 3min of 70degrees head up tilt compared to lying, defines orthostatic hypotension whether or not symptoms.
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Assessment method [1]
296758
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Timepoint [1]
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at baseline and 6 months post baseline (i-e at the end of the intervention period)
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Secondary outcome [2]
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Coordinated Stability - a test of leaning balance
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Assessment method [2]
296759
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Timepoint [2]
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at baseline and 6 months post baseline (i-e at the end of the intervention period)
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Secondary outcome [3]
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Patient-Health Questionnaire -9 items - a questionnaire to assess depression disorders
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Assessment method [3]
349752
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Timepoint [3]
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at baseline and at re-assessment (6 months later marking the end of the study)
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Eligibility
Key inclusion criteria
Having experienced one or more episode(s) of dizziness in the past year and not being currently treated for it; living independently in the community or retirement village; able to understand English.
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Minimum age
50
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
presence of a diagnosed degenerative neurological condition or severe cognitive impairment (GP-Cog score equal or below 4).
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation will be concealed and will be done by central randomisation by computer.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Participants will be randomised via a computer-generated list (www.randomization.com).
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
27/08/2012
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Actual
15/10/2012
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Date of last participant enrolment
Anticipated
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Actual
2/03/2015
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Date of last data collection
Anticipated
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Actual
22/09/2015
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Sample size
Target
300
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Accrual to date
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Final
305
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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National Health and Medical Research Council
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Address [1]
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Level 1
16 Marcus Clarke Street
Canberra ACT 2601
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Prof Stephen Lord
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Address
Falls and Balance Research Group
Neuroscience Research Australia
Barker st
Randwick 2031 NSW
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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Dr Jasmine Menant
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Address [1]
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Falls and Balance Research Group
Neuroscience Research Australia
Barker st
Randwick 2031 NSW
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Country [1]
283851
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Australia
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Secondary sponsor category [2]
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Individual
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Name [2]
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Dr Americo Migliaccio
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Address [2]
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Vision and Vestibular laboratory
Neuroscience Research Australia
Barker st
Randwick 2031 NSW
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Country [2]
283852
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Australia
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Secondary sponsor category [3]
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Individual
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Name [3]
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A/Prof Jacqueline Close
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Address [3]
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Falls and Injury Research Group
Neuroscience Research Australia
Barker st
Randwick 2031 NSW
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Country [3]
283853
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Australia
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Secondary sponsor category [4]
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Individual
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Name [4]
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A/Prof Nickolai Titov
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Address [4]
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Department of Psychology
Macquarie University
NSW 2109
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Country [4]
283854
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Australia
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Secondary sponsor category [5]
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Individual
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Name [5]
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Dr Kim Delbaere
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Address [5]
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Falls and Balance Research Group
Neuroscience Research Australia
Barker st
Randwick 2031 NSW
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Country [5]
283855
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Human Research Ethics Comittee of the University of New South Wales
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Ethics committee address [1]
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Ethics Secretariat UNSW Grants Management Office Rupert Myers Building, Level 3, South Wing The University of New South Wales SYDNEY NSW 2052
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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03/04/2012
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Approval date [1]
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30/08/2012
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Ethics approval number [1]
286996
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HC12152
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Summary
Brief summary
Brief summary: Between 10-30% of older community-living population report dizziness often leading to functional disability and psychological distress. The multifactorial aetiology of dizziness combined with a lack of validated diagnostic tests, and a tendency of clinicians to rely on poorly described symptoms and familiar assessments, are significant barriers to objectively establishing a successful diagnosis and implementing effective interventions. Thus, despite effective treatments being available, up to 40% of older people with reported dizziness remain undiagnosed and untreated. A multidisciplinary assessment battery, with new validated assessments of vestibular impairments is required for diagnosing and treating older people with dizziness. This project will aim to conduct a randomized control trial of a multifaceted dizziness intervention based on a multidisciplinary assessment. We hypothesize that a multidisciplinary assessment (tests of balance, inner ear function, blood pressure, mental health etc) followed by a tailored intervention (exercise program, vestibular rehabilitation, comprehensive geriatric assessment and medication review) will improve diagnosis, reduce self-reported dizziness, enhance postural stability and improve quality of life in older people suffering from dizziness.
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Trial website
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Trial related presentations / publications
Menant JC, Migliaccio AA, Hicks C, Lo J, Meinrath D, Ratanapongleka M, Turner J, Sturnieks DL, Delbaere K, Titov N, McVeigh C, Close JC, Lord SR. Tailored multifactorial intervention to improve dizziness symptoms and quality of life, balance and gait in dizziness sufferers aged over 50 years: protocol for a randomised controlled trial. BMC Geriatr. 2017 Feb 15;17(1):56. doi: 10.1186/s12877-017-0450-3. PMID: 28202037; PMCID: PMC5312521. Menant JC, Migliaccio AA, Sturnieks DL, Hicks C, Lo J, Ratanapongleka M, et al. Reducing the burden of dizziness in middle-aged and older people: A multifactorial, tailored, single-blind randomized controlled trial. PLoS Med, 2018 Jul 24;15(7):e1002620. doi: 10.1371/journal.pmed.1002620. eCollection 2018 Jul PMID: 30040818 Menant JC, Meinrath D, Sturnieks DL, Hicks C, Lo J, Ratanapongleka M, Turner J, Migliaccio AA, Delbaere K, Titov N, Close JCT, Lord SR. Identifying Key Risk Factors for Dizziness Handicap in Middle-Aged and Older People. J Am Med Dir Assoc. 2020 Mar;21(3):344-350.e2. doi: 10.1016/j.jamda.2019.08.016. Epub 2019 Oct 17. PMID: 31631029. Figtree WVC, Menant JC, Chau AT, Hübner PP, Lord SR, Migliaccio AA. Prevalence of Vestibular Disorders in Independent People Over 50 That Experience Dizziness. Front Neurol. 2021 May 20;12:658053. doi: 10.3389/fneur.2021.658053. PMID: 34093406; PMCID: PMC8176523.
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Public notes
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Contacts
Principal investigator
Name
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Prof Stephen Lord
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Address
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Falls and Balance Research Group, Neuroscience Research Australia, Barker st, Randwick, 2031, NSW, Australia
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Country
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Australia
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Phone
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+61293991061
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Jasmine Menant
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Address
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Falls and Balance Research Group
Neuroscience Research Australia
Barker st
Randwick 2031 NSW
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Country
17235
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Australia
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Phone
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+61 2 9399 1267
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Jasmine Menant
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Address
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Falls and Balance Research Group
Neuroscience Research Australia
Barker st
Randwick 2031 NSW
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Country
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Australia
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Phone
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+61 2 9399 1267
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Fax
8163
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
main RCT data
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When will data be available (start and end dates)?
from the date of publication of the article in Plos Medicine, indefinitely.
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Available to whom?
readers of Plos Medicine
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Available for what types of analyses?
meta-analyses, data checks...
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How or where can data be obtained?
Supplementary materials of the Plos Medicine paper
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Dimensions AI
Tailored multifactorial intervention to improve dizziness symptoms and quality of life, balance and gait in dizziness sufferers aged over 50 years: protocol for a randomised controlled trial
2017
https://doi.org/10.1186/s12877-017-0450-3
Embase
Reducing the burden of dizziness in middle-aged and older people: A multifactorial, tailored, single-blind randomized controlled trial.
2018
https://dx.doi.org/10.1371/journal.pmed.1002620
Embase
Identifying Key Risk Factors for Dizziness Handicap in Middle-Aged and Older People.
2020
https://dx.doi.org/10.1016/j.jamda.2019.08.016
Embase
Reducing dizziness-related impairment in people aged 50+.
2020
N.B. These documents automatically identified may not have been verified by the study sponsor.
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