Health disparities (HD) can have a devastating impact on individuals as well as the healthcare system. Health disparities can be linked to several factors such as access to health insurance,
socioeconomic status, access to means of transportation, employment status, sick time, and physical proximity to a healthcare facility. Health disparities exist in every field, including physical therapy. Vestibular Rehabilitation (VR) is an area of practice within physical therapy that addresses dizziness and imbalance that can be attributed to vestibular system dysfunction. Access to VR can be limited and impacted by a variety of factors including geographic location.
The study “Investigating health disparities in vestibular rehabilitation” published in the Journal of Vestibular Research(2024), examined whether health disparities exist in vestibular rehabilitation (VR) between individuals identifying as Caucasian and those identifying as racial or ethnic minorities (REM).
Conducting a retrospective chart review of 343 patients from three clinics who attended outpatient VR between January 2014 and September 2020, the researchers collected data on age, gender, race/ethnicity, vestibular diagnosis, VR interventions, and pre- and post-treatment outcome measures, including the Dizziness Handicap Inventory (DHI), Activities-Specific Balance Confidence Scale (ABC), gait speed (GS), and Functional Gait Assessment (FGA).
Among these 343 patients, the cohort was composed primarily of females (218, 63.5%) and Caucasians (295, 85.9%). The most frequent vestibular diagnosis among study participants was unspecified unilateral vestibular hypofunction (89, 25.9%) while the most frequent intervention utilized was dynamic balance (308, 92.5%).
At the initial VR evaluation, REM patients exhibited higher median DHI scores (46 vs. 38, p = 0.008) and lower ABC scores (53.10% vs. 66.30%, p < 0.001) compared to Caucasian patients, indicating greater perceived dizziness-related handicap and lower balance confidence.
However, upon discharge, there were no statistically significant differences between the two groups in DHI, ABC, FGA, and GS scores, suggesting that VR effectively mitigated the initial disparities in perceived dizziness handicap and balance confidence.
The authors conclude that VR can equalize certain health disparities between REM and Caucasian patients and recommend that VR therapists collaborate with public health and policy researchers to improve access to VR services, especially for REM individuals.
Some limitations of the study include sampling bias where results derived may not be generalizable to the entire population as well as lack of analysis into assessing if there were any differences between both groups based on age.
Reference:
Summary by Saishravan Shyamsundar
Thanks to the Journal of Vestibular Research for supporting these research summaries.