Prevalência e tratamento da tontura: investigação do impacto de condições de saúde e hábitos de vida na redução dos sintomas em pacientes submetidos a um programa reabilitação vestibular na Atenção Primária à Saúde

Abstract

INTRODUCTION: Dizziness is a prevalent symptom in worldwide, yet the state of Minas Gerais (MG) - Brazil has no information on prevalence. Vestibular rehabilitation is a great treatment option for dizziness, but is little done in the scope of Primary Health Care (PHC) and it is necessary to understand how health conditions and lifestyle habits of individuals interfere in this treatment. OBJECTIVES: To investigate the prevalence of dizziness in the state of Minas Gerais according to Sample Survey of Households (SSH-MG), evaluate the effectiveness of a Vestibular Rehabilitation Program (VRP) in PHC and to verify the impact of some health conditions and lifestyle habits in reducing the impact of dizziness in patients undergoing VRP in PHC. METHODS: The research was carried out in two stages. 1) Cross-sectional observational study with analysis of individuals with dizziness symptoms reported in last month. It was determined independent statistical association between the selected variables and dizziness through multivariate analysis. 2) A quasi-experimental study with a convenience sample of 54 users submitted to a VRP in PHC, in which it was investigated the impact of health and lifestyle habits in the difference of the scores obtained at Brazilian Dizziness Handicap Inventory and Visual Analogue Scale pre and post participation in the VRP. RESULTS: The prevalence of dizziness in MG was 6.7% of symptomatic, with statistical prevalence in adults or elderly and female, and a statistically significant association with certain socioeconomic, demographic and health conditions. In the study with a VRP in PHC, most of the participants were elderly women, undergoing an average of 2.3 sessions and 77.8% of patients were submitted exclusively to otolith repositioning maneuvers. By linking the health conditions and lifestyle habits post VRP, we observed relationship between conditions "back pain" and "thyroid dysfunction" with the impact on quality of life after the intervention, beyond the habit of "use alcohol" presented relationship with the self perception of a decreased intensity of dizziness symptoms after treatment. CONCLUSION: Dizziness showed to be a prevalent symptom in MG according to the PAD-MG 2011. The VRP in PHC was effective in reducing dizziness symptoms in all treated patients. Patients with "back pain" reached a more significant improvement with the VRP. The same was observed for patients without "thyroid dysfunction". Other health conditions like "hearing loss", "tinnitus", " change in blood pressure", "metabolic disorder", "migraine", and "diabetes" and living habits like "alcohol use" and "use of cigarettes" had no impact on quality of life with treatment, since all showed improvement. The RVP in PHC should be a therapeutic option to be considered, since it has the potential to be resolute, agile, held in the area range of users and with light technology, which meets the needs of the unified health system and the reality of primary care.