Listening Time — 17:50
Editor-in-Chief Alan Jette, PT, PhD, FAPTA, talks with Pamela Dunlap about fear-avoidance beliefs and how measurement of those beliefs can help clinicians identify people at a greater risk of disability after vestibular disorder. “We had hypothesized that fear-avoidance would be associated with symptom burden, function, quality of life, disability, and psychological distress,” Dunlap says, but until the development of the Vestibular Activities Avoidance Instrument, there was no measure.
Editor-in-Chief Alan Jette, PT, PhD, FAPTA, talks with Pamela Dunlap about the real-world impact of fear-avoidance beliefs and how measurement of those beliefs can help clinicians identify people at a greater risk of disability after vestibular disorder. Jette was struck by the study finding that"activities avoidance is associated not only with activity and participation but with dizziness, function, quality of mental as well as physical health … [it's] related to a lot of different outcomes." Dunlap explains that they had hypothesized that fear-avoidance would be associated with symptom burden, function, quality of life, disability, and psychological distress,” just from what they had observed in this and other patient populations, but until the development of the Vestibular Activities Avoidance Instrument, "we didn't have a measure available to identify fear-avoidance beliefs in persons with vestibular disorders." She notes that psychologically informed, cognitive behavioral, and graded exposure treatments can help patients who are fearful and avoidant of movement. The current published research is limited, but she comments that some of the same principles can be applied to those who experience fear-avoidance beliefs with their dizziness to improve outcomes, with parallels drawn to the fear-of-falling literature. Her team is currently working on the reliability and validity of the nine-item version of the Vestibular Activities Avoidance Instrument. Dunlap is coauthor of "Fear Avoidance Beliefs Are Associated With Perceived Disability in Persons With Vestibular Disorders."