# Access to Treatment of TBI-Related Vestibular Disorders_A Systemwide Investigation

> **NIH VA I01** · JAMES A. HALEY VA MEDICAL CENTER · 2021 · —

## Abstract

Background. Dizziness is one of the most common symptoms in primary care and the most frequent
comorbidity of mild traumatic brain injury (mTBI) followed by headache [1-3]. Vertigo and dizziness are
predictors of headache persistence [4]. Vestibular rehabilitation is one of the most important and
successful treatment modalities for patients with mTBI. Significance/Impact. The challenge this project
addresses is translation of this knowledge from the specialized facility to the community level where most
Veterans with mTBI reside. The proposed research project addresses HSR&D Research Priority Topics
including the use of healthcare informatics to improve access to care and the examination of models of
service delivery and care management that promote optimal recovery, rehabilitation, and reintegration
for TBI. The long-term goal of this program of research is to improve access to and quality of health care
for Veterans with TBI-related vestibular disorders. Innovation. The short-term goals are to examine
utilization of VA services by Veterans who report dizziness (national level data) and to determine if the
treatment provided is effective (local level data). Specific Aims. The Aims are to: (1) Determine, using
national data, the utilization of VA services by OEF/OIF patients who report dizziness symptoms, (2)
Determine, using local Post-Deployment Rehabilitation & Evaluation Program (PREP) data, predictors
of severity of vestibular dysfunction and factors that influence the effectiveness of vestibular
rehabilitation, and (3) Increase the capacity to reliably measure the effectiveness of vestibular
rehabilitation for individuals with mTBI. Methodology. Aim 1 uses a retrospective, big data design
and national Comprehensive Traumatic Brain Injury Level II Examination data. Frequencies of the
different types of referral recommendations made and follow up visits will be tabulated. Logistic
regression analysis will be used to identify Veteran, clinician, and system-level factors associated with
patient likelihood of receiving a referral and following up with the referral. Aim 2 will use a
retrospective design and local (Tampa PREP) data to conduct an uncontrolled exploration of the
magnitude of change associated with vestibular rehabilitation. Postural stability, balance, self-perceived
dizziness handicap, post-concussive symptoms, and gaze stabilization outcome measures will be
evaluated using multiple linear regression. The percentage of variance explained will be calculated for
all models and compared to identify which vestibular rehabilitation outcome variable appears to be best
explained by a set of patient, clinician, and system level predictors. Aim 3 will use Aim 2 data to evaluate
the psychometric properties and responsiveness or clinical sensitivity to change of selected vestibular
function measures for the TBI-related vestibular dysfunction population. If the aims of this project are
achieved, the following will be identified: (1a) the numbe...

## Key facts

- **NIH application ID:** 9832228
- **Project number:** 1I01HX002709-01A1
- **Recipient organization:** JAMES A. HALEY VA MEDICAL CENTER
- **Principal Investigator:** SANDRA L. WINKLER
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2019-07-01 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9832228

## Citation

> US National Institutes of Health, RePORTER application 9832228, Access to Treatment of TBI-Related Vestibular Disorders_A Systemwide Investigation (1I01HX002709-01A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9832228. Licensed CC0.

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