ABSTRACT
OBJECTIVE: To determine whether demographic characteristics or balance examination findings can predict the adherence of older people with instability to a vestibular rehabilitation programme. METHODS: A prospective case-control study was conducted of 120 patients aged 65 years or more (mean age, 77.3 ± 6.33 years). Two groups were classified according to patients' adherence with the follow-up post-rehabilitation protocol. Analysed variables included: age, sex, body mass index, Timed Up and Go test findings, computerised dynamic posturography, Dizziness Handicap Inventory scores and Short Falls Efficacy Scale - International questionnaire results, number of falls, and type of vestibular rehabilitation. RESULTS: Two groups were established: adherents (99 individuals) and non-adherents (21 individuals). There were differences between the groups regarding: sex (female-to-male ratio of 4.8:1 in adherents and 1.63:1 in non-adherents), age (higher in non-adherents) and voluntary movement posturographic test results (non-adherents had poorer scores). CONCLUSION: The patients most likely to abandon a vestibular rehabilitation programme are very elderly males with low scores for centre of gravity balancing and limits of stability.
Subject(s)
Dizziness/rehabilitation , Patient Compliance , Physical Therapy Modalities/psychology , Vestibular Diseases/rehabilitation , Age Factors , Aged , Aged, 80 and over , Case-Control Studies , Dizziness/psychology , Female , Humans , Male , Postural Balance , Prospective Studies , Sex Factors , Surveys and Questionnaires , Vestibular Diseases/psychology , Vestibular Function TestsABSTRACT
Vestibular rehabilitation is effective and safe in patients with instability. However, there is insufficient evidence for distinguishing between efficacies of different dosage of therapies. Therefore, the aim of the present study was to verify whether there were differences between two computerised dynamic posturography (CDP) therapies of different numbers of sessions, in order to establish the optimal strategy. We conducted a prospective, comparative study of two different dosage of CDP therapy (a 5-session group and another of 10-session group) in patients with instability due to chronic unilateral peripheral vestibular disorder. We used balanced block randomisation to include 13 patients in each group. Improvement was assessed using the Dizziness Handicap Inventory and the CDP with the sensorial organisation test (SOT) and limits of stability (LOS). We found a statistically significant improvement in both groups in composite score, visual and vestibular input (SOT); and in reaction time, distance and directional control (LOS). If we compare the groups regarding these improvements, we found that 10-session group showed a greater benefit in distance covered and directional control of LOS. Since significant improvement is obtained with only five sessions, we believe this to be the optimal number of treatment sessions for most patients with chronic unilateral peripheral vestibular disorder. Nevertheless, those patients with more reduced limits of stability, and consequently greater likelihood of falling as a result of their diminished base of support, are candidates for rehabilitation protocols with a greater number of sessions.
Subject(s)
Biofeedback, Psychology/methods , Labyrinthitis/rehabilitation , Postural Balance , Vestibular Diseases/rehabilitation , Vestibular Neuronitis/rehabilitation , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Photic Stimulation/methods , Treatment OutcomeSubject(s)
Amyloidosis/diagnosis , Joint Diseases/etiology , Macroglossia/etiology , Shoulder Joint , Aged , Amyloidosis/complications , Female , HumansABSTRACT
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