Prospective cohort study on the predictors of fall risk in 119 patients with bilateral vestibulopathy

Dobbels, Bieke; Lucieer, Florence; Mertens, Griet; Gilles, Annick; Moyaert, Julie; Heyning, Paul Van de; Guinand, Nils; Fornos, Angelica Pérez; Herssens, Nolan; Hallemans, Ann; Vereeck, Luc; Vanderveken, Olivier M.; Rompaey, Vincent Van; Berg, Raymond van de

doi:10.1371/journal.pone.0228768

Cited by 31 publications

(50 citation statements)

References 31 publications

(51 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hermann et al (42), however, did find a significant difference in DHI scores between fallers and non-fallers. Dobbels et al (10) also found a significant difference between fallers and non-fallers on the DHI and all its subscales. This may indicate that the present sample size with 11 fallers and 16 non-fallers is too small to detect significant differences in total DHI scores.…”

Section: Proms and Fall Riskmentioning

confidence: 90%

“…Therefore, it seems sensible that a single test evaluating vestibular function is not capable of distinguishing fallers from non-fallers. As Dobbels et al (10) have suggested earlier, differentiating between the different patterns of vestibular impairments present in the BVP population and linking those with fall risk may provide the clinicians or healthcare professionals more insights in the identification of those patients at an increased risk of falling.…”

Section: Vestibular Function Tests and Fall Riskmentioning

confidence: 95%

See 1 more Smart Citation

Paving the Way Toward Distinguishing Fallers From Non-fallers in Bilateral Vestibulopathy: A Wide Pilot Observation

et al. 2021

Self Cite

View full text Add to dashboard Cite

Patients with bilateral vestibulopathy (BVP) present with unsteadiness during standing and walking, limiting their activities of daily life and, more importantly, resulting in an increased risk of falling. In BVP patients, falls are considered as one of the major complications, with patients having a 31-fold increased risk of falling compared to healthy subjects. Thus, highlighting objective measures that can easily and accurately assess the risk of falling in BVP patients is an important step in reducing the incidence of falls and the accompanying burdens. Therefore, this study investigated the interrelations between demographic characteristics, vestibular function, questionnaires on self-perceived handicap and balance confidence, clinical balance measures, gait variables, and fall status in 27 BVP patients. Based on the history of falls in the preceding 12 months, the patients were subdivided in a “faller” or “non-faller” group. Results on the different outcome measures were compared between the “faller” and “non-faller” subgroups using Pearson's chi-square test in the case of categorical data; for continuous data, Mann–Whitney U test was used. Performances on the clinical balance measures were comparable between fallers and non-fallers, indicating that, independent from fall status, the BVP patients present with an increased risk of falling. However, fallers tended to report a worse self-perceived handicap and confidence during performing activities of daily life. Spatiotemporal parameters of gait did not differ between fallers and non-fallers during walking at slow, preferred, or fast walking speed. These results may thus imply that, when aiming to distinguish fallers from non-fallers, the BVP patients' beliefs concerning their capabilities may be more important than the moderately or severely affected physical performance within a clinical setting. Outcome measures addressing the self-efficacy and fear of falling in BVP patients should therefore be incorporated in future research to investigate whether these are indeed able to distinguish fallers form non-fallers. Additionally, information regarding physical activity could provide valuable insights on the contextual information influencing behavior and falls in BVP.

show abstract

Section: Proms and Fall Riskmentioning

confidence: 90%

Section: Vestibular Function Tests and Fall Riskmentioning

confidence: 95%

Paving the Way Toward Distinguishing Fallers From Non-fallers in Bilateral Vestibulopathy: A Wide Pilot Observation

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…BV is mainly diagnosed using the criteria reported by the Barany Society, which include a combination of symptoms and vestibular test results. The symptoms mentioned in the criteria include imbalance, oscillopsia, and worsening of complaints in darkness and/or on uneven ground [6], which lead to an increased risk of falling [7]. However, these diagnostic criteria do not intend to cover the whole spectrum of symptoms and consequences associated with BV.…”

Section: Introductionmentioning

confidence: 99%

Bilateral vestibulopathy: beyond imbalance and oscillopsia

Lucieer

Hecke²,

Stiphout

et al. 2020

J Neurol

Self Cite

View full text Add to dashboard Cite

Objective To optimize the current diagnostic and treatment procedures for patients with bilateral vestibulopathy (BV), this study aimed to determine the complete spectrum of symptoms associated with BV. Method A prospective mixed-method study design was used. Qualitative data were collected by performing semi-structured interviews about symptoms, context, and behavior. The interviews were recorded and transcribed until no new information was obtained. Transcriptions were analyzed in consensus by two independent researchers. In comparison to the qualitative results, quantitative data were collected using the Dizziness Handicap Inventory (DHI), Hospital Anxiety and Depression Scale (HADS) and a health-related quality of life questionnaire (EQ-5D-5L). Results Eighteen interviews were transcribed. Reported symptoms were divided into fourteen physical symptoms, four cognitive symptoms, and six emotions. Symptoms increased in many situations, such as darkness (100%), uneven ground (61%), cycling (94%) or driving a car (56%). These symptoms associated with BV often resulted in behavioral changes: activities were performed more slowly, with greater attention, or were avoided. The DHI showed a mean score of severe handicap (54.67). The HADS questionnaire showed on average normal results (anxiety = 7.67, depression = 6.22). The EQ-5D-5L demonstrated a mean index value of 0.680, which is lower compared to the Dutch age-adjusted reference 0.839 (60–70 years). Conclusion BV frequently leads to physical, cognitive, and emotional complaints, which often results in a diminished quality of life. Importantly, this wide range of symptoms is currently underrated in literature and should be taken into consideration during the development of candidacy criteria and/or outcome measures for therapeutic interventions such as the vestibular implant.

show abstract

“…VEMP responses do not need to be absent when only implanting the semicircular canals. Many symp-tomatic patients with BVP can have preserved otolith responses [37,[54][55][56]. The presence of VEMP responses indicates that on an aggregate basis some otolithic signal is present, but it does not demonstrate useful otolith function.…”

Section: Vestibular Evoked Myogenic Potentialsmentioning

confidence: 99%

The vestibular implant: Opinion statement on implantation criteria for research1

Berg

Ramos²,

Rompaey

et al. 2020

VES

Self Cite

View full text Add to dashboard Cite

This opinion statement proposes a set of candidacy criteria for vestibular implantation of adult patients with bilateral vestibulopathy (BVP) in a research setting. The criteria include disabling chronic symptoms like postural imbalance, unsteadiness of gait and/or head movement-induced oscillopsia, combined with objective signs of reduced or absent vestibular function in both ears. These signs include abnormal test results recorded during head impulses (video head impulse test or scleral coil technique), bithermal caloric testing and rotatory chair testing (sinusoidal stimulation of 0.1 Hz). Vestibular implant (VI) implantation criteria are not the same as diagnostic criteria for bilateral vestibulopathy. The major difference between VI-implantation criteria and the approved diagnostic criteria for BVP are that all included vestibular tests of semicircular canal function (head impulse test, caloric test, and rotatory chair test) need to show significant impairments of vestibular function in the implantation criteria. For this, a two-step paradigm was developed. First, at least one of the vestibular tests needs to fulfill stringent criteria, close to those for BVP. If this is applicable, then the other vestibular tests have to fulfill a second set of criteria which are less stringent than the original criteria for BVP. If the VI-implantation is intended to excite the utricle and/or saccule (otolith stimulation), responses to cervical and ocular vestibular evoked myogenic potentials must be absent in addition to the above mentioned abnormalities of semicircular canal function. Finally, requirements for safe and potentially effective stimulation should be met, including implanting patients with BVP of peripheral origin only, and assessing possible medical and psychiatric contraindications.

show abstract

Prospective cohort study on the predictors of fall risk in 119 patients with bilateral vestibulopathy

Abstract: Objectives To identify predictive factors for falls in patients with bilateral vestibulopathy (BV). Specific variables contributing to the general work-up of a vestibular patient were compared between BV patients experiencing falls and those who did not.

Cited by 31 publications

References 31 publications

Paving the Way Toward Distinguishing Fallers From Non-fallers in Bilateral Vestibulopathy: A Wide Pilot Observation

Paving the Way Toward Distinguishing Fallers From Non-fallers in Bilateral Vestibulopathy: A Wide Pilot Observation

Bilateral vestibulopathy: beyond imbalance and oscillopsia

The vestibular implant: Opinion statement on implantation criteria for research1

Contact Info

Product

Resources

About