Abstract:Summary
Benign Paroxysmal Positional Vertigo (BPPV) can cause falls, especially in the elderly.
Aim
to study whether or not elderly patients with BPPV have a reduction on their falls after the particle repositioning maneuver (PRM).
Materials and Methods
retrospective study including elderly with BPPV who had fall(s) during the last year. All patients were submitted to the PRM according to the affected semicircular canal (SCC). After the aboli… Show more
“…Other studies showed the balance changes as a source of morbidity and mortality in people aged over 75 years, which fall could be the mainly complication, caused by intrinsic and extrinsic factors as the loss of autonomy and quality of life, what should become the object, not only for future research but priority care in the processes of primary and secondary intervention population 5 .…”
Section: Discussionmentioning
confidence: 99%
“…However, 2010 data estimate that 30 % of people over age 65 relate a fall event at least once a year and it could be represent around 70 % of accidental deaths in people aged 75 years or more 5 .…”
OBJETIVOS:analisar o desempenho de idosos no teste Dynamic Gait Index e Timed Up and Go Testpara avaliar a tendência para quedas e verificar a interferência das variáveis idade, gênero e relato de eventos de quedas pregressas.MÉTODOS:trata-se de uma pesquisa clínica, descritiva, de caráter qualitativo e quantitativo para analisar os resultados obtidos da aplicação do Dynamic Gait Index e Timed Up and Go Test- versão brasileira, em 60 voluntários, de ambos os gêneros e idade entre 60 e 83 anos (média= 68,57 ± 5,94). O projeto de pesquisa foi apreciado pelo Comitê de Ética da instituição e seguiu as recomendações do parecer 196/96 da Legislação Brasileira para pesquisa com seres humanos. Para a análise dos dados utilizou-se testes descritivos, teste de Mann-Whitney e Qui-Quadrado (X²), sendo que foi adotado o p<0,05.RESULTADOS: verificou-se que 37 (61,7%) dos 60 voluntários pontuaram com índices inferiores ao padrão de normalidade no Timed Up and Go Test, enquanto, no Dynamic Gait Index 19 (31,7%) voluntários apresentaram índices inferiores ao ponto de corte. Ocorreu associação estatisticamente significante entre Dynamic Gait Index e as variáveis idade e quedas. Neste estudo o Timed Up and Go Test apresentou associação estatisticamente significante com as variáveis quedas e gênero. Encontraram-se valores estatisticamente significantes na comparação entre as variáveis.CONCLUSÃO:foi frequente a constatação de alteração funcional de equilíbrio e de marcha, e a maioria da amostra apresentou tendência para quedas. A idade associou-se com alterações de marcha e equilíbrio, o gênero com tendência para quedas, e os relatos de eventos de quedas pregressas com os dois instrumentos aplicados. Os resultados aqui apresentados reforçam a necessidade da formação científica e profissional voltada para a atenção primária e secundária da população idosa.
“…Other studies showed the balance changes as a source of morbidity and mortality in people aged over 75 years, which fall could be the mainly complication, caused by intrinsic and extrinsic factors as the loss of autonomy and quality of life, what should become the object, not only for future research but priority care in the processes of primary and secondary intervention population 5 .…”
Section: Discussionmentioning
confidence: 99%
“…However, 2010 data estimate that 30 % of people over age 65 relate a fall event at least once a year and it could be represent around 70 % of accidental deaths in people aged 75 years or more 5 .…”
OBJETIVOS:analisar o desempenho de idosos no teste Dynamic Gait Index e Timed Up and Go Testpara avaliar a tendência para quedas e verificar a interferência das variáveis idade, gênero e relato de eventos de quedas pregressas.MÉTODOS:trata-se de uma pesquisa clínica, descritiva, de caráter qualitativo e quantitativo para analisar os resultados obtidos da aplicação do Dynamic Gait Index e Timed Up and Go Test- versão brasileira, em 60 voluntários, de ambos os gêneros e idade entre 60 e 83 anos (média= 68,57 ± 5,94). O projeto de pesquisa foi apreciado pelo Comitê de Ética da instituição e seguiu as recomendações do parecer 196/96 da Legislação Brasileira para pesquisa com seres humanos. Para a análise dos dados utilizou-se testes descritivos, teste de Mann-Whitney e Qui-Quadrado (X²), sendo que foi adotado o p<0,05.RESULTADOS: verificou-se que 37 (61,7%) dos 60 voluntários pontuaram com índices inferiores ao padrão de normalidade no Timed Up and Go Test, enquanto, no Dynamic Gait Index 19 (31,7%) voluntários apresentaram índices inferiores ao ponto de corte. Ocorreu associação estatisticamente significante entre Dynamic Gait Index e as variáveis idade e quedas. Neste estudo o Timed Up and Go Test apresentou associação estatisticamente significante com as variáveis quedas e gênero. Encontraram-se valores estatisticamente significantes na comparação entre as variáveis.CONCLUSÃO:foi frequente a constatação de alteração funcional de equilíbrio e de marcha, e a maioria da amostra apresentou tendência para quedas. A idade associou-se com alterações de marcha e equilíbrio, o gênero com tendência para quedas, e os relatos de eventos de quedas pregressas com os dois instrumentos aplicados. Os resultados aqui apresentados reforçam a necessidade da formação científica e profissional voltada para a atenção primária e secundária da população idosa.
“…Of the ten listed papers, we found nine 18,19,[23][24][25][26][27][28][29][30] (Chart 1). As far as clinical evolution is concerned, 990 (77.9%) patients became asymptomatic or improved after the first treatment done by means of the repositioning maneuver.…”
Section: Resultsmentioning
confidence: 99%
“…Before treating the patient, the maneuver can be negative for BPPV in a first assessment and positive in another one, on the same day or in a different day. Many BPPV cases did not have positioning nystagmus or dizziness at the time of the maneuver, which does not rule out the diagnostic maneauver 18,19,27 .…”
Section: Discussionmentioning
confidence: 98%
“…Ganança et al 27 stated that vertigo upon head position change enables the identification of the labyrinth involved in the BPPV without nystagmus. Failures can happen because of the movement of crystals to another semicircular canal, creating another BPPV variant.…”
Nyst agmus tests to diagnose BPPV are still relevant in the clinical evaluation of BPPV. However, in everyday practice, there are cases of vertigo caused by head movements, which do not follow this sign in the Dix-Hallpike maneuver and the turn test.
Aim:To characterize BPPV without nystagmus and treatment for it.
Materials and methods:A non-systematic review of diagnosis and treatment of benign paroxysmal positional vertigo (BPPV) without nystagmus in the PubMed, SciELO, Cochrane, BIREME, LILACS and MEDLINE databases in the years between 2001 and 2009.
Results:We found nine papers dealing with BPPV without nystagmus, whose diagnoses were based solely on clinical history and physical examination. The treatment of BPPV without nystagmus was made by Epley maneuvers, Sémont, modified releasing for posterior semicircular canal and BrandtDaroff exercises.
Conclusion:From 50% to 97.1% of the patients with BPPV without nystagmus had symptom remission, while patients with BPPV with nystagmus with symptom remission ranged from 76% to 100%. These differences may not be significant, which points to the need for more studies on BPPV without nystagmus. Braz J Otorhinolaryngol. 2011;77(6):799-804.
REVIEW ARTICLE
Objective
This article aimed to investigate older adults visiting a geriatric institution for a bone density measurement who reported dizziness on a daily or weekly basis (but who are not seeking care for dizziness), according to BPPV, vestibular function, walking abilities, and frequency of falls.
Methods
Patients coming for a bone density measurement answered questions regarding occurrence of dizziness. Patients having dizziness on a daily or weekly basis were considered eligible for the study and invited for investigation at the Ear, Nose, and Throat clinic at Södra Älvsborg Hospital, Sweden. The patients answered questions about history of dizziness, medications, and comorbidities. They were also investigated for BPPV, vestibular deficits using the video head impulse test (vHIT), walking speed, Timed Up and Go test (TUG), and for perception of verticality and horizontality and Romberg test.
Results
A total of 55 patients with dizziness were included. Fifteen (27%) were diagnosed with BPPV. Forty (73%) patients reported falling during the previous year, including 11 with BPPV. Dizziness when turning in bed was more common among patients with BPPV and increased the risk of BPPV 8‐fold.
Conclusion
BPPV is common among older adults with dizziness, including among those not seeking medical care. It is important to identify older adults with BPPV and treat the condition since BPPV may contribute to falls. Asking about dizziness when turning in bed can help to distinguish patients with increased risk for BPPV and older adults with dizziness should be investigated for BPPV even when typical history is lacking.
Level of evidence: 4
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