The frequency and impact of undiagnosed benign paroxysmal positional vertigo in outpatients with high falls risk

Hawke, Lyndon J; Barr, Christopher; McLoughlin, James A.

doi:10.1093/ageing/afab122

Cited by 13 publications

(16 citation statements)

References 36 publications

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“…With a significant odds ratio of 2.34 on fall incidence, pwBPPV are more likely to fall than their peers. This might also explain why unrecognized BPPV is highly prevalent, even up to 54% in older adults referred to fall clinics 49,56…”

Section: Discussionmentioning

confidence: 99%

Gait and Falls in Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-analysis

Pauwels

Casters

Lemkens

et al. 2023

Journal of Neurologic Physical Therapy

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Background and Purpose: Benign paroxysmal positional vertigo (BPPV) is one of the most common vestibular disorders, and is treated effectively with particle repositioning maneuvers (PRM). The aim of this study was to assess the influence of BPPV and treatment effects of PRM on gait, falls, and fear of falling. Methods: Three databases and the reference lists of included articles were systematically searched for studies comparing gait and/or falls between (1) people with BPPV (pwBPPV) and controls and (2) pre- and posttreatment with PRM. The Joanna Briggs Institute critical appraisal tools were used to assess risk of bias. Results: Twenty of the 25 included studies were suitable for meta-analysis. Quality assessment resulted in 2 studies with high risk of bias, 13 with moderate risk, and 10 with low risk. PwBPPV walked slower and demonstrated more sway during tandem walking compared with controls. PwBPPV also walked slower during head rotations. After PRM, gait velocity during level walking increased significantly, and gait became safer according to gait assessment scales. Impairments during tandem walking and walking with head rotations did not improve. The number of fallers was significantly higher for pwBPPV than for controls. After treatment, the number of falls, number of pwBPPV who fell, and fear of falling decreased. Discussion and Conclusions: BPPV increases the odds of falls and negatively impacts spatiotemporal parameters of gait. PRM improves falls, fear of falling, and gait during level walking. Additional rehabilitation might be necessary to improve gait while walking with head movements or tandem walking. Video Abstract available for more insights from the authors (see the Supplemental Digital Content Video, available at: http://links.lww.com/JNPT/A421).

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Section: Discussionmentioning

confidence: 99%

Gait and Falls in Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-analysis

Pauwels

Casters

Lemkens

et al. 2023

Journal of Neurologic Physical Therapy

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“…Patients are referred to our tertiary care center if symptoms become chronic. Especially in respect to increased risk of falls the detection of BPPV and its treatment is essential (28). Therefore, clinical testing for BPPV is routinely part of every clinical examination in our center.…”

Section: Discussionmentioning

confidence: 99%

Impact of Common Dizziness Associated Symptoms on Dizziness Handicap in Older Adults

et al. 2021

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Background: A cross-sectional observational study was designed to determine the impact of dizziness associated symptoms on the dizziness handicap inventory (DHI) in older adults (≥60 years).Methods: In total, 785 individuals referred to a multidisciplinary dizziness unit were assessed. Participants completed self-report questionnaires with general questions about symptoms of dizziness as well as the DHI. The DHI subscores (physical, functional, emotional) were calculated. Medical diagnoses were collected from the medical records of the patients. One-way MANOVA and networking analysis were used to analyze the impact of dizziness associated symptoms on dizziness handicap.Results: Most patients reported swaying dizziness (60.6%) and feeling of unsteadiness (59.8%) with substantial overlap between the types of dizziness. Most frequent dizziness associated symptoms were ear noise/tinnitus, visual problems, and nausea/vomiting. Network analysis revealed that visual disturbances, headache, and hearing impairment were associated with higher DHI and explained 12% of the DHI variance in the linear regression. In the one-way MANOVA visual problems and headache had an effect on all three DHI subscores, while hearing impairment was associated with the functional and emotional subscores of DHI.Conclusion: Distinct dizziness associated symptoms have substantial impact on dizziness handicap in older adults. A multifactorial assessment including these symptoms may assist in tailoring therapies to alleviate dizziness handicap in this group.

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“…In a French study conducted in a nursing home setting, falls before testing was one of the independent predictors of a positive COVID-19 test [ 5 ]. Furthermore, unidentified benign paroxysmal positional vertigo (BPPV) was identified in 53% of high falls risk rehabilitation outpatients, underlining the need of BPPV assessment [ 6 ].…”

Section: Tackling the Complexity Of Falls Preventionmentioning

confidence: 99%

How to tackle the global challenge of falls?

Seppälä

Velde

2022

Age and Ageing

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Worldwide, falls and accompanying injuries are increasingly common, making their prevention and management a critical global challenge. The wealth of evidence to support interventions to prevent falls has recently (2022) been distilled in the first World Falls Guideline for Prevention and Management for Older Adults. The core of falls prevention includes (i) risk assessment and stratification; (ii) general recommendations on optimising physical function and mobility for all and (iii) offering a holistic, multidomain intervention to older adults at high risk of falls, in which the older adult’s priorities, beliefs and resources are carefully considered. In recent decades, sustainable and adequately resourced falls prevention has proved challenging, although evidence suggests that suboptimal implementation of falls prevention is ineffective. Future research should focus on understanding the most successful approaches for implementation. To further optimise falls prevention, recent developments include technological innovation to identify and prevent falls, including exergaming. Further work is warranted to understand how to best incorporate the concepts of frailty and sarcopenia in falls prevention and management. This themed collection includes key articles in the field of falls prevention, covering several topics including risk factors, effective interventions, older adult’s views, implementation issues and future perspectives.

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The frequency and impact of undiagnosed benign paroxysmal positional vertigo in outpatients with high falls risk

Cited by 13 publications

References 36 publications

Gait and Falls in Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-analysis

Gait and Falls in Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-analysis

Impact of Common Dizziness Associated Symptoms on Dizziness Handicap in Older Adults

How to tackle the global challenge of falls?

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