Vestibular Physical Therapy and Fall Risk Assessment

Carender, Wendy J.; Grzesiak, Melissa; Telian, Steven A.

doi:10.1016/j.otc.2021.05.018

Cited by 4 publications

(3 citation statements)

References 73 publications

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“…Clinical trials are underway to evaluate MP in the rehabilitation of patients with balance disorders [ 17 ]. Individually suited vestibular rehabilitation training decreases the sensation of vertigo, adapts the vestibulo-ocular reflex, and most importantly—improves stability and may reduce the risk of falls [ 18 ]. The latter is of utmost importance because falls contribute to increased mortality in the older adult population [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Utility of the Novel MediPost Mobile Posturography Device in the Assessment of Patients with a Unilateral Vestibular Disorder

Rosiak

Gawrońska

Janc

et al. 2022

Sensors

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Balance disorders are a growing problem worldwide. Thus, there is an increasing need to provide an inexpensive and feasible alternative to standard posturographic platforms (SP) used for the assessment of balance and to provide a possible solution for telemonitoring of patients. A novel mobile posturography (MP) MediPost device was developed to address these issues. This prospective study used a Modified Clinical Test of Sensory Interaction on Balance to evaluate healthy individuals and patients with a unilateral vestibular disorder through SP and MP simultaneously. The control group included 65 healthy volunteers, while the study group included 38 patients diagnosed with a unilateral vestibular deficit. The angular velocity values obtained from both methods were compared by intraclass correlation coefficients (ICC) and Bland–Altman plot analysis. Diagnostic capabilities were measured in terms of sensitivity and specificity. The ICC between the two methods for conditions 2–4 was indicative of excellent reliability, with the ICC > 0.9 (p < 0.001), except for Condition 1 (standing stance, eyes open) ICC = 0.685, p < 0.001, which is indicative of moderate reliability. ROC curve analysis of angular velocity for condition 4 represents the most accurate differentiating factor with AUC values of 0.939 for SP and 0.953 for MP. This condition also reported the highest sensitivity, specificity, PPV, and NPV values with 86.4%, 87.7%, 80%, and 90.5% for SP, and 92.1%, 84.6%, 77.8%, and 94.8% for MP, respectively. The newly developed MediPost device has high sensitivity and specificity in distinguishing between healthy individuals and patients with a unilateral vestibular deficit.

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Section: Introductionmentioning

confidence: 99%

Utility of the Novel MediPost Mobile Posturography Device in the Assessment of Patients with a Unilateral Vestibular Disorder

Rosiak

Gawrońska

Janc

et al. 2022

Sensors

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“…For patients with symptomatic dizziness, it is important to consider the onset, duration, frequency, characteristics, and spontaneity of the symptoms; the degree of imbalance experienced; and presence or absence of neurologic symptoms . When there is a concern for difficulty with imbalance or falls, related interventions should be considered as appropriate, including but not limited to vestibular physical therapy and fall prevention programs . While these interventions have been developed to assist patients with dizziness and prevent fall-related injuries, their effect on dizziness-related mortality is less known.…”

Section: Discussionmentioning

confidence: 99%

Association of Symptomatic Dizziness With All-Cause and Cause-Specific Mortality

Lin,

Gallagher,

Straughan

et al. 2024

JAMA Otolaryngol Head Neck Surg

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ImportanceDizziness is a highly prevalent complaint with wide-ranging causes and resultant morbidity. Whether symptomatic dizziness and its various manifestations are associated with all-cause and cause-specific mortality is unknown.ObjectiveTo examine the associations of symptomatic dizziness and its manifestations with all-cause and cause-specific mortality.Design, Setting, and ParticipantsThis cohort study is a mortality follow-up study based on the 1999-2004 National Health and Nutrition Examination Survey. The study cohort included adults 40 years and older who completed questions about symptomatic dizziness, including problems with dizziness, balance, falling, and positional dizziness, within the past 12 months. Respondents were linked to mortality data through December 31, 2019. Data were analyzed from February to August 2023.ExposureSelf-reported symptomatic dizziness.Main Outcomes and MeasuresAll-cause and cause-specific (cardiovascular disease, diabetes, cancer, and unintentional injuries) mortality. Cox proportional hazard regression models were used to examine associations between symptomatic dizziness and all-cause and cause-specific mortality while adjusting for demographics and medical history.ResultsIn this nationally representative cohort of 9000 middle-aged and older US adults (mean [SD] age, 61.8 [13.8] years; 4570 [50.8%] female), prevalence of symptomatic dizziness was 23.8%. Specifically, 18.3% reported problems with dizziness, 14.5% reported problems with balance, 5.7% reported problems with falling, and 3.8% reported dizziness when turning in bed (positional dizziness). At a median (range) of 16.2 (0.1-20.6) years of follow-up, all-cause mortality for adults with symptomatic dizziness was higher than for those without (45.6% vs 27.1%). Symptomatic dizziness was associated with elevated risk for cause-specific mortality from diabetes (hazard ratio [HR], 1.66; 95% CI, 1.23-2.25), cardiovascular disease (HR, 1.33; 95% CI, 1.12-1.55), and cancer (HR, 1.21; 95% CI, 0.99-1.47) but not unintentional injuries (HR, 0.98; 95% CI, 0.51-1.88). Reporting problems with balance or falling was associated with increased all-cause mortality (balance: HR, 1.27; 95% CI, 1.17-1.39; and falling: HR, 1.52; 95% CI, 1.33-1.73), cardiovascular disease–specific mortality (balance: HR, 1.41; 95% CI, 1.20-1.66; and falling: HR, 1.49; 95% CI, 1.15-1.94), and diabetes-specific mortality risks (balance: HR, 1.74; 95% CI, 1.26-2.39; and falling: HR, 2.01; 95% CI, 1.26-3.18). There was no association between positional dizziness and mortality (HR, 0.98; 95% CI, 0.82-1.19).Conclusions and RelevanceIn this cohort study, symptomatic dizziness was associated with increased risk for all-cause and diabetes-, cardiovascular disease–, and cancer-specific mortality. The imprecision of the effect size estimate for cancer-specific mortality prevents making a definitive conclusion. Future studies are needed to determine whether symptomatic dizziness indicates underlying health conditions contributing to mortality or if early intervention for imbalance and falls can reduce mortality risk.

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“…Physiotherapeutic intervention is safe, effective, and free from serious adverse effects, reduces the need for medication, and reduces the occurrence of dizziness in the medium to long term [21]. Therefore, it is recommended for various types of dizziness [87]. Similarly, a rehabilitation intervention performed through telerehabilitation could have the same clinical benefits with the addition of increased long-term patient compliance and remote patient monitoring by a physiotherapist.…”

Section: Clinical Implication and Future Study Directionsmentioning

confidence: 99%

Effectiveness of Telerehabilitation in Dizziness: A Systematic Review with Meta-Analysis

Grillo,

Zitti,

Cieślik

et al. 2024

Sensors

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Dizziness can be a debilitating condition with various causes, with at least one episode reported in 17% to 30% of the international adult population. Given the effectiveness of rehabilitation in treating dizziness and the recent advancements in telerehabilitation, this systematic review aims to investigate the effectiveness of telerehabilitation in the treatment of this disorder. The search, conducted across Medline, Cochrane Central Register of Controlled Trials, and PEDro databases, included randomized controlled trials assessing the efficacy of telerehabilitation interventions, delivered synchronously, asynchronously, or via tele-support/monitoring. Primary outcomes focused on dizziness frequency/severity and disability, with secondary outcomes assessing anxiety and depression measures. Seven articles met the eligibility criteria, whereas five articles contributed to the meta-analysis. Significant findings were observed regarding the frequency and severity of dizziness (mean difference of 3.01, p < 0.001), disability (mean difference of −4.25, p < 0.001), and anxiety (standardized mean difference of −0.16, p = 0.02), favoring telerehabilitation. Telerehabilitation shows promise as a treatment for dizziness, aligning with the positive outcomes seen in traditional rehabilitation studies. However, the effectiveness of different telerehabilitation approaches requires further investigation, given the moderate methodological quality and the varied nature of existing methods and programs.

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Vestibular Physical Therapy and Fall Risk Assessment

Cited by 4 publications

References 73 publications

Utility of the Novel MediPost Mobile Posturography Device in the Assessment of Patients with a Unilateral Vestibular Disorder

Utility of the Novel MediPost Mobile Posturography Device in the Assessment of Patients with a Unilateral Vestibular Disorder

Association of Symptomatic Dizziness With All-Cause and Cause-Specific Mortality

Effectiveness of Telerehabilitation in Dizziness: A Systematic Review with Meta-Analysis

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