Fall risk assessment and effect of vestibular rehabilitation in the elderly population

Abstract

Background Accidental falls in elderly represent a major healthcare problem; they are a major cause of accidental death in people above 65 years of age. They result in both physical and psychological trauma, where fear of falling is a major consequence that leads to a vicious cycle that makes elderlies more isolated and dependent, making them more vulnerable to falls. Falls are multifactorial, where dizziness is a common factor in elderlies. Thus, a multi-systemic approach is essential for the assessment of balance functions; it also serves as a guide for treatment planning, either in the presence of a cause-specific pathology or when presbyvestibulopathy is the sole issue. Vestibular rehabilitation is useful in training elderlies to improve their dizziness and balance functions. Aim The aim of the study is to assess fall risk in elderly participants and to assess the role of customized vestibular rehabilitation in decreasing dizziness and falls in elderlies identified to be at risk of falling. Results All elderlies diagnosed at fall risk showed statistically significant improvement in dizziness handicap inventory, dynamic gait index, and computerized dynamic posturography after vestibular rehabilitation. As for dizziness, handicap inventory participants showed statistically significant improvement in the total score and in each of its three aspects (functional, emotional, and physical) after vestibular rehabilitation. The Dynamic Gait Index showed statistically significant improvement after vestibular rehabilitation, where they all became non-fallers. Subjects improved significantly in sensory organization test, limits of stability, vestibular stimulation test, motor control test, and faller assessment test of computerized dynamic posturography. Performance on the subjective assessment test was not significantly correlated to the objective assessment methods. The Dynamic Gait Index is sensitive in the detection of elderlies at risk of falling. Conclusions Falls in elderlies is an important subject that must be taken seriously due to its major consequences. Full balance assessment is crucial for offering customized vestibular rehabilitation, which has proved to be useful in minimizing dizziness and fall risk in elderlies.

Exploring the Potentials of Wearable Technologies in Managing Vestibular Hypofunction

“…Natural aging results in changes to the vestibular system because of age-related vestibular hair cell loss and neuronal cell loss in parts of the brain involved in processing vestibular information [20]. Therefore, VH represents a significant public health issue, especially for the elderly [21]. Understanding this condition and developing effective methods for its assessment is essential.…”

Clinical Validation of Estimated Muscle Activations during Phases of Elderly Gait

“…After the age of 65, the frequency of falls and the severity of the resulting injuries increases in community-dwelling adults [1,2]. Typical related injuries vary between bruising, lacerations, and fractures to the upper and lower extremities, while some may even prove to be fatal [1,[3][4][5].…”

“…After the age of 65, the frequency of falls and the severity of the resulting injuries increases in community-dwelling adults [1,2]. Typical related injuries vary between bruising, lacerations, and fractures to the upper and lower extremities, while some may even prove to be fatal [1,[3][4][5]. Furthermore, long hospitalizations result in financial over-burdening of national health systems [6][7][8], with costs rising to €474.4 million in countries in the EU like Holland [9].…”

“…Furthermore, long hospitalizations result in financial over-burdening of national health systems [6][7][8], with costs rising to €474.4 million in countries in the EU like Holland [9]. Their psychological impact is also worth noting since the fear of falling may impede the individual during everyday living and make him/her feel nonautonomous [1,10].…”

A Fall Risk Assessment Model for Community-Dwelling Elderly Individuals Based on Gait Parameters

“…Internal factors include history of falls, gait and balance disorders, visual impairment, medication, chronic health conditions, etc. In addition, vestibular dysfunction is also considered a major intrinsic health risk that can lead to dizziness and imbalance in the elderly [27], [28]. Gait and balance impairment is a strong predictor of falls [29], as aging affects postural control and coordination.…”