Falls Among People With Bilateral Vestibulopathy

Herssens, Nolan; How, Daniella; Berg, Raymond van de; McCrum, Christopher

doi:10.1001/jamaoto.2021.3673

Cited by 10 publications

(12 citation statements)

References 64 publications

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“…42,51,52,54 The percentage of participants with BVP with a recent history of falls (48%) was slightly higher than the literature average of 42% reported in a previous review on falls in BVP. 4 We observed a significant association between age and Mini-BESTest total score in both BVP and healthy groups. One of the included studies with healthy control data has previously reported an age-balance relationship.…”

Section: Discussionmentioning

confidence: 57%

“…About 30-40% of people with BVP suffer from oscillopsia (movement induced blurred vision) during head motion, due to reduced or absent vestibular-ocular reflex (VOR) . 3 In addition, people with BVP have a higher risk of falls, 4 as well as increased variability in various gait parameters 5,6 and often report difficulty and instability while walking in dimly lit environments and on uneven ground. [7][8][9] Due partly to these symptoms, avoidance of falls and reduction in mobility may occur and negatively impact societal participation, which may in turn be linked with the increase in depression and reduced quality of life in people with vestibular disorders.…”

Section: Introductionmentioning

confidence: 99%

“…Regarding the increasing falls risk in BVP, the data on exactly how falls occur most often in BVP is limited to a few studies. 4,8,9,12,18,19 People with BVP compensate for their vestibular deficit with a combination of the remaining proprioceptive and visual function and as such, their balance control might not be sufficiently examined in clinical settings when examination tasks use zero or only a single sensory perturbation. 20 Tools such as the Berg Balance Scale (BBS) and the Timed "Up & Go" Test (TUG) specifically designed to identify balance problems and predict fall risk may therefore not be suitable for the BVP population.…”

Section: Introductionmentioning

confidence: 99%

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Assessing Balance in People with Bilateral Vestibulopathy using the Mini-Balance Evaluation Systems Test (Mini-BESTest)

Zhu¹,

Stiphout²,

Karabulut³

et al. 2023

Preprint

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Background and aim: Bilateral Vestibulopathy (BVP) leads to unsteadiness when walking, which worsens in darkness or on uneven ground, as well as oscillopsia during head or body movement. A previous review concluded that clinical balance tests that challenge multiple aspects of balance should be investigated, since simple tests struggle to distinguish between BVP and healthy participants. Our aim was (1) to test if the more comprehensive Mini-BESTest is feasible in BVP, (2) to examine how participants perform in terms of their overall and subcomponent scores and (3) to compare these scores with healthy reference data from the literature.Methods: Fifty participants with BVP completed the Mini-BESTest as part of a larger study. The Mini-BESTest has 4 components: anticipatory, reactive postural control, sensory orientation and dynamic gait. It comprises 14 items with a maximum score of 28. Falls incidence in the previous 12 months was obtained by questionnaire. To compare the overall and sub-scores between our participants with BVP and those of healthy participants from the literature (n=327; obtained via PubMed searches and contacting authors), Mann-Whitney U tests were used. Sub scores within the BVP group were also compared. Spearman correlations were used to investigate the relationships between Mini-BESTest score and age.Results: No floor or ceiling effects were observed. Participants with BVP had significantly lower Mini-BESTest total scores than the healthy group (BVP mean=20.8, Healthy mean=24.2, U(NBVP=49, NHealthy=327)=4564.00, p<0.001, d=0.52). Three sub scores of the Mini-BESTest (anticipatory, reactive postural control, sensory orientation) were significantly lower in BVP (U(NBVP=50, NHealthy=190)=2364.50, p<0.001, d=0.75; U(NBVP=49, NHealthy=190)=3737.00, p=0.028, d=0.3; U(NBVP=50, NHealthy=190)=1223.50, p<0.001, d=1.22, respectively), while the dynamic gait sub scores were not significantly different (U(NBVP=50, NHealthy=190)=4374.50, p=0.367, d=0.11). A stronger negative Spearman correlation between age and Mini-BESTest total score was found in the BVP group (ρ = -0.67; 95% CI: -0.74 to -0.35; p < 0.001) than in the healthy group (ρ = -0.32; 95% CI: -0.32 to -0.11; p < 0.001). Mini-BESTest total scores were not significantly different between participants with BVP who had and had not experienced a fall in the previous 12 months.Conclusions: Our findings illustrate that the Mini-BESTest can be used with people with BVP and confirm the commonly reported balance deficits in BVP. The negative association between age and balance was stronger in BVP, perhaps related to the age-related decline in the remaining functional sensory systems with which people with BVP compensate.

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Section: Discussionmentioning

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Assessing Balance in People with Bilateral Vestibulopathy using the Mini-Balance Evaluation Systems Test (Mini-BESTest)

Zhu¹,

Stiphout²,

Karabulut³

et al. 2023

Preprint

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“…Additionally, approximately 5% of patients with MD experience syncope during drop attacks, 37 which may increase their risk of fall‐related injuries. Furthermore, patients with bilateral MD or delayed contralateral MD may exhibit an even higher risk of falling than that of patients with other forms of MD 40–43 . By contrast, studies have yielded contradictory results regarding vestibular vertigo as a cause of traffic accidents.…”

Section: Discussionmentioning

confidence: 99%

Increased Risk of Injury in Ménière's Disease and Effects of Treatment: Population‐Based Retrospective Cohort Study

Wu¹,

Lin

Chien

et al. 2022

Otolaryngol.--head neck surg.

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Objective To investigate the risk of injury in patients with Ménière’s disease (MD) and the effects of treatment. Study Design Population-based retrospective cohort study. Setting Data were collected from the Longitudinal Health Insurance Database 2005, containing the information of 2 million randomly selected individuals in Taiwan. Methods We enrolled 90,481 patients with newly diagnosed MD between 2000 and 2017 and 361,924 matched individuals without MD. The study outcomes were diagnoses of all-cause injuries. The Kaplan-Meier method was used to determine the cumulative incidence rates of injury in the MD and non-MD cohorts, and a log-rank test was used to analyze the differences between the cohorts. Cox proportional hazards models were used to calculate the 18-year hazard ratios of each cohort. Results A total of 80,151 patients were diagnosed with injuries during the follow-up period: 24,031 and 56,120 from the MD and non-MD cohorts, respectively. The adjusted hazard ratio (aHR) was 2.19 (95% CI, 2.16-2.35) after adjusting for demographic characteristics and comorbidities. Subgroup analysis revealed that MD was associated with an increased incidence of unintentional and intentional injuries (aHR, 2.24 [95% CI, 2.21-2.41] and 2.05 [95% CI, 2.01-2.19], respectively). Treatment with diuretics, antivertigo medications, or surgery did not reduce the risk of injury (aHR, 0.98 [95% CI, 0.59-1.54], 0.94 [95% CI, 0.58-1.50], and 0.99 [95% CI, 0.61-1.54]). Conclusion MD is independently associated with an increased risk of injuries. Medical or surgical treatment for MD does not reduce the risk of injury in patients with MD. Physicians should counsel patients with MD regarding preventive measures for avoiding subsequent injuries.

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“…Human motion measurement and analysis represent a major topic in the medical field to understand people's gross motor function, e.g. to identify possible risks of fall 1 or to understand gait deviations 2 . This is usually performed with an optoelectronic system in a gait laboratory.…”

Section: Background and Summarymentioning

confidence: 99%

A dataset of asymptomatic human gait and movements obtained from markers, IMUs, insoles and force plates

et al. 2023

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Human motion capture and analysis could be made easier through the use of wearable devices such as inertial sensors and/or pressure insoles. However, many steps are still needed to reach the performance of optoelectronic systems to compute kinematic parameters. The proposed dataset has been established on 10 asymptomatic adults. Participants were asked to walk at different speeds on a 10-meters walkway in a laboratory and to perform different movements such as squats or knee flexion/extension tasks. Three-dimensional trajectories of 69 reflective markers placed according to a conventional full body markerset, acceleration and angular velocity signals of 8 inertial sensors, pressure signals of 2 insoles, 3D ground reaction forces and moments obtained from 3 force plates were simultaneously recorded. Eight calculated virtual markers related to joint centers were also added to the dataset. This dataset contains a total of 337 trials including static and dynamic tasks for each participant. Its purpose is to enable comparisons between various motion capture systems and stimulate the development of new methods for gait analysis.

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Falls Among People With Bilateral Vestibulopathy

Cited by 10 publications

References 64 publications

Assessing Balance in People with Bilateral Vestibulopathy using the Mini-Balance Evaluation Systems Test (Mini-BESTest)

Assessing Balance in People with Bilateral Vestibulopathy using the Mini-Balance Evaluation Systems Test (Mini-BESTest)

Increased Risk of Injury in Ménière's Disease and Effects of Treatment: Population‐Based Retrospective Cohort Study

A dataset of asymptomatic human gait and movements obtained from markers, IMUs, insoles and force plates

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