Value of dynamic postural control tests on elderly people with vestibulopathy

Ortuño-Cortés, Miguel A.; Martín-Sanz, Eduardo; Guzmán, Rafael Barona de

doi:10.1016/s2173-5735(09)70121-8

Cited by 2 publications

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References 14 publications

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“…Los resultados del estudio confirman la gran prevalencia de complicaciones relacionadas con el equilibrio en sujetos que han sufrido una lesión cerebral [22,23,[165][166][167][168][169][170]. Pese a que el sistema NedSVE/IBV ha sido usado previamente en sujetos sanos e individuos con patología vestibular, éste es el primer estudio en investigar la validez clínica del sistema en población con DCA [135,171,172]. Un alto porcentaje de la muestra presentaba problemas de equilibrio, pese a que algunos participantes habían alcanzado la máxima valoración en algunas escalas comúnmente utilizadas en la práctica clínica.…”

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Intervenciones basadas en realidad virtual para el entrenamiento de las estrategias de equilibrio en sujetos crónicos con daño cerebral adquirido

Rodríguez¹

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Balance disorders are one of the most common impairments referred by individuals who have suffered a brain injury. Rehabilitation of balance is a key aspect of the neurorehabilitation interventions, because it is associated with an increase in selfdependency. In chronic stages, the mere repetition of movements may be a necessary but not a sufficient condition to sustain functional changes in the motor skills.Interventions based on the motor learning principles, which focus on intensive, repetitive, task-oriented, and adaptive difficulty tasks, have shown to provide clinical benefits to individuals after a brain lesion, even long time after the onset. Virtual reality has been previously proposed to design training programs tailored to the needs of each individual, in a safe and controlled way. However, most of the studies presented to date have focused on the motor skills of the upper limb or on the general mobility. This document describes a set of exercises specifically designed to train the balance strategies, as well as their clinical effectiveness, under different conditions, in the rehabilitation of balance. Similarly, the interaction and assessment tools used in this work are analyzed to ensure their performance and to determine the subjective perceptions derived from their use.The studies presented here show that the experimental interventions combining virtual reality-based exercises specifically designed to train the balance strategies and conventional physical therapy programs can provide clinical benefits to the balance condition of brain injury population, even in chronic stages. In addition, these interventions can provide benefits over pure physical therapy protocols, and even as a part of telerehabilitation protocols, in which the subjects undergo the training sessions at their own place. The studies also show that the proposed exercises are usable, motivating, and provide good levels of presence and immersion. The in-depth evaluation of the interaction tools provides evidence that the needs and perceptions of patients and physical therapists are different and must be taken into account, besides their performance, to integrate these systems in the clinical setting, but also in telerehabilitation protocols, which can reduce, under some circumstances, the costs associated to the neurorehabilitation programs.

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Intervenciones basadas en realidad virtual para el entrenamiento de las estrategias de equilibrio en sujetos crónicos con daño cerebral adquirido

Rodríguez¹

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Assessment of clinical and laboratory tests in predicting risks of fall in the elderly

Taha

Shafik

Saber³

2012

Egypt J Otolaryngol

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EnAbstract Introduction Falls and unstable balance are multifactorial problems and rank high among serious clinical problems faced by the elderly. They are a cause of substantial rates of mortality and morbidity as unintentional injuries. Aim of the work The aim of the study was to explore the most common risk factors for falls in the elderly and to construct the most specific test battery including clinical and laboratory tests capable of determining risk for falls in the elderly. Materials and methods A 6-month prospective study was carried out on a sample of 30 elderly persons of age at least 60 years, reporting more than one fall within last 6 months. Detailed history on neuro-otological symptoms, previous falls, dizziness episodes, and symptoms of systemic disease or osteoarthritis was taken. Visual acuity, musculoskeletal examination, complete neurological examination, and a complete vestibular test battery in the form of the videonystagmography (VNG) test battery, vestibular-evoked myogenic potentials, and computerized dynamic posturography was performed. All participants underwent radiological diagnosis and grading of the osteoarthritic knee and hip. The mobility and gait screening protocol was used, which includes the timed up and go test (TUG), fall risk assessment screening tool (FRAST), and Dynamic Gait Index (DGI). Results Most patients suffered from peripheral vestibular dysfunction and the most frequent VNG abnormality was unilateral vestibular lesion. Radiological assessment of knee and hip osteoarthritis revealed 36.76% with grades II and III. Significant impairment of vision was found in 40% of the elderly. TUG test revealed high risk of falls in those elderly. In total, 20 participants revealed moderate or high risk for falls by FRAST. There was significant correlation between the number of falls and SOT tests (C5 and C6) together with adaptation tests reflecting vestibular pattern of dysfunction. Functional test of dynamic posturography revealed a highly significant correlation between limits of stability reaction time, movement velocity, and tandem of gait step and the number of falls. TUG showed a highly significant correlation in elderly people who experienced falls, whereas DGI showed only significant correlation and FRAST showed nonsignificant correlation. A highly significant correlation was found between SOT C5 and C6 scores and TUG and DGI with a weak correlation with FRAST. Vestibular-evoked myogenic potential asymmetry and unilateral canal paresis revealed nonsignificant results with all functional tests except DGI, which revealed a weak correlation with them. Analysis of variance test revealed that the vestibular dysfunction group is more vulnerable to falls than other groups. Conclusion The VNG test battery and computerized dynamic posturography in conjunction with stance tests in the elderly who complain of dizziness can identify those with high risk of a fall.

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Value of dynamic postural control tests on elderly people with vestibulopathy

Cited by 2 publications

References 14 publications

Intervenciones basadas en realidad virtual para el entrenamiento de las estrategias de equilibrio en sujetos crónicos con daño cerebral adquirido

Intervenciones basadas en realidad virtual para el entrenamiento de las estrategias de equilibrio en sujetos crónicos con daño cerebral adquirido

Assessment of clinical and laboratory tests in predicting risks of fall in the elderly

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