302 Vestibular Assessment and Rehabilitation within a Day Hospital Falls Assessment Service: Is it Necessary and is it Feasible?

Abstract

Abstract Background Benign Paroxysmal Positional Vertigo (BPPV) and other vestibular disorders are very common and often missed in older populations and are a significant risk factor and cause of falls. Vestibular rehabilitation is increasingly recognised as an effective intervention for the management of vestibular dysfunction in all age groups. This review aimed to explore the prevalence of vestibular disorders in the cohort attending an integrated day hospital falls assessment service and the feasibility of delivering vestibular rehabilitation interventions as part of this service. Methods We retrospectively reviewed the charts of all the patients who attended a new ambulatory day hospital between Nov 2018 and April 2019. Inclusion criteria included a recent history of falls and aged over 75. All patients had received a comprehensive geriatric assessment which included screening for vestibular symptoms and on-site assessment (if indicated) by a physiotherapist with expertise in vestibular rehabilitation. Results 40 patients (33 women, 7 men) with a mean age of 82 were seen in this period. All had suffered recent falls with 10 having suffered a fracture. 5 patients (12%) tested positive for Benign Paroxysmal Positional Vertigo and 2 others (5%) had evidence of both peripheral and central vestibular impairment. Vestibular rehabilitation interventions, including particle repositioning manoeuvres were delivered within the day hospital setting with review appointments offered to all patients. Conclusion This review highlights the high prevalence of vestibular disorders, especially BPPV (12%) in older fallers. It supports the feasibility of delivering vestibular assessments and rehabilitation as a component of the physiotherapy input within a day hospital falls service.