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

Abstract

BackgroundAccidental 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.AimThe 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.ResultsAll 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.ConclusionsFalls 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.