Duration of clinical course and fall risk in subjects admitted to vestibular rehabilitation in a hospital in the Autonomous City of Buenos Aires
A descriptive study
Abstract
Objective: To identify the duration of clinical course and the fall risk in subjects with vestibular disorders admitted to vestibular rehabilitation in a rehabilitation hospital and describe their clinical-demographic and balance characteristics.
Materials and method: A descriptive, cross-sectional and retrospective study was conducted using consecutive non-probability sampling technique. The variables were classified into primary and secondary and these, in turn, were divided into clinical-demographic and balance variables.
Results: The sample consisted of 159 subjects. The duration of clinical course was >6 months in 71.1% of subjects. Regarding dynamic balance, assessed by the Dynamic Gait Index and Functional Gait Assessment, 70.5% of subjects had fall risk. The most prevalent diagnosis was peripheral vestibulopathy in 52.8% of subjects.
Conclusion: We identified the duration of clinical course and the fall risk and described the clinical-demographic and balance characteristics of subjects with vestibular disorders admitted to vestibular rehabilitation.
References
Bisdorff A, Von Brevern M, Lempert T, Newman-Toker DE. Classification of vestibular symptoms: towards an international classification of vestibular disorders. J Vestib Res. 2009;19(1-2):1-13.
Martín Nogueras AM. Bases neurofisiológicas del equilibrio postural [Internet]. Salamanca: Universidad de Salamanca. [citado 2020 Mar 17]. Disponible en: https://gredos.usal.es/bitstream/handle/10366/115263/NeurofisiologiaEquilibrioPostural.AMMartin.pdf?sequence=1
Horak FB. Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? Age Ageing. 2006;35(2):ii7-ii11.
Camacho R. Tratamiento de los trastornos del equilibrio. Inf Ter Sist Nac Salud. 2002;26:44-47.
Bisdorff A, Bosser G, Gueguen R, Perrin P. The epidemiology of vertigo, dizziness, and unsteadiness and its links to co-morbidities. Frontiers in Neurology. 2013;4:29.
Guerra-Jiménez G, Rodríguez AA, González JCF, Plasencia DP, Macías ÁR. Epidemiología de los trastornos vestibulares en la consulta de otoneurología. Acta Otorrinolaringológica Española. 2017;68(6):317-322.
Yardley L, Owen N, Nazareth I, Luxon L. Prevalence and presentation of dizziness in a general practice community sample of working age people. Br J Gen Pract. 1998;48(429):1131-1135.
Skøien AK, Wilhemsen K, Gjesdal S. Occupational disability caused by dizziness and vertigo: a register-based prospective study. Br J Gen Pract. 2008;58(554):619-623.
Agrawal Y, Carey JP, Della Santina CC, Schubert MC, Minor LB. Disorders of balance and vestibular function in US adults: data from the National Health and Nutrition Examination Survey, 2001-2004. Archives of internal medicine. 2009;169(10):938-944.
Whitney SL, Alghwiri AA, Alghadir A. An overview of vestibular rehabilitation. Handb Clin Neurol. 2016;137:187-205.
Melgarejo Meana FA, Benfatto N, Del Bono M, Sosa AM, Almirón CJ. Rehabilitación precoz en un paciente con neuritis vestibular. Fronteras en Medicina. 2019;14(2):98-100.
Benito Orejas JI, Alonso-Vielba J, Valda-Rodrigo J, Cifuentes-Navas VA. Resultados y seguimiento de la rehabilitación vestibular. Rev. ORL. 2020; 11(1):107-114.
Nevitt MC, Cummings SR, Hudes ES. Risk factors for injurious falls: a prospective study. J Gerontol. 1991;46(5):M164-70.
Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. Declaración de la Iniciativa STROBE (Strengthening the Reporting of Observational studies in Epidemiology): directrices para la comunicación de estudios observacionales. Gaceta Sanitaria. 2008;22(2):144-150.
Meldrum D, McConn Walsh R. Rehabilitación Vestibular. In: Stokes M. Fisioterapia en la Rehabilitación Neurológica. 3th ed. Barcelona: Elsevier; 2013. p. 267-288.
Shumway CA, Baldwin M, Polissar N, Gruber W. Predicting the probability for falls in community dwelling older adults. Phys Ther. 1997;77(8):812-819.
Walker L, Austin G, Banke M, Foxx R, Gaetano L, Gardner A, et al. Reference Group Data for the Functional Gait Assessment, Physical Therapy. 2007;87(1):1468–1477.
Wrisley DM, Kumar NA. Functional gait assessment: Concurrent, discriminative, and predictive validity in community-dwelling older adults. Phys Ther. 2010;90(5):761-773.
Martínez-Vila E, Fernández M, Sieira P. Síndrome vestibular central. Rev. Med. Univ. Navarra. 2003;47(4):51-59.
Strupp M, Arbusow V. Acute vestibulopathy. Current opinion in Neurology. 2001;14(1):11-20.
de Oca Rosas DM, de Oca Fernández EM. La otorrinolaringología del adulto mayor. In Anales de Otorrinolaringología Mexicana. 2006;51(1):33-37.
Conde T, Gorostidi M, Camafort M, Abad M, Martin E, Morales F, et al. Documento de la Sociedad Española de Hipertensión-Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA) sobre las guías ACC/AHA 2017 de hipertensión arterial. Hipertensión y riesgo vascular. 2018; 35(3):119-129.
OMS: Organización Mundial de la Salud [Internet]. Ginebra: OMS; 1948 [actualizado 4 Nov 2019; citado 17 Mar 2020]. Disponible en: https://www.who.int/topics/epilepsy/es/
Encolombia [Internet]. Colombia: encolombia; 1998 [actualizado 2019; citado 10 Nov 2019]. Disponible en: https://encolombia.com/medicina/guiasmed/alteracion-visual/definicionyaspectos/
OMS: Organización Mundial de la Salud [Internet]. Ginebra: OMS; 1948 [actualizado 16 Ene 2018; citado 10 Nov 2019]. Disponible en: https://www.who.int/es/news-room/fact-sheets/detail/falls
Schubert, MC. Vestibular Function Tests. In: Herdman SJ, Clendaniel RA, authors. Vestibular Rehabilitation. 4th ed. Philadelphia: F.A. Davis Company; 2014. p. 178-194.
Kierstan B. American Academy of Ophthalmology [Internet]. Washington D.C. Estados Unidos. 18 de Marzo del 2019. Disponible en: https://www.aao.org/salud-ocular/enfermedades/nistagmo
Franco-Gutierrez V, Pérez-Vázquez P. Exploración Oculomotora. Rev. ORL. 2018;9(3):169-192.
Brandt T, Dieterich M, Strupp M. Introductory Remarks: In: Brandt T, Dieterich M, Strupp M. Vertigo and Dizziness. 2nd ed. London: Springer; 2013. London; Springer; 2013. p. 1-52.
Batuecas Caletrío Á, Muñoz Herrera ÁM, Bronstein AM. Importancia de la maniobra de impulso óculo-cefálico o Head impulse test en la consulta otorrinolaringológica general. Rev. Soc. Otorrinolaringol. Castilla Leon Cantab. La Rioja. 2012;3(32):266-270.
Freeman L, Gera G, Horak FB, Blackinton MT, Besch M, King L. Instrumented Test of Sensory Integration for Balance: A Validation Study. J Geriatr Phys Ther. 2018 Apr/Jun;41(2):77-84.
Whitney SL, Wrisley DM. The influence of footwear on timed balance scores of the modified clinical test of sensory interaction and balance. Arch Phys Med Rehabil. 2004;85(3):439-443.
Bohannon RW, Larkin PA, Cook AC, Gear J, Singer J. Decrease in timed balance test scores with aging. Phys Ther. 1984 Jul;64(7):1067-70.
Benito Orejas JI, Alonso-Vielba J, Valda-Rodrigo J, Cifuentes-Navas VA. Resultados y seguimiento de la rehabilitación vestibular. Rev. ORL. 2020;11(1):107-114.
Vereeck L, Wuyts F, Truijen S, Van de Heyning P. Clinical assessment of balance: normative data, and gender and age effects. Int J Audiol. 2008 Feb;47(2):67-75.
Lin HW, Bhattacharyya N. Balance disorders in the elderly: epidemiology and functional impact. Laryngoscope. 2012 Aug;122(8):1858-61.
Castillo-Bustamante M, Mendilaharzu A, Ricardo MA, Binetti AC. Características epidemiológicas y comorbilidades asociadas en pacientes con migraña vestibular definida en Hospital Británico de Buenos Aires; 2014-2016. Rev. Fed. Argent.
Furman JM, Raz Y, Whitney SL. Geriatric vestibulopathy assessment and management. Curr Opin Otolaryngol Head Neck Surg. 2010;18(5):386-91.
Baloh RW, Jacobson KM, Socotch TM. The effect of aging on visual-vestibuloocular responses. Exp Brain Res. 1993;95(3):509-16.
Serra UM, Meliz JL. Polifarmacia en el adulto mayor. Revista Habanera de Ciencias Médicas. 2013;12(1):142-151.
Dhalwani N, Fahami R, Sathanapally H, Seidu S, Davies MJ, Khunti K. Association between polypharmacy and falls in older adults: a longitudinal study from England. BMJ Open. 2017;7(10):e016358.
Lawson J, Bamiou DE. Dizziness in the older person. Rev Clin Gerontol. 2005;15(3-4):187.
Jacobson GP, Newman CW. The development of the Dizziness Handicap Inventory. Arch Otolaryngol Head Neck Surg. 1990 Apr;116(4):424-7.
