Vestibular rehabilitation in elderly patients with postural instability: reducing the number of falls—a randomized clinical trial
Our previous study had shown the effectiveness of vestibular rehabilitation (VR) in improving balance in elderly patients, assessed immediately afterwards.
The main goal of the present study is to consider whether this improvement in balance assessment turns out in a reduction of the number of falls.
139 elderly patients with high risk of falls were included and randomized to one of the following study arms: computerized dynamic posturography (CDP) training, optokinetic stimulus, exercises at home or control group. Patients were assessed with objective outcome measures (sensorial organization test and limits of stability of CDP, number of falls and number of hospital admissions due to falls) and subjective outcome measures (dizziness handicap inventory and short falls efficacy scale-international) during a 12-month follow-up period.
Average number of falls significantly declined from 10.96 (before VR) to 3.03 (12-month follow-up) in the intervention group (p < 0.001); meanwhile, in the control group, the average number of falls changed from 3.36 to 2.61 during a 12-month follow-up period (p = 0.166).
The present study provides evidence that VR can decisively improve balance in elderly patients with instability, which can lead in turn to a significant reduction of falls.
We recommend performing VR in any older person with high risk of falls.
KeywordsElderly Falls Computerized dynamic posturography Optokinetic Vestibular rehabilitation
This study was funded by the project PI11/01328, integrated into the State Plan for R + D + I 2008–2011 and funded by the ISCIII—Subdirección General de Evaluación y Fomento de la Investigación and the European Regional Development Fund: “Reduction of falls in the elderly by improving balance through vestibular rehabilitation”.
Compliance with ethical standards
Conflict of interest
The authors report no conflicts of interest.
Research involving human participants and/or animals
The study was performed according to the protocol approved by the Independent Ethics Committee of Galicia (Protocol 2010/139).
Signed informed consent was obtained from all participants.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
- 8.McDonell MN, Hillier SL (2015) Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev 1:CD005397Google Scholar
- 22.Nashner LM (2011) Computerized dynamic posturography. In: Goebel JA (ed) Practical management of the dizzy patient. Lippincott Williams & Wilkins, Philadelphia, pp 143–170Google Scholar
- 23.Cawthorne T (1944) The physiological basis for head exercises. J Chart Soc Physiother 30:106Google Scholar
- 27.Semont A, Vitte E, Freyss G (1992) Falls in the elderly: a therapeutic approach by optokinetic reflex stimulations. In: Vellas B, Toupet M, Rubenstein L, Albarède JL, Christen Y (eds) Falls balance and gait disorders in the elderly. Elsevier, Paris, pp 153–159Google Scholar