Prognostic factors that modify outcomes of vestibular rehabilitation in elderly patients with falls

Abstract

Background

Our previous study has shown that vestibular rehabilitation (VR) is an effective technique to reduce falls in elderly patients. It would be interesting to establish patients’ clinical characteristics in which vestibular rehabilitation is expected to be more effective.

Aims

Evaluate factors that could modify rehabilitation outcomes in elderly patients with previous falls.

Methods

Fifty-seven patients randomized to one of the intervention group (computerized dynamic posturography—CDP—training, optokinetic stimulus or exercise at home) and with previous falls were analyzed. Patients were assessed with objective outcome measures (sensorial organization test and limits of stability—LOS—of CDP, modified timed up and go test—TUG—and number of falls) and with subjective outcome measures (dizziness handicap inventory and Short falls efficacy scale-international—Short FES-I) during a 12-month follow-up period.

Results

In the logistic regression model, a worse score in the maximum excursion (MXM), and a shorter time in the TUG significantly associated with a reduction > 50% of falls. Also, association with a higher score in the Short FES-I was close to a statistical significance. There was no statistical significance association with other covariables.

Discussion

In patients with reduced limits of stability, VR seems to be more effective and they should be encouraged to perform it. But on the other hand, patients with longer time in the TUG show worse outcomes and may benefit more with gait training.

Conclusions

VR in elderly people with previous falls is effective regardless of their age and gender.

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Acknowledgements

We would like to thank Andrés Blanco Hortas (Fundación Instituto de Investigación Sanitaria de Santiago de Compostela) for his statistical expertise.

Funding

This study was funded by the project PI11/01328, integrated into the State Plan for R + D + I 2008–2011 and funded by the ISCIIISubdirección 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”.

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Correspondence to Marcos Rossi-Izquierdo.

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The study was performed according to the protocol approved by the Independent Ethics Committee of Galicia (Protocol 2010/139).

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Signed informed consent was obtained from all the participants.

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Rossi-Izquierdo, M., Gayoso-Diz, P., Santos-Pérez, S. et al. Prognostic factors that modify outcomes of vestibular rehabilitation in elderly patients with falls. Aging Clin Exp Res 32, 223–228 (2020). https://doi.org/10.1007/s40520-019-01185-8

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Keywords

  • Vestibular rehabilitation
  • Outcomes
  • Prognostic factor
  • Falls
  • Elderly