Department of Otolaryngology, University Hospital Lucus Augusti, Calle Dr. Ulises Romero, 1, 27003, Lugo, Spain.
Clinical Epidemiology Unit, Hospital Clínico Universitario, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain.
Aging Clin Exp Res. 2018 Nov;30(11):1353-1361. doi: 10.1007/s40520-018-1003-0. Epub 2018 Jul 14.
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.
我们之前的研究表明，前庭康复（VR）在改善老年人平衡方面是有效的，并且在治疗后即刻即可评估。
本研究的主要目的是考虑这种平衡评估的改善是否会导致跌倒次数的减少。
纳入了 139 名有高跌倒风险的老年患者，并将其随机分为以下研究组之一：计算机动态姿势描记术（CDP）训练、视动刺激、家庭运动或对照组。在 12 个月的随访期间，通过客观的结果测量（感觉组织测试和 CDP 的稳定性极限、跌倒次数和因跌倒而住院的次数）和主观的结果测量（头晕障碍量表和短距离跌倒效能国际量表）评估患者。
干预组的平均跌倒次数从 VR 前的 10.96 次显著下降到 12 个月随访时的 3.03 次（p<0.001）；而对照组的平均跌倒次数从 3.36 次下降到 12 个月随访时的 2.61 次（p=0.166）。
本研究提供了证据表明 VR 可以显著改善不稳定老年人的平衡，这反过来又可以显著减少跌倒。
我们建议对有高跌倒风险的老年人进行 VR。
