Califano Luigi, Cangiano Iacopo, Nobile Alessandro, Teggi Roberto
Department of audiology and phoniatrics, San Pio Hospital, Benevento, Italy.
Otorhinolaryngology affiliationision, IRCCS San Raffaele Scientific Institute, Milano, Italy.
Eur Arch Otorhinolaryngol. 2025 Jan 30. doi: 10.1007/s00405-025-09234-x.
Balance problems in the elderly are a major social concern, primarily due to the risk of falls. One of the reasons of fast worsening of stability and therefore falling is represented by acute BPPV. Treatment through repositioning maneuvers could significantly reduce the risk of further falls of the patients treated with. The physical ability of older individuals to be treated with maneuvers is a topic of debate due to possible joint stiffness and less compliance with movements. There are few previous studies focusing on the practicality and effectiveness of physical therapy for BPPV in people over 80 years.
We conducted a retrospective study collecting data on 517 patients to assess the feasibility, effectiveness, safety and the number of therapeutic maneuvers necessary to get therapeutic success when treating individuals over 80 years compared to those aged between 18 and 64.
We found no difference in terms of number of maneuvers needed to get therapeutic success between the two groups. As for the therapeutic maneuver no difference in success and feasibility of execution was found between Semont and Epley maneuvers which proved equally effective in the two groups.
Our data are not inconsistent with the hypothesis that repositioning maneuvers for posterior canal BPPV are feasible and demonstrated a good efficacy in all elderly people. This could encourage the diagnosis and treatment of BPPV also for the purpose of reducing the risk of falls in the elderly.
老年人的平衡问题是一个主要的社会关注点,主要是因为存在跌倒风险。急性耳石症是导致稳定性迅速恶化进而跌倒的原因之一。通过复位手法进行治疗可显著降低接受治疗患者再次跌倒的风险。由于可能存在关节僵硬以及对动作的依从性较差,老年人接受手法治疗的身体能力是一个有争议的话题。此前很少有研究关注80岁以上人群耳石症物理治疗的实用性和有效性。
我们进行了一项回顾性研究,收集了517例患者的数据,以评估与18至64岁的患者相比,治疗80岁以上个体时治疗成功所需手法的可行性、有效性、安全性及数量。
我们发现两组在治疗成功所需手法数量方面没有差异。至于治疗手法,在Semont手法和Epley手法之间,未发现成功和执行可行性方面的差异,这两种手法在两组中均证明同样有效。
我们的数据与以下假设并不矛盾,即后半规管耳石症的复位手法是可行的,并且在所有老年人中都显示出良好的疗效。这可能会鼓励对耳石症进行诊断和治疗,以降低老年人跌倒的风险。