Bicknell Erin Dale, Ferguson Laura, da Silva Alisha, Theoharidis Tiffany, Gohil Khyati, Langford Jennifer, Clarke Melissa, McGann Anne, Bower Wendy
The Royal Melbourne Hospital-Physiotherapy Department, Parkville, Victoria, Australia.
The Royal Melbourne Hospital-Subacute Ambulatory Care Services, Royal Park Campus, Parkville, Victoria, Australia.
Age Ageing. 2025 Mar 3;54(3). doi: 10.1093/ageing/afaf039.
Benign paroxysmal positional vertigo (BPPV) is common in older adults with a falls history. The feasibility of routine physiotherapy management in subacute inpatients is not known.
Examine the feasibility of implementing routine BPPV physiotherapy management in older subacute inpatients and ascertain the proportion BPPV positive.
Subacute inpatients aged ≥50 years sustaining a fall within six months were assessed for BPPV. Feasibility was defined as >75% of eligible patients able to be assessed for BPPV. Implementation was also evaluated through surveys completed by study physiotherapists. Demographic, falls, medical history, frailty, functional mobility information and modified dizziness handicap inventory (DHI) versions were also collected.
Overall, 67% of 447 eligible patients underwent BPPV assessment; 301 completed ≥ one BPPV assessment, 146 could not be assessed, most commonly due to physical limitation, cognition precluding assessment, declining assessment or discharged prior. Physiotherapists perceived BPPV management to be acceptable (88%), appropriate (90%) and feasible (76%) however constrained by patient-factors, time required and environmental barriers. BPPV was found in 6% of those assessed, with 35% reporting current dizziness or unsteadiness. Modified DHI scores were significantly higher in those BPPV positive (5-item P ≤ .001; 8-item P = .001).
BPPV management was not feasible in this population predominantly due to physical limitations and cognitive impairment. Physiotherapists perceive BPPV management as important but difficult amongst these patient-factors and competing clinical priorities. Subjective symptoms may not indicate BPPV risk, however, the 5-item DHI may identify need for individual assessment.
良性阵发性位置性眩晕（BPPV）在有跌倒史的老年人中很常见。亚急性住院患者进行常规物理治疗管理的可行性尚不清楚。
研究对老年亚急性住院患者实施常规BPPV物理治疗管理的可行性，并确定BPPV阳性的比例。
对年龄≥50岁、在6个月内有跌倒史的亚急性住院患者进行BPPV评估。可行性定义为>75%的符合条件患者能够接受BPPV评估。还通过研究物理治疗师完成的调查对实施情况进行了评估。同时收集了人口统计学、跌倒情况、病史、虚弱程度、功能活动信息以及改良头晕残障量表（DHI）版本。
总体而言，447名符合条件的患者中有67%接受了BPPV评估；301名完成了≥1次BPPV评估，146名无法进行评估，最常见的原因是身体受限、认知障碍无法评估、拒绝评估或提前出院。物理治疗师认为BPPV管理是可接受的（88%）、合适的（90%）和可行的（76%），但受到患者因素、所需时间和环境障碍的限制。在接受评估的患者中，6%被发现患有BPPV，35%报告有当前头晕或不稳症状。BPPV阳性患者的改良DHI评分显著更高（5项P≤0.001；8项P = 0.001）。
在这一人群中，BPPV管理不可行，主要原因是身体受限和认知障碍。物理治疗师认为BPPV管理很重要，但在这些患者因素和相互竞争的临床优先事项中实施困难。主观症状可能并不表明存在BPPV风险，然而，5项DHI可能有助于确定个体评估的需求。
