OBJECTIVE: To determine the effect of vestibular rehabilitation on reduction of fall risk in individuals with unilateral vestibular hypofunction and to identify those factors that predict fall risk reduction. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary referral center. PATIENTS: Forty-seven patients with unilateral vestibular hypofunction, aged 28 to 86 years, who were at risk for falls on initial assessment. INTERVENTION: All patients underwent vestibular rehabilitation including adaptation exercises, designed to improve gaze stability, and gait and balance exercises. MAIN OUTCOME MEASURES: Fall risk (Dynamic Gait Index), visual acuity during head movements (Dynamic Visual Acuity), and subjective complaints were measured initially, at 2-week intervals, and at completion of physical therapy. RESULTS: As a group, the patients had significantly reduced risk for falls (p <0.001) after rehabilitation. Time from onset of symptoms did not affect the efficacy of vestibular rehabilitation. Both older (> or = 65 yr) and younger (< 65 yr) adults showed significant reductions in fall risk with vestibular rehabilitation (p <0.001). However, a significantly greater proportion (Chi2= 0.016) of older adults remained at risk for falls at discharge compared with young adults (45% versus 11%). Initial Dynamic Gait Index and Dynamic Visual Acuity scores predicted fall risk reduction in patients with unilateral vestibular hypofunction. A model was developed using initial Dynamic Gait Index and Dynamic Visual Acuity scores to predict fall risk reduction. CONCLUSIONS: Vestibular rehabilitation is effective in significantly reducing fall risk in individuals with unilateral vestibular deficit. The model predicts fall risk reduction with good sensitivity (77%) and specificity (90%).
OBJECTIVE: To determine the effect of vestibular rehabilitation on reduction of fall risk in individuals with unilateral vestibular hypofunction and to identify those factors that predict fall risk reduction. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary referral center. PATIENTS: Forty-seven patients with unilateral vestibular hypofunction, aged 28 to 86 years, who were at risk for falls on initial assessment. INTERVENTION: All patients underwent vestibular rehabilitation including adaptation exercises, designed to improve gaze stability, and gait and balance exercises. MAIN OUTCOME MEASURES: Fall risk (Dynamic Gait Index), visual acuity during head movements (Dynamic Visual Acuity), and subjective complaints were measured initially, at 2-week intervals, and at completion of physical therapy. RESULTS: As a group, the patients had significantly reduced risk for falls (p <0.001) after rehabilitation. Time from onset of symptoms did not affect the efficacy of vestibular rehabilitation. Both older (> or = 65 yr) and younger (< 65 yr) adults showed significant reductions in fall risk with vestibular rehabilitation (p <0.001). However, a significantly greater proportion (Chi2= 0.016) of older adults remained at risk for falls at discharge compared with young adults (45% versus 11%). Initial Dynamic Gait Index and Dynamic Visual Acuity scores predicted fall risk reduction in patients with unilateral vestibular hypofunction. A model was developed using initial Dynamic Gait Index and Dynamic Visual Acuity scores to predict fall risk reduction. CONCLUSIONS: Vestibular rehabilitation is effective in significantly reducing fall risk in individuals with unilateral vestibular deficit. The model predicts fall risk reduction with good sensitivity (77%) and specificity (90%).
Authors: Courtney D Hall; Susan J Herdman; Susan L Whitney; Stephen P Cass; Richard A Clendaniel; Terry D Fife; Joseph M Furman; Thomas S D Getchius; Joel A Goebel; Neil T Shepard; Sheelah N Woodhouse Journal: J Neurol Phys Ther Date: 2016-04 Impact factor: 3.649
Authors: Khalid A Alahmari; Patrick J Sparto; Gregory F Marchetti; Mark S Redfern; Joseph M Furman; Susan L Whitney Journal: IEEE Trans Neural Syst Rehabil Eng Date: 2014-03 Impact factor: 3.802
Authors: Bara A Alsalaheen; Susan L Whitney; Gregory F Marchetti; Joseph M Furman; Anthony P Kontos; Michael W Collins; Patrick J Sparto Journal: Pediatr Phys Ther Date: 2014 Impact factor: 3.049