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Adherence of older people with instability in vestibular rehabilitation programmes: prediction criteria

Published online by Cambridge University Press:  16 January 2017

A Soto-Varela*
Affiliation:
Division of Neurotology, Department of Otorhinolaryngology, Complexo Hospitalario Universitario, Santiago de Compostela, Spain Department of Dermatology and Otorhinolaryngology, University of Santiago de Compostela, Spain
A Faraldo-García
Affiliation:
Department of Otorhinolaryngology, Complexo Hospitalario Universitario, Santiago de Compostela, Spain
M Del-Río-Valeiras
Affiliation:
Department of Otorhinolaryngology, Complexo Hospitalario Universitario, Santiago de Compostela, Spain
M Rossi-Izquierdo
Affiliation:
Department of Otorhinolaryngology, University Hospital Lucus Augusti, Lugo, Spain
I Vaamonde-Sánchez-Andrade
Affiliation:
Department of Otorhinolaryngology, Complexo Hospitalario Universitario, Santiago de Compostela, Spain
P Gayoso-Diz
Affiliation:
Clinical Epidemiology Unit, Complexo Hospitalario Universitario, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain
A Lirola-Delgado
Affiliation:
Department of Otorhinolaryngology, Complexo Hospitalario Universitario, Santiago de Compostela, Spain
S Santos-Pérez
Affiliation:
Division of Neurotology, Department of Otorhinolaryngology, Complexo Hospitalario Universitario, Santiago de Compostela, Spain Department of Dermatology and Otorhinolaryngology, University of Santiago de Compostela, Spain
*
Address for correspondence: Dr Andrés Soto-Varela, Department of Otorhinolaryngology, Complexo Hospitario Universitario de Santiago, Travesía da Choupana, s/n. Postal Code: 15706, Santiago de Compostela, Spain Fax: 00 34 981 950 454 E-mail: andres.soto@usc.es

Abstract

Objective:

To determine whether demographic characteristics or balance examination findings can predict the adherence of older people with instability to a vestibular rehabilitation programme.

Methods:

A prospective case–control study was conducted of 120 patients aged 65 years or more (mean age, 77.3 ± 6.33 years). Two groups were classified according to patients’ adherence with the follow-up post-rehabilitation protocol. Analysed variables included: age, sex, body mass index, Timed Up and Go test findings, computerised dynamic posturography, Dizziness Handicap Inventory scores and Short Falls Efficacy Scale – International questionnaire results, number of falls, and type of vestibular rehabilitation.

Results:

Two groups were established: adherents (99 individuals) and non-adherents (21 individuals). There were differences between the groups regarding: sex (female-to-male ratio of 4.8:1 in adherents and 1.63:1 in non-adherents), age (higher in non-adherents) and voluntary movement posturographic test results (non-adherents had poorer scores).

Conclusion:

The patients most likely to abandon a vestibular rehabilitation programme are very elderly males with low scores for centre of gravity balancing and limits of stability.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2017 

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References

1 Black, FO, Angel, CR, Pesznecker, SC, Gianna, C. Outcome analysis of individualized vestibular rehabilitation protocols. Am J Otol 2000;21:543–51Google Scholar
2 Cohen, HS, Kimball, KT. Increased independence and decreased vertigo after vestibular rehabilitation. Otolaryngol Head Neck Surg 2003;128:6070 Google Scholar
3 Rossi-Izquierdo, M, Santos-Pérez, S, Soto-Varela, A. What is the most effective vestibular rehabilitation technique in patients with unilateral peripheral vestibular disorders? Eur Arch Otorhinolaryngol 2011;268:1569–74Google Scholar
4 McDonnell, MN, Hillier, SL. Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev 2015;(1):CD005397 Google Scholar
5 Rossi-Izquierdo, M, Soto-Varela, A, Santos-Pérez, S, Sesar-Ignacio, A, Labella-Caballero, T. Vestibular rehabilitation with computerised dynamic posturography in patients with Parkinson's disease: improving balance impairment. Disabil Rehabil 2009;31:1907–16CrossRefGoogle ScholarPubMed
6 Rossi-Izquierdo, M, Ernst, A, Soto-Varela, A, Santos-Pérez, S, Faraldo-García, A, Sesar-Ignacio, A et al. Vibrotactile neurofeedback balance training in patients with Parkinson's disease: reducing the number of falls. Gait Posture 2013;37:195200 Google Scholar
7 Kao, CL, Chen, LK, Chern, CM, Hsu, LC, Chen, CC, Hwang, SJ. Rehabilitation outcome in home-based versus supervised exercise programs for chronically dizzy patients. Arch Gerontol Geriatr 2010;51:264–7Google Scholar
8 Kristinsdottir, EK, Baldursdottir, B. Effect of multi-sensory balance training for unsteady elderly people: pilot study of the “Reykjavik model.” Disabil Rehabil 2014;36:1211–18Google Scholar
9 Johansson, M, Akerlund, D, Larsen, HC, Andersson, G. Randomized controlled trial of vestibular rehabilitation combined with cognitive-behavioral therapy for dizziness in older people. Otolaryngol Head Neck Surg 2001;125:151–6Google Scholar
10 Kammerlind, AS, Håkansson, JK, Skogsberg, MC. Effects of balance training in elderly people with nonperipheral vertigo and unsteadiness. Clin Rehabil 2001;15:463–70Google Scholar
11 Yardley, L, Kirby, S. Evaluation of booklet-based self-management of symptoms in Ménière disease: a randomized controlled trial. Psychosom Med 2006;68:762–9Google Scholar
12 Geraghty, AW, Kirby, S, Essery, R, Little, P, Bronstein, A, Turner, D et al. Internet-based vestibular rehabilitation for adults aged 50 years and over: a protocol for a randomised controlled trial. BMJ Open 2014;4:e005871 Google Scholar
13 Ricci, NA, Aratani, MC, Caovilla, HH, Ganança, FF. Challenges in conducting a randomized clinical trial of older people with chronic dizziness: before, during and after vestibular rehabilitation. Contemp Clin Trials 2015;40:2634 Google Scholar
14 Yardley, L, Barker, F, Muller, I, Turner, D, Kirby, S, Mullee, M et al. Clinical and cost effectiveness of booklet based vestibular rehabilitation for chronic dizziness in primary care: single blind, parallel group, pragmatic, randomised controlled trial. BMJ 2012;344:e2237 Google Scholar
15 Schlenk, EA, Ross, D, Stilley, CS, Dunbar-Jacob, J, Olshansky, E. Research participation among older adults with mobility limitation. Clin Nurs Res 2009;18:348–69Google Scholar
16 Soto-Varela, A, Gayoso-Diz, P, Rossi-Izquierdo, M, Faraldo-García, A, Vaamonde-Sánchez-Andrade, I, del-Río-Valeiras, M et al. Reduction of falls in older people by improving balance with vestibular rehabilitation (ReFOVeRe study): design and methods. Aging Clin Exp Res 2015;27:841–8Google Scholar
17 Pérez, N, Garmendia, I, Martín, E, García-Tapia, R. Cultural adaptation of 2 questionnaires for health measurement in patients with vertigo [in Spanish]. Acta Otorrinolaringol Esp 2000;51:572–80Google Scholar
18 Kempen, GI, Yardley, L, van Haastregt, JC, Zijlstra, GA, Beyer, N, Hauer, K et al. The Short FES-I: a shortened version of the falls efficacy scale-international to assess fear of falling. Age Ageing 2008;37:4550 Google Scholar
19 Brassington, GS, Atienza, AA, Perczek, RE, DiLorenzo, TM, King, AC. Intervention-related cognitive versus social mediators of exercise adherence in the elderly. Am J Prev Med 2002;23:80–6Google Scholar
20 Cassidy, EL, Baird, E, Sheikh, JI. Recruitment and retention of elderly patients in clinical trials: issues and strategies. Am J Geriatr Psychiatry 2001;9:136–40Google Scholar
21 Soto-Varela, A, Faraldo-García, A, Rossi-Izquierdo, M, Lirola-Delgado, A, Vaamonde-Sánchez-Andrade, I, del-Río-Valeiras, M et al. Can we predict the risk of falls in elderly patients with instability? Auris Nasus Larynx 2015;42:814 Google Scholar