Disequilibrium of Aging: Response to a 3-Month Program of Vestibular Therapy

ABSTRACT

Objective: To determine if vestibular therapy can be used to decrease falls, decrease vertigo, and increase safety in the elderly. Method: One hundred community-dwelling elderly (mean age 79) patients with disequilibrium of the aging (elders with disequilibrium, unsteadiness, and risks for falls due to degeneration of sensory or motor systems for balance) (note that disequilibrium of the aging is a typical term used by otologists and neurologists as a diagnostic category; references for this description are noted in the Introduction of this article) were tested before and after vestibular therapy on Romberg clinical tests of balance, vestibular ocular motor tests using infrared video goggles, and Dix–Hallpike tests for positional vertigo. Vestibular therapy interventions were balance retraining, ocular motor exercises, and repositioning or redistribution techniques. Results: Following 3 months of vestibular therapy interventions and at 3 months following discharge from vestibular therapy, there was an 80% reduction of falls. A fall was defined as a total loss of balance with a drop to the floor, without loss of consciousness. Initially, 56 of the 100 participants had reported falls in the 6 months prior to their first visit to our clinic, with only 11 of these 56 reporting falls at 3 months following intervention. Benign paroxysmal positional vertigo (BPPV) had abated in 90% as measured by negative Dix–Hallpike tests, as 91 of the 100 participants initially had BPPV, all but 9 normalized through treatment. Romberg clinical tests of balance had normalized in 71% (78 of the 100 had positive Romberg initially, and 55 of the 78 had negative responses at 3 months).Conclusions: Interventions of vestibular therapy can result in decreased vertigo and decreased risks for falls in the elderly.

KEYWORDS. :

• Vertigo
• imbalance
• falls
• safety
• elderly
• therapy