Reducing Rate of Falls in Older People by Means of Vestibular Rehabilitation: Preliminary Study

Reducing Rate of Falls in Older People With the Improvement of Balance by Means of Vestibular Rehabilitation: Preliminary Study

The aim of this study is to evaluate the effectiveness of vestibular rehabilitation to improve the balance in older people and reduce the number of falls, comparing three arms with different vestibular rehabilitation strategies (dynamic posturography exercises, optokinetic stimuli and exercises at home) and a control group.

Vestibular rehabilitation has been shown to be effective in compensating patients with residual instability as a result of vestibular system disorders or Parkinson's disease. It is also useful for treating lack of balance in the elderly (presbivertigo). However, there is no systematic, controlled and prospective analysis of whether vestibular rehabilitation is effective in reducing the number of falls in the elderly, or whether its effects in this age group are temporary or persist over time.

This study compare vestibular rehabilitation with three different strategies (dynamic posturography exercises, optokinetic stimuli and exercises at home) and a control group, in people over 65 years. Balance tests are performed before vestibular rehabilitation and three weeks, six months and one year after it. Number of falls are quantified one year after vestibular rehabilitation.

Inclusion Criteria:

Persons with a high risk of falling shall meet at least one of the following requirements:

• Having fallen at least once in the last 12 months.
• Using more than 15 seconds or needing support in the TUG test (normal limit calculated in previous studies).
• Obtaining a mean CDP SOT balance score of < 68% (normal limit calculated in previous studies).
• Having fallen at least once in the CDP SOT.

Exclusion Criteria:

• Cognitive decline that prevents the patient from understanding the examinations and vestibular rehabilitation exercises.
• Organic conditions that prevent standing on two feet, necessary for assessment of balance and performance of vestibular rehabilitation exercises.
• Balance disorders caused by conditions other than age (neurologic, vestibular...).
• Reduced cultural level that prevents the patient from understanding the examinations and from granting informed consent.