Caídas en ancianos con vestibulopatíavaloración clínica vs. instrumental

  1. Ortuño Cortés, Miguel Angel
  2. Barona de Guzmán, Rafael
  3. Martín Sanz, Eduardo
  4. Quinzá Valero, Vicente
Revue:
Therapeía: estudios y propuestas en ciencias de la salud

ISSN: 1889-6111 2660-4264

Année de publication: 2010

Número: 2

Pages: 79-90

Type: Article

D'autres publications dans: Therapeía: estudios y propuestas en ciencias de la salud

Résumé

Introduction-Objectives. We analyze the importance of a sample of clinical tests of balance and the static posturography (SP) in the valuation of the number of falls in elders with and vithout vestibular disorders. Material and method. 120 elders from 65 to 80 years old were studied (60 with vestibular disorders and 60 as controls). We included the number of falls suffered during the previous year to the study. They did 4 clinical tests (one leg standing with opened eyes, Timed Up and Go test, Tinetti Test and Berg Test) and a SP with the NedSVE/IBV system, including four conditions: Opened Eyes Romberg (OER), Closed Eyes (CER), on Foam Opened Eyes (FOR) and on Foam Closed Eyes (FCR). Results. The patients suffered more number of falls than the control group subjects (p = .006). The only parameter of the SP that related to the number of falls was the Maximum Anteroposterior Displacement in the OER condition (CP = .159; p = .034). Clinical tests were correlated by the number of falls of the sample. Berg test got the best correlation (CP = –.327; p = .000). Conclusions. Elders with vestibular disorders had significantly more number of falls than the control group subjects. There weren’t differences among the clinical subgroups. The clinical tests got major value than the SP in the valuation of the number of falls of the studied sample.

Références bibliographiques

  • Salvá A, Bolivar I, Pera G, Arias C. Incidencia y consecuencias de las caídas en la población anciana viviendo en la comunidad. Med Clin. Barcelona; 2004; 122: 172-6.
  • Barona de Guzmán R. Interés de la posturografía en el diagnóstico y tratamiento del vértigo y el desequilibrio en especialidades médico-quirúrgicas. Rev Biomecánica; febrero del 2003: 11-14.
  • Vellas BJ, Wayne L, Romero L, Baumgartner RN, Rubinstein LZ, Garry PJ. One leg balance is an important predictor of injurious fall in older persons. J Am Geriatr Soc 1997; 45: 735-738.
  • Podsialo D, Richardson S. The Timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991; 39: 142-8.
  • Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc 1986; 34: 119-26.
  • Berg K, Wood-Dauphinée S, Williams JI, Gayton D. Measuring balance in the elderly: preliminary development of an instrument. Physiotheraphy Canada 1989; 41: 304-11.
  • Baydal-Bertomeu JM, Barberá-Guillem R, Soler-Gracia C, Peydró de Moya MF, Prat JM, Barona de Guzmán R. Determinación de los patrones de comportamiento postural en población sana española. Acta Otorrinolaringol Esp 2004; 55: 260-9.
  • Lázaro M, Cuesta F, León A, Sánchez C, Feijoo R, Montiel M et al. Valor de la posturografía en ancianos con caídas de repetición. Med Clin 2005; 124 (6): 207-10.
  • Herdman SJ, Blatt P, Schubert MC, Tusa RJ. Falls in patients with vestibular deficits. Am J Otol 2000; 21: 847-51.
  • Campbell AJ, Borrie MJ, Spears GF, Jackson SL, Brown JS, Fitzgerald LJ. Circumstances and consequences of falls experienced by a community population 70 years and over during a prospective study. Age Ageing 1990; 19: 136-41.
  • Baloh RW, Corona S, Jacobson KM, Enrietto JA, Bell T. A prospective study of posturography in normal older people. J Am Geriatr Soc 1998 Apr; 46 (4): 438-43.
  • Brauer SG, Burns YR, Galley P. A prospective study of laboratory and clinical measures of postural stability to predict community-dwelling fallers. J Gerontol A Biol Sci Med Sci 2000 Aug; 55 (8): M469-76.
  • Maki BE, Holliday PJ, Topper AK. A prospective study of postural balance and risk of falling in an ambulatory and independent elderly population. J Gerontol 1994; 49: M72-84.
  • Melzer I, Benjuya N, Kaplanski J. Postural stability in te elderly: a comparison between fallers and non-fallers. Age Ageing 2004 Nov; 33 (6): 602-7.
  • Topper AK, Maki BE, Holliday PJ. Are activity-based assessments of balance and gait in the elderly predictive of risk of falling and/or type of fall? J Am Geriatr Soc 1993; 41: 479-87.
  • Whitney SL, Marchetti GF, Schade AI. The relationship between falls history and computerized dynamic posturography in persons with balance and vestibular disorders. Arch Phys Med Rehabil 2006; 87 (3): 402-7.
  • Nevitt MC, Cummings SR, Kidd S. Risk factors for recurrent nonsyncopal falls. A prospective study. JAMA 1989; 261: 2663-8.
  • Vaillant J, Martigne P, Vuillerme N, Caillat-Miousse JL, Parisot J, Juvin R et al. Modification des performances au “Timed-up and Go” test et à l’appui monopodal par l’addition d’une charge cognitive: valeur discriminative des résultats. Ann Readapt Med Phys 2006 Feb; 49 (1): 1-7.
  • Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go test. Phys Ther 2000; 80 (9): 896-903.
  • Thomas JI, Lane JV. A pilot study to explore the predictive validity of 4 measures of falls risk in frail elderly patients. Arch Phys Med Rehabil 2005 Aug; 86(8): 1636-40.
  • Whitney JC, Lord SR, Close JC. Streamlining assessment and intervention in a fall clinic using the Timed Up and Go Test and Physiological Profile Assessments. Age Ageing 2005 Nov; 34 (6): 567-71.
  • Cohen HS, Kimball KT. Decreased ataxia and improved balance after vestibular rehabilitation. Otolaryngol Head Neck Surg 2004 Apr; 130 (4): 418-25.
  • Rey-Martínez JA, Boleas-Aguirre MS, Pérez Fernández N. Análisis postural de la prueba “Timed-up-and-go” en pacientes con vértigo. Acta Otorrinolaringol Esp 2005; 56: 107-11.
  • Whitney SL, Marchetti GF, Schade A, Wrisley DM. The sensitivity and specificity of the Timed “Up & Go” and the Dynamis Gait Index for self-reported falls in persons with vestibular disorders. J Vest Res 2004; 14(5): 397-409.
  • Bergland A, Jarnlo GB, Laake K. Predictors of falls in the elderly by location. Aging Clin Exp Res 2003 Feb; 15 (1): 43-50.
  • Tinetti ME, Williams TF, Mayewski R. Fall risk index for elderly patients based on number of chronic disabilities. Am J Med 1986; 80: 429-34.
  • Montero-Odasso M, Schapira M, Duque G, Soriano ER, Kaplan R, Camera LA. Gait disorders are associated with non-cardiovascular falls in elderly people: a preliminary study. BMC Geriatr 2005 Dec 1; 5: 15.
  • Raiche M, Hebert R, Prince F, Corriveau H. Screening older adults at risk of falling with the Tinetti balance scale. Lancet 2000 Sep 16; 356 (9234): 1001-2.
  • Vasallo M, Stockdale R, Sharma JC, Briggs R, Allen S. A comparative study of the use of four fall risk assessment tools on acute medical wards. J Am Geriatr Soc 2005 Jun; 53 (6): 1034-8.
  • Neira Álvarez M, Rodríguez-Mañas L. Caídas repetidas en el medio residencial. Rev Esp Geriatr Gerontol 2006; 43(4): 201-6.
  • Baloh RW, Ying SH, Jacobson KM. A longitudinal study of gait and balance dysfuntion in normal older people. Arch Neurol 2003; 60 (6): 835-9.
  • Laughton CA, Slavin M, Katdare K, Nolan L, Bean JF, Kerrigan DC et al. Aging, muscle activity and balance control: physiologic changes associated with balance impairment. Gait and Posture 2003; 18: 101-108.
  • Pérennou D, Decavel P, Manckoundia P, Penven Y, Mourey F, Launay F et al. Evaluation de l’équilibre en pathologie neurologique et gériatrique. Ann Readapt Med Phys 2005; 48: 317-335.
  • Lajoie Y, Gallagher SP. Predicting falls within the elderly community: comparison of postural sway, reaction time, the Berg balance scale and the Activities-specific Balance Confidence (ABC) scale for comparing fallers and non-fallers. Arch Gerontol Geriatr 2004; 38 (1): 11-26.
  • Riddle DL, Stratford PW. Interpreting validity indexes for diagnostic tests: an illustration using the Berg Balance Tes. Phys Ther 1999; 79: 939-48.