Routine benign paroxysmal positional vertigo (BPPV) physiotherapy management: a feasibility study

IF 6 2区 医学 Q1 GERIATRICS & GERONTOLOGY
Erin Dale Bicknell, Laura Ferguson, Alisha da Silva, Tiffany Theoharidis, Khyati Gohil, Jennifer Langford, Melissa Clarke, Anne McGann, Wendy Bower
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引用次数: 0

Abstract

Background Benign paroxysmal positional vertigo (BPPV) is common in older adults with a falls history. The feasibility of routine physiotherapy management in subacute inpatients is not known. Objective Examine the feasibility of implementing routine BPPV physiotherapy management in older subacute inpatients and ascertain the proportion BPPV positive. Methods Subacute inpatients aged ≥50 years sustaining a fall within six months were assessed for BPPV. Feasibility was defined as >75% of eligible patients able to be assessed for BPPV. Implementation was also evaluated through surveys completed by study physiotherapists. Demographic, falls, medical history, frailty, functional mobility information and modified dizziness handicap inventory (DHI) versions were also collected. Results Overall, 67% of 447 eligible patients underwent BPPV assessment; 301 completed ≥ one BPPV assessment, 146 could not be assessed, most commonly due to physical limitation, cognition precluding assessment, declining assessment or discharged prior. Physiotherapists perceived BPPV management to be acceptable (88%), appropriate (90%) and feasible (76%) however constrained by patient-factors, time required and environmental barriers. BPPV was found in 6% of those assessed, with 35% reporting current dizziness or unsteadiness. Modified DHI scores were significantly higher in those BPPV positive (5-item P ≤ .001; 8-item P = .001). Conclusion BPPV management was not feasible in this population predominantly due to physical limitations and cognitive impairment. Physiotherapists perceive BPPV management as important but difficult amongst these patient-factors and competing clinical priorities. Subjective symptoms may not indicate BPPV risk, however, the 5-item DHI may identify need for individual assessment.
常规良性阵发性位置性眩晕(BPPV)物理治疗管理的可行性研究
背景:良性阵发性位置性眩晕(BPPV)常见于有跌倒史的老年人。亚急性住院患者常规物理治疗管理的可行性尚不清楚。目的探讨老年亚急性住院患者BPPV常规物理治疗管理的可行性,确定BPPV阳性比例。方法对6个月内跌倒的≥50岁住院亚急性患者进行BPPV评估。可行性定义为75%的符合条件的患者能够评估BPPV。实施情况也通过研究物理治疗师完成的调查进行评估。还收集了人口统计、跌倒、病史、虚弱、功能活动信息和改进的头晕障碍量表(DHI)版本。总体而言,447名符合条件的患者中有67%接受了BPPV评估;301例完成了≥1次BPPV评估,146例无法评估,最常见的原因是身体限制、认知排除评估、评估下降或先前出院。物理治疗师认为BPPV管理是可接受的(88%),适当的(90%)和可行的(76%),但受到患者因素,所需时间和环境障碍的限制。6%的被评估者出现BPPV, 35%的人报告当前头晕或不稳定。BPPV阳性患者改良DHI得分显著高于对照组(5项P≤0.001;8项P = .001)。结论BPPV治疗在该人群中不可行,主要是由于身体限制和认知障碍。物理治疗师认为BPPV管理是重要的,但在这些患者因素和相互竞争的临床优先事项中是困难的。主观症状可能并不表明BPPV风险,然而,5项DHI可能确定需要进行个人评估。
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来源期刊
Age and ageing
Age and ageing 医学-老年医学
CiteScore
9.20
自引率
6.00%
发文量
796
审稿时长
4-8 weeks
期刊介绍: Age and Ageing is an international journal publishing refereed original articles and commissioned reviews on geriatric medicine and gerontology. Its range includes research on ageing and clinical, epidemiological, and psychological aspects of later life.
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