Posturography in elderly people with vestibular disorder and falls
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Abstract
Introduction: Static and dynamic posturography has been used to investigate the ability of older people with vestibular disorders to maintain balance under varying conflicting sensory conditions. The goal of testing is to quantify the velocity of oscillation and the center of pressure displacement in different conditions of visual, somatosensory and visual-vestibular conflicts, and the limit of stability. Objective: To analyze the literature of the quantitative assessment of postural stability and balance using static and dynamic computerized posturography in elderly patients with vestibular dysfunction. Methods: A research was performed in the databases LILACS, EMBASE, MEDLINE, Scielo, Cochrane, ISI Web of Knowledge and virtual libraries of theses and dissertations in publications of the last 20 years, using the keywords: “elderly”, “Postural Balance”, “Postural Control”, “Assessment”, “Falls”, “Posturography”, “Vestibular” and / or dizziness.” Results: There are several models of computerized posturography that measure the postural responses and the fall risk in older individuals, in different environmental sensory stimuli, including virtual reality technology. Elderly people with imbalance, dizziness, and/or a history of falls have worse performance than elderly with no complaints and no history of falls and younger subjects. Conclusion: The posturography is a valuable tool for quantitative analysis of postural control, and it allows identify the sensory conditions in which the elderly with vestibular disorders have major instability.
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Konrad HR, Girardi M, Helfert R. Balance and Aging. Laryngoscope. 1999;109(9):1454-60. http://dx.doi.org/10.1097/00005537-199909000-00019
Suarez H, Arocena M. Las alteraciones del equilibrio en el adulto mayor. Rev Med Clín Condes. 2009;20(4):401-7.
Horak FB. Clinical assessment of balance disorders. Gait Posture. 1997;6(1):76-84. http://dx.doi.org/10.1016/S0966-6362(97)00018-0
Hageman PA, Leibowitz JM, Blanke D. Age and gender effects on postural control measures. Arch Phys Med Rehabil. 1995;76(10):961-5. http://dx.doi.org/10.1016/S0003-9993(95)80075-1
Keshner EA. Anormalidades posturais nas disfunções vestibulares. In: Herdman SJ. Reabilitação Vestibular. 2a ed. São Paulo: Manole; 2002. p.52-71.
Mochizuki L, Amadio AC. Aspectos biomecânicos da postura ereta: a relação entre centro de massa e o centro de pressão. Rev Port Ciênc Desporto. 2003;3(3):77-83.
Baloh RW, Spain S, Socotch TM, Jacobson KM, Bell T. Posturography and balance problems in older people. J Am Geriatr Soc. 1995;43(6):638-44.
Baloh RW, Jacobson KM, Enrietto JA, Corona S, Honrubia V. Balance disorders in older persons: quantification with posturography. Otolaryngol Head Neck Surg. 1998;119(1):89-92. http://dx.doi.org/10.1016/S0194-5998(98)70177-9
Bittar RSM. Como a posturografia dinâmica computadorizada pode nos ajudar nos casos de tontura? Arq Int Otorrinolaringol. 2007;11(3):330-3.
Cusin FS, Ganança MM, Ganança FF, Ganança CF, Caovilla HH. Balance Rehabilitation Unit (BRU) posturography in Menière's disease. Braz J Otorhinolaryngol. 2010;76(5):611-7. http://dx.doi.org/10.1590/S1808-86942010000500013
Di Fabio RP. Sensitivity and specificity of platform posturography for identifying patients with vestibular dysfunction. Phys Ther. 1995;75(4):290-305.
Di Fabio RP. Meta-analysis of the sensitivity and specificity of platform posturography. Arch Otolaryngol Head Neck Surg. 1996;122(2):150-6. http://dx.doi.org/10.1001/archotol.1996.01890140036008
Pedalini ME, Cruz OL, Bittar RS, Lorenzi MC, Grasel SS. Sensory organization test in elderly patients with and without vestibular dysfunction. Acta Otolaryngol. 2009;129(9):962-5.
Piirtola M, Era P. Force platform measurements as predictors of falls among older people: a review. Gerontology. 2006;52(1):1-16. http://dx.doi.org/10.1159/000089820
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 http://dx.doi.org/10.1016/j.apmr.2005.11.002
Blaszczyk JW, Orawiec R, Duda-Klodowska D, Opala G. Assessment of postural instability in patients with Parkinson's disease. Exp Brain Res. 2007;183(1):107-14.http://dx.doi.org/10.1007/s00221-007-1024-y
Shivitz N, Koop MM, Fahimi J, Heit G, Bronte-Stewart HM. Bilateral subthalamic nucleus deep brain stimulation improves certain aspects of postural control in Parkinson's disease, whereas medication does not. Mov Disord. 2006;21(8):1088-97. http://dx.doi.org/10.1002/mds.20905
Cohen H, Heaton LG, Congdon SL, Jenkins HA. Changes in sensory organization test scores with age. Age Ageing. 1996;25(1):39-44. http://dx.doi.org/10.1093/ageing/25.1.39
Furman JM. Role of posturography in the management of vestibular patients. Otolaryngol Head Neck Surg. 1995;112(1):8-15. http://dx.doi.org/10.1016/S0194-5998(95)70300-4
Baloh RW, Corona S, Jacobson KM, Enrietto JA, Bell T. A prospective study of posturography in normal older people. J Am Geriatr Soc. 1998;46(4):438-43.
Wallmann HW. Comparison of elderly nonfallers and fallers on performance measures of functional reach, sensory organization, and limits of stability. J Gerontol A Biol Sci Med Sci. 2001;56(9):M580-3.
http://dx.doi.org/10.1093/gerona/56.9.M580
Buatois S, Gueguen R, Gauchard GC, Benetos A, Perrin PP. Posturography and Risk of Recurrent Falls in Healthy Non-Institutionalized Persons Aged Over 65. Gerontology. 2006;52(6):345-352. http://dx.doi.org/10.1159/000094983
Ortu-o-Cortés MA, Martín-Sanz E, Barona-de Guzmán R. Static posturography versus clinical tests in elderly people with vestibular pathology. Acta Otorrinolaringol Esp. 2008;59(7):334-40.
Suarez H, Arocena M, Geisinger D, Suarez A, Carrera X. Analysis of the role of virtual reality technology in the assessment and rehabilitation of Instability in the elderly population. In: Vincent ML, Moreau TM. Accidental falls: causes, preventions and interventions. Nova York: Nova Science; 2008. p. 107-20.
Gazzola JM, Doná F, Ganança MM, Suarez H, Ganança FF, Caovilla HH. Realidade virtual na avaliação e reabilitação dos distúrbios vestibulares. Acta ORL. 2009;27(1):22-7.
Suarez H, Musé P, Suarez A, Arocena M. Assessment of the risk of fall, related to visual stimulation, in patients with central vestibular disorders. Acta Otolaryngol. 2001;121(2):220-4. http://dx.doi.org/10.1080/000164801300043587
Gazzola JM. Controle postural de idosos vestibulopatas crônicos com e sem histórico de quedas submetidos à estimulação visual por realidade virtual. Tese [Doutorado]. São Paulo: Universidade Federal de São Paulo; 2010.
Matsumura BA, Ambrose AF. Balance in the Elderly. Clin Geriatr Med. 2006;22(2):395-412. http://dx.doi.org/10.1016/j.cger.2005.12.007
Booth FW, Weeden SH, Tseng BS. Effect of aging on human skeletal muscle. And motor function. Med. Sci. Sports exerc. 1994;26(5):556-60. http://dx.doi.org/10.1249/00005768-199405000-00006
Thornell LE, Lindstrom M, Renault V, Mouly V, Butler Browm GS. Satellite cell and training in the elderly. Scand J Med Sci Sports. 2003;13(1):48-55. http://dx.doi.org/10.1034/j.1600-0838.2003.20285.x
Lewis RF, Zee DS, Goldstein HP, Guthrie BL. Proprioceptive and retinal afference modify postsaccadic ocular drift. J Neurophysiol. 1999;82(2):551-63.
Konrad HR, Girardi M, Helfert R. Balance and Aging. Laryngoscope. 1999;109:1454-60. http://dx.doi.org/10.1097/00005537-199909000-00019
Shepard NT. Evaluation of the patient with dizziness and balance disorders. In: Katz J, Medwetsky L, Burkhart B. Handbook of clinical audiology. 6th ed. Media PA: Williams & Wilkins; 2007.
Nakayama M, Helfert RH, Konrad HR, Caspary DM. Scanning electron microscopic evaluation of age-related changes in the rat vestibular epithelium. Otolaryngol Head Neck Surg. 1994;111(6):799-806. http://dx.doi.org/10.1016/S0194-5998(94)70571-2
Horak FB, Hlavacka F. Somatossensory loss increases vestibulospinal sensitivity. J Neurophysiol. 2001;86(2):575-85.
Gazzola JM, Ganança FF, Aratani MC, Perracini MR, Ganança MM. Clinical evaluation of elderly people with chronic vestibular disorder. Braz J Otorhinolaryngol. 2006;72(4):515-22.
Mitchell PD, Mitchell TN. The age-dependent deterioration in light touch sensation on the plantar aspect of the foot in a rural community in India: implications when screening for sensory impairment. Lepr Rev. 2000;71(2):169-78.
Richardson JK, Ashton-Miller JA. Peripheral neuropathy: an often-overlooked cause of falls in the elderly. Postgrad Med. 1996;99(6):161-72.
Norré ME. Posture in otoneurology. Acta Otorhinolaryngol Belg. 1990;44(2):55-181.
Gassmann KG, Rupprecht R. Dizziness in an older community dwelling population: a multifactorial syndrome. J Nutr Health Aging. 2009;13(3):278-82. http://dx.doi.org/10.1007/s12603-009-0073-2