Effects of using cane and vestibular rehabilitation on the walking function in elderly patients with dizziness |
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| Authors: | Akihiro Ohara Miyamoto Yasuhiro Fumihiro Mochizuki Tatsuya Shinohe Yoshiyuki Sasano Kaori Suzuki Koshi Mikami Izumi Koizuka |
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| Affiliation: | 1. Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan;2. Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan;3. Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan;4. Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109, USA;5. Department of Otolaryngology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511, Japan;1. Department of Otolaryngology, JA Kochi Hospital, Kochi 783-8509, Japan;2. Department of Otolaryngology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, Japan;1. Department of Otolaryngology, Head and Neck Surgery, Shizuoka City Shizuoka Hospital, Shizuoka, 10-93 Oute-cho, Aoi-ku, Shizuoka 420-8630, Japan;2. Department of Otolaryngology, Shin-Suma General Hospital, Kobe, Hyogo 654-0048, Japan;1. Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan;2. Department of Otolaryngology, Tokyo Medical and Dental University, Tokyo, Japan;3. Department of Otolaryngology Head and Neck Surgery, Musashino Red Cross Hospital, Tokyo, Japan;4. Department of Otolaryngology, Juntendo University Nerima Hospital, Tokyo, Japan;5. Department of Head and Neck Surgery, Kameda Medical Center, Kamogawa, Japan;1. Otorhinolaryngology, Faculty of Medicine, Kafr Elsheikh University, Egypt;2. Otorhinolaryngology, Faculty of Medicine, Tanta University, Egypt |
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| Abstract: | ObjectiveAdults over the age of 65 years with balance disorders are at about twice the risk of falls, compared with those without balance disorders. Falls contribute to about 74% of the proximal femoral fractures commonly seen in the elderly. Since balance disorders are more prevalent in older adults than in younger adults, it is important to deal with balance disorders in older adults to prevent falls and the resulting deterioration in their ADL (activity of daily living). In this study, we investigated the effects of vestibular rehabilitation (VR) and cane use on improving gait and balance in patients aged over 65 years with balance disorder.Methods: Patients aged over 65 years presenting to the Department of Otolaryngology at St. Marianna University School of Medicine between July 1 and November 1, 2018, with symptoms of dizziness for ≥ 3 months and a Japanese translation of the Dizziness Handicap Inventory score of ≥ 26 were included in the study. We quantitatively analyzed their gait before and after VR, and with and without the use of a cane.ResultsA total of 21 patients participated in the study (14 women; mean age 73.9 ± 6.9 years). Before VR, using a cane made no difference to step length or walking speed. After VR, using a cane increased step length from 50.5 cm (95% confidence interval [CI], 47.4–53.7 cm) to 52.0 cm (95% CI, 48.9–55.1 cm) (p = 0.039). There was no change in walking speed. A comparison of walking assessment results while using a cane before and after VR showed that step length increased from 49.9 cm (95% CI, 46.6–53.2 cm) to 52.0 cm (95% CI, 48.9–55.1 cm) (p = 0.005), and walking speed increased from 90.5 cm/s (95% CI, 82.7–98.4 cm/s) to 96.1 cm/s (95% CI, 88.3–103.9 cm/s) (p = 0.005).ConclusionsWalking speed and step length with the use of a cane significantly improved following VR. VR and cane use may act synergistically to improve walking. |
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