scholarly journals Paving the Way Toward Distinguishing Fallers From Non-fallers in Bilateral Vestibulopathy: A Wide Pilot Observation

2021 ◽  
Vol 12 ◽  
Author(s):  
Nolan Herssens ◽  
Bieke Dobbels ◽  
Julie Moyaert ◽  
Raymond Van de Berg ◽  
Wim Saeys ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Fear Of Falling ◽  
Daily Life ◽  
Contextual Information ◽  
Vestibular Function ◽  
Future Research ◽  
Risk Of Falling ◽  
Bilateral Vestibulopathy ◽  
Activities Of Daily Life ◽  
Increased Risk

Patients with bilateral vestibulopathy (BVP) present with unsteadiness during standing and walking, limiting their activities of daily life and, more importantly, resulting in an increased risk of falling. In BVP patients, falls are considered as one of the major complications, with patients having a 31-fold increased risk of falling compared to healthy subjects. Thus, highlighting objective measures that can easily and accurately assess the risk of falling in BVP patients is an important step in reducing the incidence of falls and the accompanying burdens. Therefore, this study investigated the interrelations between demographic characteristics, vestibular function, questionnaires on self-perceived handicap and balance confidence, clinical balance measures, gait variables, and fall status in 27 BVP patients. Based on the history of falls in the preceding 12 months, the patients were subdivided in a “faller” or “non-faller” group. Results on the different outcome measures were compared between the “faller” and “non-faller” subgroups using Pearson's chi-square test in the case of categorical data; for continuous data, Mann–Whitney U test was used. Performances on the clinical balance measures were comparable between fallers and non-fallers, indicating that, independent from fall status, the BVP patients present with an increased risk of falling. However, fallers tended to report a worse self-perceived handicap and confidence during performing activities of daily life. Spatiotemporal parameters of gait did not differ between fallers and non-fallers during walking at slow, preferred, or fast walking speed. These results may thus imply that, when aiming to distinguish fallers from non-fallers, the BVP patients' beliefs concerning their capabilities may be more important than the moderately or severely affected physical performance within a clinical setting. Outcome measures addressing the self-efficacy and fear of falling in BVP patients should therefore be incorporated in future research to investigate whether these are indeed able to distinguish fallers form non-fallers. Additionally, information regarding physical activity could provide valuable insights on the contextual information influencing behavior and falls in BVP.

Treatment of vertigo and postural instability using visual illusions

2014 ◽  
Vol 128 (11) ◽  
pp. 1005-1007 ◽  
Author(s):  
G van Kerckhoven ◽  
A Mert ◽  
J A De Ru
Keyword(s):  
Gold Standard ◽  
Prosthetic Valve ◽  
Standard Treatment ◽  
Vestibular Function ◽  
Prosthetic Valve Endocarditis ◽  
Postural Instability ◽  
Risk Of Falling ◽  
Important Advance ◽  
Dizziness Handicap Inventory ◽  
Increased Risk

AbstractBackground:Ototoxicity caused by medication can lead to debilitating symptoms such as dizziness, vertigo and postural instability. There is no current ‘gold standard’ treatment available.Case report:A 79-year-old male, with bilateral loss of vestibular function caused by gentamicin toxicity after surgery for prosthetic valve endocarditis, complained of dizziness, difficulty in walking and an increased risk of falling. Physical examination showed a positive head thrust test suggesting bilateral loss of vestibular function.Results:The patient underwent a specific motion-based virtual reality enhanced protocol for peripheral vestibular disease. He showed a great improvement, with a 50 per cent reduction in his Dizziness Handicap Inventory score.Conclusion:Computer-aided rehabilitation programmes might represent an important advance in gait and posture training.

Somatosensory Impairments, Falls History and Fear of Falling in Glaucoma - A Survey Study Approach

2021 ◽  
Vol 65 (1) ◽  
pp. 11-15
Author(s):  
Caitlin O’Connell ◽  
Gadi Wollstein ◽  
Ian P. Conner ◽  
Mark S. Redfern ◽  
Kevin C. Chan ◽  
...  
Keyword(s):  
Visual Field ◽  
Older Workers ◽  
Daily Living ◽  
Fear Of Falling ◽  
Survey Study ◽  
Risk Of Falling ◽  
Study Approach ◽  
Increased Risk ◽  
Visual Field Deficits ◽  
The Relationship

The primary aim was to determine if somatosensory impairments alter the association between falls history and glaucoma severity. A secondary aim was to identify the activities of daily living that cause increased concern related to falling in glaucoma and their association with glaucoma severity. Established questionnaires about falls and fear of falling (FoF) were mailed to participants diagnosed with glaucoma. Ninety-eight participants responded. Self-reported feet numbness and tingling symptoms were used to determine the presence of somatosensory impairments. Self-reported falls in glaucoma are associated with visual field deficits in both eyes, particularly in the presence of somatosensory impairments. In addition, increased FoF levels are linked with worse visual field deficits in both eyes, especially when performing challenging walking tasks. Somatosensory impairments alter the relationship between falls risk and visual field deficits in glaucoma. This information may be helpful in identifying older workers at an increased risk of falling.

scholarly journals Patients’ thoughts on their falls in a rehabilitation hospital: a qualitative study of patients with stroke

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saika Aihara ◽  
Shin Kitamura ◽  
Masayuki Dogan ◽  
Sachiko Sakata ◽  
Kunitsugu Kondo ◽  
...  
Keyword(s):  
Fear Of Falling ◽  
Lessons Learned ◽  
Positive Thinking ◽  
Risk Of Falling ◽  
Comprehensive Information ◽  
Increased Risk ◽  
Before And After ◽  
Risky Behaviours ◽  
Past Experiences ◽  
Need For Rehabilitation

Abstract Background Patients with stroke in rehabilitation wards are at an increased risk of falling. Although patients’ participation in establishing medical safety is considered crucial, there is limited evidence on their perspectives of falls. This study aims to comprehensively elucidate the subjective falling experience of patients with stroke who have been admitted to rehabilitation wards. Methods Twenty-three consecutive patients with stroke (44 to 90 years) who experienced a fall during hospitalisation were interviewed within 1 week after the fall, and thematic analysis was used to analyse the data. Results Five themes surrounding fall events were extracted from the narratives: ‘Psychological background before the action’, ‘Support for the action’, ‘Direct causes of the fall’, ‘Patients’ awareness after the fall’, and ‘Changes in attitudes and behaviours after the fall’. ‘Psychological background before the action’ comprised hastiness or hesitation to call for help. Participants often took an action based on ‘Support for the action’ derived from their past experiences of moving safely, their confidence, and/or motivation to challenge themselves to move. ‘Direct causes of the fall’ consisted of unfamiliar actions, training fatigue, the surrounding environment, reduced physical function due to paralysis, lack of attention, overconfidence in their ability, and insufficient prediction of falls. ‘Patients’ awareness after the fall’ consisted of re-affirming difficult movements, the need for rehabilitation, a reduced ability to move, an increased risk of falling, the need for attention while moving, a fear of falling, and a lack of lessons learned from falling. Finally, patients demonstrated ‘Changes in attitudes and behaviours after the fall’ such as embodying a positive attitude to cope with the risk of falling or behavioural changes to reduce the risk of falling. Conclusions Comprehensive information on patients’ perspectives before and after the fall was elucidated, uncovering many aspects including the psychological background for why patients engaged in risky behaviours resulting in falls, presence of positive thinking, and behaviour after the fall. By incorporating the patients’ views on fall incidences and their assessment, we can develop appropriate prevention strategies against falls.

scholarly journals Daily Life Benefits and Usage Characteristics of Dynamic Arm Supports in Subjects with Neuromuscular Disorders

Sensors ◽  
2020 ◽  
Vol 20 (17) ◽  
pp. 4864
Author(s):  
Johannes Essers ◽  
Alessio Murgia ◽  
Anneliek Peters ◽  
Kenneth Meijer
Keyword(s):  
Social Life ◽  
Daily Life ◽  
Contextual Information ◽  
Neuromuscular Disorders ◽  
Activities Of Daily Life ◽  
Self Reports ◽  
Actual Use ◽  
And Performance ◽  
Over Time

Neuromuscular disorders cause progressive muscular weakness, which limits upper extremity mobility and performance during activities of daily life. Dynamic arm supports can improve mobility and quality of life. However, their use is often discontinued over time for unclear reasons. This study aimed to evaluate whether users of dynamic arm supports demonstrate and perceive quantifiable mobility benefits over a period of two months. Nine users of dynamic arm supports were included in this observational study. They had different neuromuscular disorders and collectively used four different arm supports. They were observed for three consecutive weeks during which they were equipped with a multi-sensor network of accelerometers to assess the actual use of the arm support and they were asked to provide self-reports on the perceived benefits of the devices. Benefits were experienced mainly during anti-gravity activities and the measured use did not change over time. The self-reports provided contextual information in domains such as participation to social life, in addition to the sensor system. However self-reports overestimated the actual use by up to three-fold compared to the accelerometer measures. A combination of objective and subjective methods is recommended for meaningful and quantifiable mobility benefits during activities of daily life.

scholarly journals Daily Life Benefits and Usage Characteristics of Dynamic Arm Supports in Subjects with Neuromuscular Disorders

2020 ◽  
Author(s):  
Johannes Essers ◽  
Alessio Murgia ◽  
Anneliek Peters ◽  
Kenneth Meijer
Keyword(s):  
Social Life ◽  
Daily Life ◽  
Contextual Information ◽  
Neuromuscular Disorders ◽  
Activities Of Daily Life ◽  
Self Reports ◽  
Arm Support ◽  
Actual Use ◽  
And Performance ◽  
Over Time

Neuromuscular disorders cause progressive muscular weakness, which limits upper extremity mobility and performance during activities of daily life. A dynamic arm support can improve mobility and quality of life. However, their use is often discontinued over time for unclear reasons. This study aimed to evaluate whether users of dynamic arm supports demonstrate and perceive quantifiable mobility benefits over a period of two months. Nine users of dynamic arm supports were included in this observational study. They had different neuromuscular disorders and collectively used four different arm supports. They were observed for three consecutive weeks during which they were equipped with a multi-sensor network of accelerometers to assess the actual use of the arm support and they were asked to provide self-reports on the perceived benefits of the devices. Benefits were experienced mainly during anti-gravity activities and the measured use did not change over time. The self-reports provided contextual information in domains such as participation to social life, in addition to the sensor system. However self-reports overestimated the actual use by up to three-fold compared to the accelerometer measures. A combination of objective and subjective methods is recommended for meaningful and quantifiable mobility benefits during activities of daily life.

Cervicothoracic Mechanical Impairment as Part of Complete Neurological Fall Risk Appraisal

2020 ◽  
pp. 1-9
Author(s):  
Janine L. Johnston ◽  
Graham Featherstone ◽  
Shane L. Harms ◽  
Glen T. D. Thomson
Keyword(s):  
Risk Factors ◽  
Soft Tissue ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Musculoskeletal Symptoms ◽  
Risk Of Falling ◽  
Risk Appraisal ◽  
Fall Risk Factors ◽  
Increased Risk ◽  
Restricted Mobility

ABSTRACT: Background: Assessment of individuals at risk for falling entails comprehensive neurological and vestibular examinations. Chronic limitation in cervical mobility reduces gaze accuracy, potentially impairing navigation through complex visual environments. Additionally, humans with scoliosis have altered otolithic vestibular responses, causing imbalance. We sought to determine whether dynamic cervical mobility restrictions or static cervicothoracic impairments are also fall risk factors. Methods: We examined 435 patients referred for soft-tissue musculoskeletal complaints; 376 met criteria for inclusion (mean age 52; 266 women). Patients were divided into nonfallers, single fallers, and multiple fallers, less or greater than 65 years old. Subject characteristics, dynamic cervical rotations, and static cervicothoracic axial measurements were compared between groups. Fear of falling was evaluated using the Falls Efficacy Scale-International questionnaire. Results: Long-standing cervicothoracic pain and stiffness conferred increased risk of falling. Neck rotation amplitudes decreased with longer duration musculoskeletal symptoms and were significantly more restricted in fallers, doubling the risk of falling and contributing to increased fear of falling. Mid-thoracic scoliosis amplitudes increased over time, but static axial abnormalities were not greater among fallers, although thoracic kyphoscoliosis heightened fear of falling. Conclusion: In patients at fall risk, thoracic kyphoscoliosis and dynamic neck movements should be assessed, in addition to standard vestibular and neurological evaluations. Additionally, patients with soft tissue cervicothoracic pain and restricted mobility have increased fall frequency and fear of falling, independent of other fall risk factors and should undergo complete fall risk appraisal.

scholarly journals Fear of falling in community-dwelling older adults presenting to the emergency department for minor injuries: Impact on return to the ED and future falls

CJEM ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. 692-700
Author(s):  
Marie-Pier Lanoue ◽  
Marie-Josée Sirois ◽  
Jeffrey J. Perry ◽  
Jacques Lee ◽  
Raoul Daoust ◽  
...  
Keyword(s):  
Emergency Department ◽  
Fear Of Falling ◽  
Strong Predictor ◽  
Community Dwelling ◽  
Risk Of Falling ◽  
Predictive Values ◽  
Minor Injury ◽  
Increased Risk ◽  
Minor Injuries ◽  
A Minor

ABSTRACTObjectives1) To characterize mild, moderate, and severe fear of falling in older emergency department (ED) patients for minor injuries, and 2) to assess whether fear of falling could predict falls and returns to the ED within 6 months of the initial ED visit.MethodsThis study was part of the Canadian Emergency and Trauma Initiative (CETI) prospective cohort (2011–2016). Patients ages ≥ 65, who were independent in their basic daily activities and who were discharged from the ED after consulting for a minor injury, were included. Fear of falling was measured by the Short Falls Efficacy Scale International (SFES-I) in order to stratify fear of falling as mild (SFES-I = 7-8/28), moderate (SFES-I = 9-13/28), or severe (SFES-I = 14-28/28). Many other physical and psychological characteristics where collected. Research assistants conducted follow-up phone interviews at 3 and 6 months’ post-ED visit, in which patients were asked to report returns to the ED.ResultsA total of 2,899 patients were enrolled and 2,009 had complete data at 6 months. Patients with moderate to severe fear of falling were more likely to be of ages ≥ 75, female, frailer with multiple comorbidities, and decreased mobility. Higher baseline fear of falling increased the risk of falling at 3 and 6 months (odds ratio [OR]-moderate-fear of falling: 1.63, p < 0.05, OR-severe-fear of falling 2.37, p < 0.05). Fear of falling positive predictive values for return to the ED or future falls were 7.7% to 17%.ConclusionAlthough a high fear of falling is associated with increased risk of falling within 6 months of a minor injury in older patients, fear of falling considered alone was not shown to be a strong predictor of return to the ED and future falls.

scholarly journals The Effect of Parkinson’s Disease on the Step Response to a Backwards Pull

2008 ◽  
Author(s):  
Molly A. McVey ◽  
Antonis P. Stylianou ◽  
Carl W. Luchies ◽  
Kelly E. Lyons ◽  
Rajesh Pahwa ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Fall Risk ◽  
Fear Of Falling ◽  
Economic Impacts ◽  
Postural Instability ◽  
Step Response ◽  
Risk Of Falling ◽  
Effective Interventions ◽  
Increased Risk

Postural instability is one of the most disabling symptoms of Parkinson’s disease (PD) and often leads to falls. Falls can have severe physical, psychological, and economic impacts including fractures, fear of falling, and loss of independence [1]. Effective interventions to reduce fall risk exist [2, 3] and would be most effective if they could be implemented prior to a fall occurring. Unfortunately, the current methods to evaluate postural instability in PD are not sensitive enough to predict those who are at an increased risk of falling so it is difficult to identify the best time to begin fall interventions.

A Silenced Population

Crisis ◽  
2017 ◽  
Vol 38 (6) ◽  
pp. 433-442 ◽  
Author(s):  
Kim Gryglewicz ◽  
Melanie Bozzay ◽  
Brittany Arthur-Jordon ◽  
Gabriela D. Romero ◽  
Melissa Witmeier ◽  
...  
Keyword(s):  
At Risk ◽  
Depressive Symptomatology ◽  
The United States ◽  
Future Research ◽  
At Risk Youth ◽  
Peer Relationship ◽  
Student Records ◽  
Cross Sectional ◽  
Increased Risk ◽  
Method Student

Abstract. Background: Given challenges that exceed the normal developmental requirements of adolescence, deaf and hard-of-hearing (DHH) youth are believed to be at elevated risk for engaging in suicide-related behavior (SRB). Unfortunately, little is known about the mechanisms that put these youth potentially at risk. Aims: To determine whether peer relationship difficulties are related to increased risk of SRB in DHH youth. Method: Student records (n = 74) were retrieved from an accredited educational center for deaf and blind students in the United States. Results: Peer relationship difficulties were found to be significantly associated with engagement in SRB but not when accounting for depressive symptomatology. Limitations: The restricted sample limits generalizability. Conclusions regarding risk causation cannot be made due to the cross-sectional nature of the study. Conclusion: These results suggest the need for future research that examines the mechanisms of the relationship between peer relationship difficulties, depression, and suicide risk in DHH youth and potential preventive interventions to ameliorate the risks for these at-risk youth.

"He seems odd": The effects of risk-irrelevant information and actuarial risk estimates on mock jurors' perceptions of sexual recidivism risk

2020 ◽  
Author(s):  
Jennifer Kamorowski ◽  
Karl Ask ◽  
Maartje Schreuder ◽  
Marko Jelicic ◽  
Corine de Ruiter
Keyword(s):  
Contextual Information ◽  
Individual Characteristics ◽  
Risk Estimate ◽  
Case Vignette ◽  
Future Research ◽  
Sexual Recidivism ◽  
Mock Jurors ◽  
Related Factors ◽  
Risk Estimates ◽  
Actuarial Risk

Previous research has shown that mock and actual jurors give little weight to actuarial sexual offending recidivism risk estimates when making decisions regarding civil commitment for so-called sexually violent predators (SVPs). We hypothesized that non-risk related factors, such as irrelevant contextual information and jurors’ information-processing style, would influence mock jurors’ perceptions of sexual recidivism risk. This preregistered experimental study examined the effects of mock jurors’ (N = 427) need for cognition (NFC), irrelevant contextual information in the form of the offender’s social attractiveness, and an actuarial risk estimate on mock jurors’ estimates of sexual recidivism risk related to a simulated SVP case vignette. Mock jurors exposed to negative risk-irrelevant characteristics of the offender estimated sexual recidivism risk as higher than mock jurors exposed to positive information about the offender. However, this effect was no longer significant after mock jurors had reviewed Static-99R actuarial risk estimate information. We found no support for the hypothesis that the level of NFC moderates the relationship between risk-irrelevant contextual information and risk estimates. Future research could explore additional individual characteristics or attitudes among mock jurors that may influence perceptions of sexual recidivism risk and insensitivity to actuarial risk estimates.

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