AUTHOR=Herssens Nolan , Dobbels Bieke , Moyaert Julie , Van de Berg Raymond , Saeys Wim , Hallemans Ann , Vereeck Luc , Van Rompaey Vincent 

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

JOURNAL=Frontiers in Neurology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.611648

DOI=10.3389/fneur.2021.611648

ISSN=1664-2295

ABSTRACT=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 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 accompanied 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, 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 the Pearson Chi-squared test in case for categorical data, for continuous data the 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, 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 speeds. These results may thus imply that, when aiming to distinguish fallers from non-fallers, a BVP-patient’s beliefs concerning their capabilities may be more important than the moderate 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 behaviour and falls in BVP.