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      Impacto de la rehabilitación vestibular en el riesgo de caída y la confianza del paciente Translated title: Impact of vestibular rehabilitation on the risk of falling and patient confidence

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          Abstract

          RESUMEN Introducción: Las alteraciones del sistema vestibular como la hipofunción vestibular unilateral, predisponen al usuario a sufrir caídas alterando así su confianza. Objetivo: Determinar el impacto de la rehabilitación vestibular en el riesgo de caídas y el grado de confianza en mujeres con hipofunción vestibular unilateral. Material y método: Se realiza estudio prospectivo en 20 pacientes de género femenino mayores de 60 años con diagnóstico de patología vestibular periférica. Se evalúa el riesgo de caídas con escala Tinetti y el grado de confianza al realizar actividades de la vida diaria por medio de la escala ABC (Activities-specific Balance Confidence), antes y después de realizar terapia de rehabilitación vestibular (RV). Resultados: Las dos variables estudiadas Tinetti y escala ABC demostraron mejoras significativas en la mayoría de las pacientes, demostrando que a medida que aumenta el grado de confianza disminuye el riesgo de caídas. Conclusión: Los resultados obtenidos de este estudio sugieren que la terapia de RV es eficiente en mejorar el riesgo de caídas y favorecer el aumento de confianza en las actividades de la vida diaria en el grupo de pacientes estudiadas.

          Translated abstract

          ABSTRACT Introduction: Changes in the vestibular system, such as unilateral vestibular hypo-function, predispose the user to suffer falls, thus altering his confidence. Aim: To determine the impact of vestibular rehabilitation on the risk of falls and the degree of confidence in women with unilateral vestibular hypofunction. Material and method: A prospective study was conducted in 20 female patients over 60 years of age with a diagnosis of peripheral vestibular pathology. The risk of falls with a Tinetti scale and the degree of confidence in carrying out activities of daily living are evaluated through the ABC scale (Activities-specific Balance Confidence), before and after performing vestibular rehabilitation therapy (VRT). Results: The two variables studied, Tinetti and ABC scale showed significant improvements in most of the patients, demonstrating that as the degree of confidence increases the risk of falls decreases. Conclusion: The results obtained from this study suggest that VRT is efficient in improving the risk of falls and favoring an increase in confidence in the activities of daily life in the group of patients studied.

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          Falls efficacy as a measure of fear of falling.

          We developed the Falls Efficacy Scale (FES), an instrument to measure fear of falling, based on the operational definition of this fear as "low perceived self-efficacy at avoiding falls during essential, nonhazardous activities of daily living." The reliability and validity of the FES were assessed in two samples of community-living elderly persons. The FES showed good test-retest reliability (Pearson's correlation 0.71). Subjects who reported avoiding activities because of fear of falling had higher FES scores, representing lower self-efficacy or confidence, than subjects not reporting fear of falling. The independent predictors of FES score were usual walking pace (a measure of physical ability), anxiety, and depression. The FES appears to be a reliable and valid method for measuring fear of falling. This instrument may be useful in assessing the independent contribution of fear of falling to functional decline among elderly people.
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            The prevalence and correlates of fear of falling in elderly persons living in the community.

            Fear of falling has been recognized as a potentially debilitating consequence of falling in elderly persons. However, the prevalence and the correlates of this fear are unknown. Prevalence of fear of falling was calculated from the 1-year follow-up of an age- and gender-stratified random sample of community-dwelling elderly persons. Cross-sectional associations of fear of falling with quality of life, frailty, and falling were assessed. The prevalence of fear increased with age and was greater in women. After adjustment for age and gender, being moderately fearful of falling was associated with decreased satisfaction with life, increased frailty and depressed mood, and recent experience with falls. Being very fearful of falling was associated with all of the above plus decreased mobility and social activities. Fear of falling is common in elderly persons and is associated with decreased quality of life, increased frailty, and recent experience with falls.
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              Covariates of fear of falling and associated activity curtailment.

              With a sample survey (N = 266) of elderly adults residing in six housing developments in Massachusetts, we used logistic regression to: (a) identify covariates of fear of falling among all subjects and (b) identify covariates of activity curtailment among the subset of subjects who were afraid of falling. Fifty-five percent of respondents were afraid of falling; of those who were afraid, 56% had curtailed activity due to this fear. Factors associated with fear of falling were: being female, having had previous falls, and having fewer social contacts. Factors associated with activity curtailment among those who were afraid were: not communicating about falls; having less social support; and knowing someone who had fallen. Falls history appears an important contributor to fear of falling, whereas the impact of this fear on activities appears more a function of social support. These findings suggest different strategies for the primary and secondary prevention of fear of falling.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                orl
                Revista de otorrinolaringología y cirugía de cabeza y cuello
                Rev. Otorrinolaringol. Cir. Cabeza Cuello
                Sociedad Chilena de Otorrinolaringología, Medicina y Cirugía de Cabeza y Cuello (Santiago, , Chile )
                0718-4816
                September 2019
                : 79
                : 3
                : 307-314
                Affiliations
                [2] Viña del Mar Santiago de Chile orgnameUniversidad Santo Tomás orgdiv1Escuela de Kinesiología orgdiv2Departamento de Ciencias de la Rehabilitación Chile
                [3] Viña del Mar orgnameInstituto Neurobalance Chile
                [1] Viña del Mar orgnameUniversidad Santo Tomas orgdiv1Escuela de Kinesiología orgdiv2Departamento de Ciencias de la Rehabilitación Chile
                Article
                S0718-48162019000300307
                2e03d0f8-afd5-4973-a168-26bfade7ba6c

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 22 April 2019
                : 11 May 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 21, Pages: 8
                Product

                SciELO Chile

                Categories
                ARTÍCULOS DE INVESTIGACIÓN

                Unilateral vestibular hypofunction,vestibular rehabilitation,risk of falls,confidence,Hipofunción vestibular unilateral,rehabilitación vestibular,riesgo de caídas,confianza

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