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      Rehabilitación vestibular en personas mayores con disfunción vestibular Translated title: Vestibular rehabilitation in older people with vestibular dysfunction

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          Abstract

          RESUMEN Introducción y objetivos: El mareo y el desequilibrio son síntomas comunes en el anciano y tienen un gran impacto en su calidad de vida. Material y métodos: Revisión narrativa. Resultados: Se revisan los principales factores que condicionan la inestabilidad en el anciano, el impacto de las caídas y las exploraciones más rentables desde el punto de vista diagnóstico y terapéutico en estos pacientes. Por último, se incide en la necesidad de un abordaje multidisciplinar destacando la importancia de la rehabilitación vestibular en el tratamiento de estos trastornos. Conclusiones: La inestabilidad en el anciano es de origen multifactorial y no obedece solamente a razones fisiológicas. De ahí la necesidad de identificar los factores precipitantes, tratarlos si es posible y realizar un abordaje multidisciplinar que minimice la morbimortalidad asociada a este proceso y mejorando su calidad de vida. La rehabilitación vestibular puede mejorar significativamente el equilibrio de los ancianos con inestabilidad lo cual conduciría a una reducción significativa de las caídas.

          Translated abstract

          ABSTRACT Introduction: Dizziness and imbalance are common symptoms in the elderly and have a great impact on their quality of life. Material and methods: Narrative review. Results: Main factors that condition instability in the elderly and the impact of falls are reviewed, as well as the most profitable tests in diagnosis. Finally, the need to perform a multidisciplinary approach was discussed, highlighting the importance of vestibular rehabilitation in the treatment of these disorders. Conclusions: Instability in the elderly is multifactorial and not only due to physiological reasons. Hence the need to identify precipitating factors, treat them if possible and carry out a multidisciplinary approach that minimizes the morbidity and mortality associated with this process and improve their quality of life. Vestibular rehabilitation can significantly ameliorate balance in the elderly with instability which would lead to a significant reduction in falls.

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          Most cited references48

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          The costs of fatal and non-fatal falls among older adults.

          To estimate the incidence and direct medical costs for fatal and non-fatal fall injuries among US adults aged >or=65 years in 2000, for three treatment settings stratified by age, sex, body region, and type of injury. Incidence data came from the 2000 National Vital Statistics System, 2001 National Electronic Injury Surveillance System-All Injury Program, 2000 Health Care Utilization Program National Inpatient Sample, and 1999 Medical Expenditure Panel Survey. Costs for fatal falls came from Incidence and economic burden of injuries in the United States; costs for non-fatal falls were based on claims from the 1998 and 1999 Medicare fee-for-service 5% Standard Analytical Files. A case crossover approach was used to compare the monthly costs before and after the fall. In 2000, there were almost 10 300 fatal and 2.6 million medically treated non-fatal fall related injuries. Direct medical costs totaled 0.2 billion dollars for fatal and 19 billion dollars for non-fatal injuries. Of the non-fatal injury costs, 63% (12 billion dollars ) were for hospitalizations, 21% (4 billion dollars) were for emergency department visits, and 16% (3 billion dollars) were for treatment in outpatient settings. Medical expenditures for women, who comprised 58% of the older adult population, were 2-3 times higher than for men for all medical treatment settings. Fractures accounted for just 35% of non-fatal injuries but 61% of costs. Fall related injuries among older adults, especially among older women, are associated with substantial economic costs. Implementing effective intervention strategies could appreciably decrease the incidence and healthcare costs of these injuries.
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            Exercise to prevent falls in older adults: an updated systematic review and meta-analysis

            Previous meta-analyses have found that exercise prevents falls in older people. This study aimed to test whether this effect is still present when new trials are added, and it explores whether characteristics of the trial design, sample or intervention are associated with greater fall prevention effects.
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              What is balance?

              Balance is a term frequently used by health professionals working in a wide variety of clinical specialities. There is no universally accepted definition of human balance, or related terms. This article identifies mechanical definitions of balance and introduces clinical definitions of balance and postural control. Postural control is defined as the act of maintaining, achieving or restoring a state of balance during any posture or activity. Postural control strategies may be either predictive or reactive, and may involve either a fixed-support or a change-in-support response. Clinical tests of balance assess different components of balance ability. Health professionals should select clinical assessments based on a sound knowledge and understanding of the classification of balance and postural control strategies.
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                Author and article information

                Journal
                orl
                Revista ORL
                Rev. ORL
                Ediciones Universidad de Salamanca (Salamanca, Salamanca, Spain )
                2444-7986
                March 2020
                : 11
                : 1
                : 67-78
                Affiliations
                [1] Cangas de Narcea Asturias orgnameHospital Carmen y Severo Ochoa orgdiv1Servicio de ORL España
                [2] Gijón Asturias orgnameHospital de Cabueñes orgdiv1Servicio de Otorrinolaringología España
                Article
                S2444-79862020000100007 S2444-7986(20)01100100007
                10.14201/orl.20953
                2fc18ecb-8308-4afc-b482-7cdbeae5bcfb

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

                History
                : 22 June 2019
                : 12 July 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 48, Pages: 12
                Product

                SciELO Spain

                Categories
                Artículo de revisión

                elderly,instability,vestibular rehabilitation,inestabilidad,mareo,caídas,ancianos,rehabilitación vestibular,dizziness,falls

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