Vestibulopathy
Conditions
Brief summary
Falls can be serious for older people, sometimes even leading to trips to the hospital. It's important to find ways to help prevent falls, especially for older people. Doctors have different tests they use to figure out who might be more likely to fall. One test they use is called the Time Up and Go (TUG) test, where a person has to stand up, walk a bit, and sit back down. Now there's a newer version of this test called the quantitative TUG (QTUG), which uses special sensors to measure how well someone can keep their balance. But not many doctors use it yet because they're not sure how good it is compared to other tests. We want to study how good the QTUG is at measuring balance in older people with dizziness problems. Study 1: First, the Principal Investigator (PI) will look at data from previous routine tests done on 55 older adults seen within the regional department of Neurotology between 2018 and 2024 to see how the QTUG results match up with what the doctor already knows about balance problems. Study 2: Secondly, the PI will conduct a larger study with 120 older adults (+65 years) who have dizziness issues. Participants will be asked to undertake a variety of tests, including the QTUG test, 30 sec sit to stand test, and the PI will ask them questions about how they feel about their balance. Study 3: Sixty of the recruited 120 patients will do special exercises for six months to help improve their balance, while the other sixty will only do these exercises at the end of the study. The PI will then compare the data to see if the QTUG test can tell if exercises are helping or not. Study 4: Finally, the PI will recruit another 60 elderly participants to see if the QTUG test can tell who's more likely to fall over the next year. The PI will compare the results of the test to what happens to these people within a year to see how accurate the QTUG test is at predicting falls. Using data from these studies, the PI hopes to learn if the QTUG test is a good way to measure balance problems in older people and if it can help doctors figure out who might be at risk of falling, and if the exercises are helping to prevent falls.
Interventions
BEHAVIORALVestibular Rehabilitation
60 participants will be randomised to receive vestibular rehabilitation that includes adaptive, habituation and substitution exercises; Gait retraining; Lower limb strengthening; Cervical spine treatment by a trained physiotherapist at the Royal Hallamshire Hospital Physiotherapy Department. This rehabilitation programme is delivered as part of routine care.
Sponsors
Sheffield Teaching Hospitals NHS Foundation Trust
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Older adults (aged \>65) * Diagnosis of vestibular pathology including unilateral vestibulopathy/vestibular neuritis or bilateral vestibulopathy, Meniere disease, vestibular associated migraines, PPPD, Presby vestibulopathy (PVP), vestibular paroxysmia, vestibular schwannoma, third window syndrome. * Able to walk independently with or without walking aid. * Able to provide consent
Exclusion criteria
* Visual impairment. * Diagnosis of Benign paroxysmal positional vertigo (BPPV) or haemodynamic dizziness (Postural hypotension, cardiogenic dizziness/POTS, heart arrythmia, heart attack). * Diagnosis of neurological disorder such as: multiple sclerosis, cerebrovascular accident, Parkinson's disease, dementia, diabetic neuropathy, epilepsy. * Not fluent in English. * Pregnant
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Falls Risk Estimate (FRE) | From participant enrolment to completion of the intervention at 6 months | A statistical percentage (0% to 100%) indicating a patient's statistical risk of falling, compared to independent reference samples based on age and gender |
| Frailty Index (FI) | From participant enrolment to completion of the intervention at 6 months | An objective estimate (often based on Fried's frailty phenotype) that categorizes the patient's level of frailty (e.g., robust, pre-frail, or frail) |
Countries
United Kingdom
Outcome results
None listed