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Review
January 6, 2022

Falls Among People With Bilateral Vestibulopathy: A Review of Causes, Incidence, Injuries, and Methods

Author Affiliations
  • 1Space Medicine Team (HRE-OM), European Astronaut Centre, European Space Agency, Cologne, Germany
  • 2Department of Rehabilitation Sciences and Physiotherapy/MOVANT, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
  • 3Institute of Sport and Exercise Sciences, Münster University, Münster, Germany
  • 4Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Health Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University Medical Centre+, Maastricht, the Netherlands
  • 5Faculty of Physics, Tomsk State University, Tomsk, Russia
  • 6Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
JAMA Otolaryngol Head Neck Surg. Published online January 6, 2022. doi:10.1001/jamaoto.2021.3673
Abstract

Importance  People with bilateral vestibulopathy experience severe balance and mobility issues. Fear and anxiety are associated with reduced activity, which can further affect balance and fall risk. Understanding and intervening on falls in this population is essential. The aims of this narrative review are to provide an overview of the current knowledge and applied methods on fall incidence, causes, and injuries in bilateral vestibulopathy.

Observations  Eleven articles reporting falls incidence in people with bilateral vestibulopathy were deemed eligible, including 3 prospective and 8 retrospective studies, with a total of 359 participants, of whom 149 (42%) fell during the assessed period. When reported, the most common perceived causes of falls were loss of balance, darkness, and uneven ground. Information on sustained injuries was limited, with bruises and scrapes being the most common, and only 4 fractures were reported. As most studies included falls as a secondary, descriptive outcome measure, fall data obtained using best practice guidelines were lacking. Only 6 studies reported their definition of a fall, of which 2 studies explicitly reported the way participants were asked about their fall status. Only 3 studies performed a prospective daily fall assessment using monthly fall diaries (a recommended practice), whereas the remaining studies retrospectively collected fall-related data through questionnaires or interviews. While most studies reported the number of people who did and did not fall, the number of total falls in individual studies was lacking.

Conclusions and Relevance  The findings from this review suggest that falls in people with bilateral vestibulopathy are common but remain an understudied consequence of the disease. Larger prospective studies that follow best practice guidelines for fall data collection with the aim of obtaining and reporting fall data are required to improve current fall risk assessments and interventions in bilateral vestibulopathy.

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