A STUDY TO FIND OUT THE EFFECTIVENESS OF VESTIBULAR REHABILITATION IN IMPROVING DAILY LIFE FUNCTIONS IN ELDERLY (60-75) : Mamta Sehrawat *
ABSTRACT
Background of the study:
EIB is a condition which can affects the elite and recreational athletes at any level. An athlete suffering from EIB may present with the several complaints during exercise. Spiro metric parameters such as FEV1 and PEF can be used as main diagnostic tools for EIB. Recognition of EIB helps in subsiding complications and improving the health of the athlete, it could help in providing better conditions for athletes with asthma considering the prophylactic and therapeutic use.
Aim and Objective of the Study: The main aim of the study is to evaluate the effect of exercise (free running) on bronchospasm in the football players of Punjab State Universities by measuring the pulmonary functions parameters such as FEV1, PEF/MMEF at different intervals of exercise.
Methodology: This is an observational cross sectional study. In this study, 107 elite football players of 17 to 25 years of age from the 3 State Universities of Punjab were taken on the basis of inclusion criteria. Then Spiro metric parameters (FEV1, PEF/MMEF) were recorded at pre, post 5 minutes and post 12 minutes of exercise. Mean standard deviation and percentile was used to prepare summary statistics. Unpaired t – Test was the tool for statistical analysis at the p<0.05 level of significance between the various demographic parameters.
Results: The total prevalence of EIB among the 3 State Universities was found to be 18.69%.
Conclusion: It is concluded from the study that elite football players are prone to EIB, and the possible cause can be the temperature, relative humidity, duration and intensity of exercise. Players should take some effective measures such as warm up, stretching prior to the game in order to prevent themselves from EIB.
Key words: EIB, spirometery, pulmonary functions, FEV1, PEF/MMEF
OBJECTIVES:
To find out the effectiveness of vestibular rehabilitation in improvement of daily life functions in elderly (60-75)
DESIGN:
Randomized control trial is conducted to examine the association between the vestibular disability and vestibular rehabilitation. 50 subjects including both sexes will be taken who can understand instructions and were not suffering from neurological disorders such as stroke, parkinsonism etc.
SETTING:
Shramjeevi Physiotherapy department in Udaipur
Aggrawaldharmshala Physiotherapy department in Udaipur
In and around my locality
SUBJECTS:
50 subjects of both sexes with age group 60 to 75
Subjects who can understand instructions, Cooperative subjects ,ABC scale between 10-90.
MAIN OUTCOME MEASURES:
1. Activities of daily living
2. ABC (The Activities-specific Balance Confidence) scale for Balance
3. Berg-Balance Scale
RESULTS:
Vertigo decreased and independence in activities of daily living improved significantly. Improvement was not affected by age, gender, or history of vertigo.
CONCLUSION :
For many patients a simple home program of vestibular habituation head movement exercises is related to reduction in symptoms and increasing independence in activities of daily living.
Background
Balance is one of those ‘ordinary’ body functions we do not think about until its disruption. Sit in a violently spinning roller coaster ride for a few minutes, however, and then try to walk upright. You’ll become actualy aware that your vestibular system , located in your inner ear has been upset1.The dizziness and nausea you feel are symptoms that the roller coaster ride disrupted the normal functioning of the system that maintains proper balance.
The Vestibular System
The vestibular system, which is a contributor to our balance system and our sense of spatial orientation, is the sensory system that provides the dominant input about movement and equilibrioception. The vestibular sense provides information related to movement and head position and is important for development of balance, coordination, eye control, attention, being secure with movement and some aspects of language development 2,3.
Symptoms of Vestibular Impairment
Disorders of the vestibular system are characterized by vertigo, disequilibrium, disorientation, and blurred vision2.
Vertigo
Vertigo, a specific kind of dizziness, refers to illusion of self-motion, usually described as a sense of spinning or falling, although the person is actually sitting or lying still. Vertigo seems to be caused by an inequality in the signals ascending the vestibular nerves to the vestibular nuclei. When the signals are equal, as is the case for persons without disabilities and for persons with total bilateral vestibular loss, the person doesn’t experience vertigo.
Disequilibrium
Disequilibrium refers to poor balance or a sense of being unable to correct postural displacements off the gravitational vertical. Because the vestibular system has projections from the vestibular nuclei to the spinal cord, the system generates postural reflexes that compensate for head movement when the head moves off the center of gravity. Disequilibrium can be caused by loss or impairment of the labyrinthine righting responses, which generates a compensatory postural reflex to maintain the head’s upright position in response to movement of the trunk. Disequilibrium is also caused by other kind of sensory loss as well as various orthopedic problems, such as leg-length discrepancy, subluxed bones in the foot, or muscular weakness 5.
Disorientation
Disorientation refers to the sense of not knowing one’s location in egocentric space, such as the direction of the gravitational vertical, or one’s location in geographical space. Vestibular function is more directly involved in egocentric orientation5.
Blurred Vision
Blurred vision can be caused by an impaired vestibuloocular reflex. This reflex is the compensatory oscillopsia, disequilibrium, blurred vision while moving, disorientation, or a combination of the above. The functional assessment of these patients reflects these problems.
Vestibular Rehabilitation
Vestibular rehabilitation is an exercise approach to the remediation of disequilibrium and dizziness symptoms associated with vestibular pathology.
The aim of vestibular rehabilitation are –
1. To decrease dizziness,
2. Increase balance function, and
3. Increase general activity level.
The exercises are designed dependent on the impairements identified through evaluation, to promote CNS compensation for the deficits of the vestibular system.
Physiological basis for Vestibular Rehabilitation
Vestibular rehabilitation is based on the following principles:
1. Adaptation: It refers to a long term improvement in the vestibular systems ability to adapt to head movement, achieved by the movement of an image across the retina.
2. Habituation: It refers to reduction in symptoms and pathological responses produced by repetitive exposure to the provoking stimulus. It is central process. Movements should be practiced 2 to 3 times per day.
3. Substitution: These exercises synthesize the use of vision and somatosensory cues with vestibular cues to enhance central programming to improve gaze stability and postural stability.Pathology within the vestibular system leads to an alteration in the bilateral reliance on sensory information. Patients with bilateral vestibular loss substitute vision and proprioception for use of vestibular information.
4. Compensation: Compensation is a gradual process of functional recovery that is probably of central origin11.Patient’s with vestibular loss use different compensatory strategies to improve their ability to see clearly during a head rotation12.
VR Exercises 30
1. Basic exercises:
” Shake & Nod; eyes open, eyes closed, visual fixation.
” Progress from sitting, standing, then walking (starting slowly if necessary, increasing speed).
2. General activities:
” ball games, walking on different surfaces or in different places, sports dance and exercise, travel.
3. Special exercises:
” for unsteadiness, turning over in bed, reaching, dealing with different visual patterns / environments.
Aim of Study
To find out the effectiveness of vestibular rehabilitation in improvement of daily life functions in elderly (60-75).
Need or purpose of study
Purpose of study is to find out the effectiveness of vestibular rehabilitation in improvement of daily life functions in elderly (60-75), suffering from the problem of disequilibrium, blurred vision, disorientation, and vertigo.
Hypothesis
There is significant effect of vestibular rehabilitation in improvement of daily life functions in elderly.
Null Hypothesis
There is no significant effect of vestibular rehabilitation in improvement of daily life functions in elderly.
Size of sample:
50 subjects are included , male and females age group between 60 to 75
Sample technique:
Randomized control trial
Design of study:
Experimental study
Resource of data:
Orbit Hospital, gurgaon.
Inclusive criteria:
Both sexes with age groupbetween 60 to 75
Subjects who can understand instructions (Cooperative subjects)
ABC scale between 10-90
Exclusive criteria: .
-Subjects below 60 and above 75
-Subjects with systemic illness
-Subjects with neurological conditions
-ABC scale below 10 and above 90
Outcome measure:
1. ABC (The Activities-specific Balance Confidence) scale for Balance
2. Berg-Balance Scale
Procedure:
Randomized control trial will be conducted to examine the association between the vestibular disability and vestibular rehabilitation. 50 subjects.
Cawthorne-Cooksey exercises
RESULTS :
There is significant improvement in BMI, fat and hip-waist ratio in middle aged women after the abdominal strengthening exercises.
BMI: 1st day BMI mean as compare to 1st month BMI mean is 28.68± 27.58 and S.d. is 3.600±3.59 and t test is 54.44 and Pvalue is .001.
ACTIVITIES SPECIFIC BALANCE CONFIDENCE (ABC) SCALE
BERG BALANCE SCALE
Result Discussion
Vertigo decreased and independence in activities of daily living improved significantly. Improvement was not affected by age, gender, or history of vertigo.
Limitation of Study :
” Sample size limited to 50
” This study is done over female only
” Age group is between 40-60.
Future Scope:
” Further study can be done on age group other than 40-60.
” Further study can be done over males.
” Other exercises rather than abdominal strengthening can be done for reduction of weight.
CONCLUSION
In this study the aim was to evaluate the effectiveness of abdominal strengthening exercises in reduction of waist circumference in middle aged women. Based on results of statistical analysis, this study found that abdominal exercises reduce the waist circumference in middle aged women.For many patients a simple home program of vestibular habituation head movement exercises is related to reduction in symptoms and increasing independence in activities of daily living.
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15. www.Google.com