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Program
at The New York Eye and Ear Infirmary Helps Elderly Prevent Falls
Special
Rehabilitation Team Diagnoses, Treats Balance Problems
Agnes F., 82, had fallen onto the street while boarding a bus in 1999 and suffered a
head injury. She complained of dizziness and imbalance problems afterward, began using a walking cane
and severely cut back on her activities in her home and in the community
because of a fear of falling. She came to the program in March 2002. Six months later, after weekly therapy on a
balance machine and a home-therapy regimen that involved walking, head turning
and gazing exercises, she is leaving the program -- without a cane and with
renewed confidence!
New York (October 2002) -- Falls are the major cause of injury
in the elderly and lead to over 300,000 hip fractures annually in the United
States. Half of the elderly who fall do so repeatedly.
Model programs such as the Vestibular Rehabilitation Program at The New York Eye and Ear Infirmary help identify and correct
the balance problems that lead to debilitating and costly falls in America's
rapidly growing elderly population.
"Falls are not a normal product
of aging; they can be prevented," said Linda
Vetere, director of the
program, which in the past has grown from one to three full-time therapists
and has a medical director and eight audiologists who provide testing.
"To
avoid falling, we first need to assess the underlying cause of an older
person's imbalance and determine whether it involves an inner ear problem, vision impairment or
the body's sensory system," said the program's medical director, Ronald Hoffman, M.D.
"Then
we can offer them rehabilitative therapy and coping strategies to avoid
falls."
All patients are referred to
the special program by their physician. Some have complex problems, such as a
tumor on a cranial nerve that leads to disequilibrium, and they require
complex solutions, such as re-teaching the brain to cope through specific,
repeated exercises.
Other patients' problems are
simple, such as weak ankles or legs, and they can be helped with simple
exercises and a walker. Each is provided with a tailored treatment and coping
strategy.
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How
are Patients Evaluated?
Audiologists in the program evaluate patients
for dizziness, hearing loss, imbalance and postural instability and use a
range of state-of-the-art diagnostic technology to measure:
- Hearing (audiometric evaluations)
- Eye movement (computerized
electronystagmography and videonystagmography)
- Posture (computerized dynamic platform
posturography)
- Brain stem response and
- Function of the cochlea of the inner ear (electrocochleography)
Treatments may include:
- Habituation exercises (walking and head
turning)
- SMART Balance Master (a machine the size of
a shower stall that patients stand on which provides objective assessment
and retraining of patients with balance and mobility disorders. Depending
on the need, the machine has a stable or unstable support surface and
stable or dynamic visual surround with visual biofeedback.)
- Gaze stabilization exercises
- Balance training
- Strength training
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About
The New York Eye and Ear Infirmary
The New York Eye and Ear
Infirmary is the oldest specialty hospital in the Western hemisphere and is a
teaching affiliate of New York Medical College. It has approximately 142,000
outpatient visits annually and over 20,000 surgical procedures per year.
The New York Eye and Ear Infirmary is a member of Continuum Health Partners, Inc., which also includes
Beth Israel, St. Luke's Roosevelt, and Long Island College Hospitals.
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