ASSESSMENT AND REHABILITATION PROGRAM IN DIZZINESS PATIENTS PRESENTING VERTEBRAL FRACTURE

Abstract

Vertebral fragility fractures, usually occurring in elderly people affected by osteoporosis, due to bones resistance alteration, produce balance disorders [1].Balance is the correct connection between the subject and the surrounding environment [2]. Neuro-physiological, biomechanical, emotional, psychological and relational factors have an important influence in posture assessment and balance maintenance, because of the universally recognized role of “polisensorial system.” A preferential motor-sensorial strategy is always present with possibility of readaptation during life, especially after a central or peripheral injury, establishing neuro-plastic processes and compensation mechanisms to restore physiological functions. Dizziness is defined as a subjective and unpleasant perception of instability or uncertainty in posture, walking and movement in the space. It frequently occurs in adult population and it is usually associated with general discomfort and confusional state [3-4]. Osteoporotic vertebral body fractures, due to dishomogeneous bone resorption, cause alteration of the mechanical properties of the injured vertebra as well as the adjacent disc and vertebra. Vertebral fractures in elderly subjects with osteoporosis, if not properly treated, may lead to balance impairment related to progressive increase of dorsal kyphosis, which displaces forward the centre of gravity, exposing the subjects to an increased risk of falls and permanent disability [1]. Moreover, bone demineralization affecting all skeletal system including temporal bone, which cointains cochlea and vestibular labyrinth, is strongly associated to postural impairment in elderly people [5]. The aim is teaching patients selected exercises, performed both with the specialist and autonomously repeated at home; the treatment is based on proprioceptive and vestibular rehabilitation exercises, to improve their postural control and global quality of life.