Keeping Your Patients on Their Feet

Vestibular, central nervous and corneo-retinal potential testing is readily available to physicians in assessing patient risk for falls. Many patients are asymptomatic with inner ear disturbances being the leading risk for falls. The right equipment enables physicians to quickly and easily treat patients and reduce the risk and incidence of falls in the ageing population.

Falls have a major impact on both patient outcome and financial ramifications. As part of the strategy to move health care to an outcomes focus, assessment and screening for risk of falls is high on the priority for MACRA and MIPS scoring.

Falls become increasingly more often with advancing age. It is thought that 30-40% of people over the age of 65 experience a fall every year with roughly half of those resulting in injury, 10% of which are serious. The annual cost of these falls is estimated at $30 billion.

The falls that are included in this are based on reduced patient functionality and not attributed to an acute event such as a stroke.

A fall can have a significant impact on a patient, even if they are not seriously injured. The patient can experience loss of confidence and quality of life resulting in a loss of social connection and independence.

Patients who do sustain serious injury can become incapacitated or result in morbid outcomes. Once patients have a single fall then this heightens the patients fear of falling again in the future.

Risk factors associated with falls can be environmental or intrinsic. Environmental factors include pets, medications, footwear, household rugs or clutter and uneven surfaces.

Intrinsic factors can include loss of muscle strength, slowed reflexes, vision and proprioception. Patients often blame themselves for being distracted, clumsy or rushing. Additionally, many patients will not proactively report their fall to their physician either due to embarrassment or lack of understanding about the significance of the event.

A thorough patient examination of falls risk and assessment can help many patients better understand their propensity to fall. This can help identify treatable causes thereby reducing risk and improving outcomes.

Provision of a thorough assessment extends beyond a patient questionnaire. Gait disturbances, strength, medications and balance can all be assessed.

Balance assessment measures inner ear disturbances and can be performed in the comfort of a primary care physicians office with the right equipment. Balance problems associated with the vestibular response can often be easily treated and show a marked patient improvement within weeks of commencing suitable exercises.

Good balance is associated with communication between the eyes and the vestibular system. Head movement helps trigger signals to the eyes through the vestibulo-ocular reflex.

The VAT-ENG test assesses eye movement looking specifically for vestibular dysfunction. Patients that suffer with dizziness, vertigo and/or balance disorders can benefit from this testing. Testing is performed with the patient seated and electrodes are attached to the patient’s head. Eye movements are recorded and analyzed to determine vestibulo-ocular communication.

The vestibular reflex can be easily improved by the patient performing simple eye exercises that they can do comfortably at home. The exercises help retrain the brain to recognize and process signals from the vestibular system to help with coordination of vision and proprioception.

Follow up assessments can be performed after 3 months to determine improvement in the patient condition. Patients are frequently pleased with the improvement in their balance and well being resulting in an increase in confidence and lower risk of falls.

To find out more about this reimbursable test or other tools for your practice, you can call 888 315 1519 or go to www.ancillarymedsolutions.com. You can also contact me directly at vhudson@ancillarymedsolutions.com and I would be happy to help!