Physical therapy (PT) within three months of presentation for dizziness was associated with an 86% reduction in the odds of falling by 12 months, a study found.
Researchers conducted a cross-sectional study using U.S. commercial insurance and Medicare Advantage claims from January 2006 through December 2015 to examine the association between PT and falls requiring medical care within 12 months of presentation for dizziness after accounting for presentation setting, Charlson Comorbidity Index, diagnosis code, and sociodemographic characteristics. Secondary outcomes included factors associated with falls requiring medical care and factors associated with receipt of PT after presentation for dizziness. Results were published Sept. 14 by JAMA Otolaryngology–Head & Neck Surgery.
Overall, 805,454 adults with a new diagnosis of symptomatic dizziness or vestibular disorders were included in the study. The median age was 52 years, and 62% were women. A total of 45,771 patients (6%) received PT within three months of presentation for dizziness and 60,060 (7%) had a fall requiring medical attention within 12 months after presentation for dizziness. In adjusted models, patients were least likely to receive PT if they were female (adjusted odds ratio [OR], 0.80; 95% CI, 0.78 to 0.81), ages 50 to 59 years (adjusted OR compared with patients ages 18 to 39 years, 0.67; 95% CI, 0.65 to 0.70), and had more comorbid conditions (adjusted OR, 0.71; 95% CI, 0.70 to 0.73). Patients who received PT within three months of presentation were more likely to have a reduced fall risk over the next 12 months, with the greatest risk reduction in the three months after PT. The adjusted ORs were 0.14 (95% CI, 0.14 to 0.15) at three to 12 months, 0.18 (95% CI, 0.18 to 0.19) at six to 12 months, and 0.23 (95% CI, 0.23 to 0.24) at nine to 12 months.
The authors noted that more research, ideally with a clinical trial design, is needed to explore the independent impact of PT on subsequent falls for adults with dizziness and said that health care has emphasized technological advances and devices to help decrease fall risk in patients with dizziness. “These data emphasize the importance of counseling and initiating preventive measures at the time of dizziness presentation in any setting (ED or outpatient) to potentially reduce the burden of fall-related injuries and deaths,” they wrote. “However, there is evidence that PT is underused for patients with dizziness.”