gms | German Medical Science

Background/research question: Dizziness, vertigo and balance disorders (VDB) affect up to 50% of older adults [1]. Symptoms like gait instability and fear of falling can lead to a reduction in physical activity levels. In the MobilE-PHY2 study, a care pathway to improve mobility and participation in patients with VDB, integrating general practices and physiotherapy, was tested in a randomized controlled trial [2]. Our aim was to evaluate the impact of the care pathway on the physical activity levels of patients with VDB.

Methods: The intervention group (IG) followed the care pathway for three months, while the control group (CG) received standard care. Patients wore an activity tracker (movisens GmbH) for one week at baseline (t0) and at six months (t2). They also maintained a diary to document daily activities and episodes of dizziness. Customized software (DataAnalyser, movisens GmbH) calculated mean activity (g) and cadence (60-second intervals). Datasets with less than four days and ten hours per day were excluded from the analysis [3]. Two-factor repeated-measures ANOVA were used to analyze changes in mean g and cadence over time between groups. A subgroup analysis was performed for IG participants who did and did not receive physiotherapy. Correlations examined the relationship between dizziness frequency and mean g.

Results: The analysis included data of 761 days from 46 patients (n=20 IG, n=26 CG). The mean duration of dizziness was significantly longer in the IG (56 minutes, SD 48) compared to the CG (27 minutes, SD 27) (p=0.01). A weak but significant correlation was found between dizziness frequency and mean activity levels (r=-0.2, p=0.01) at t2. For mean g, no significant effects were detected for group (p=0.3), time (p=0.06), or interaction (p=0.9). Similarly, for mean cadence no significant group differences (p=0.3) or interaction effects were found (p=0.7), though a significant effect over time was observed (p=0.01), (η2≤0.02 for all ANOVA). Adding dizziness frequency as a factor did not alter significance level. The subgroup analysis also showed no significant effects.

Conclusion: Patients with more frequent dizziness tended to have slightly lower levels of physical activity. The care pathway had no significant effect on the physical activity level in older adults with VDB in daily life, regardless of physiotherapy. These findings should be interpreted with caution, considering that 36 participants (44%) were excluded from the analysis, including 50% of those in the IG who received physiotherapy.

Competing interests: No conflicts of interest are declared.