Vestibüler Sistemde Yaşa Bağlı Değişikliklerin Denge Üzerine Etkilerinin Araştırılması: Bir Derleme

Year 2023, Volume: 37 Issue: 3, 309 - 321, 25.01.2024

Aygül Köseoğlu , Mehmet Kaan Altunok , Mustafa Oğuz Kethüdaoğlu , Suzan Aydın , Havva Ezgi Albayrak , Hande Besna Göçen , Bülent Abut Özsezikli

https://doi.org/10.18614/deutip.1330102

Abstract

Vestibüler sistem (VS), başın yer çekimine göre hareketini algılayıp denge, otonomik fonksiyon, uzaysal algı ve oryantasyon üzerine düzenlemeler yaparak bireyin hayatta kalabilmesi için hayati görevler üstlenir. VS’nin intraüterin dönemde gelişmeye başlayan ilk sistem olmasının yanı sıra çocukluk dönemiyle birlikte gelişimine devam etmektedir. Başlangıç zamanı çeşitli faktörlere bağlı olarak değişmekle birlikte yaşlanmayla VS dejenere olduğu bilinmektedir. Literatürde duyusal vestibüler tüylü hücre sayısının doğumdan yaşlılığa her on yılda yaklaşık %6 oranında azaldığı da gösterilmiştir. Bunun yanı sıra vestibüler çekirdeklerdeki nöronlar, 40 ila 90 yaşları arasında her on yılda yaklaşık %3 oranında azaldığı da bilinmektedir. VS’deki yaşa bağlı bu değişiklikler yaşlı bireylerde baş dönmesi, denge kaybı, dengesiz yürüme, artan düşmeler ve hatta ajitasyona, yalnızlık ve özgüven kayıplarına neden olabilmektedir. Bunun yanı sıra literatürde vestibüler bozukluğa bağlı düşmelerin yaşlı yetişkinler arasında ölüm sebepleri arasında üçüncü ila onuncu önde gelen ölüm nedeni arasında olduğu da bildirilmektedir. Bu anlamda ülkelerin sağlık sistemlerinin sağlıklı yaşlanma eylem planlamalarında ve yaşa bağlı düşmeleri engelleyici stratejilerin geliştirilmesinde yaşa bağlı VS disfonksiyonlarının belirlenmesi oldukça önemlidir. Aynı zamanda özellikle geriatrik rehabilitasyon alanında çalışan fizyoterapistlerin muhtemel vestibüler rehabilitasyon programlarının oluşturulmasında VS’nin yaşa bağlı değişimlerini ve denge üzerine olan etkilerini iyi bilmeleri oldukça değerlidir. Vestibüler bozukluklar için vestibüler rehabilitasyona ek olarak uygulanan sanal gerçeklik uygulamalarının ümit vadettiği, yaşlı popülasyonda özellikle işitme problemlerinin gözden kaçırılmaması ve ihtiyaç halinde işitme cihazlarının reçete edilmesi gerektiğini düşünmekteyiz.

Keywords

geriatrik rehabilitasyon, postural denge, vestibüler disfonksiyon, vestibüler rehabilitasyon

Supporting Institution

Yoktur.

Project Number

Yoktur.

Thanks

Yoktur.

Investigation of the Effects of Age-Related Changes in the Vestibular System on Balance: A Review

Abstract

The vestibular system (VS) undertakes vital tasks for the survival of the individual by perceiving the movement of the head according to gravity and adjusting on balance, autonomic function, spatial perception, and orientation. In addition to being the first system to develop in the intrauterine period, the VS continues to develop with childhood. Although the onset time varies depending on various factors, it is known that VS degenerates with aging. It has also been shown in the literature that the number of sensory vestibular hair cells decreases by approximately 6% per decade from birth to old age. In addition, neurons in the vestibular nuclei are known to decrease by about 3% per decade between the ages of 40 and 90. These age-related changes in VS may cause dizziness, loss of balance, unsteady gait, increased falls and even agitation, loneliness, and loss of self-confidence in elderly individuals. In addition, it is reported in the literature that falls due to vestibular disorder are among the third to tenth leading causes of death among older adults. In this sense, it is very important to determine age-related VS dysfunctions in the healthy aging action plans of the health systems of the countries and in the development of strategies to prevent age-related falls. At the same time, it is very valuable for physiotherapists working in the field of geriatric rehabilitation to know well the age-related changes of VS and its effects on balance in the creation of possible vestibular rehabilitation programs. We think that virtual reality applications applied in addition to vestibular rehabilitation for vestibular disorders are promising, especially hearing problems in the elderly population should not be overlooked and hearing aids should be prescribed if needed.

Keywords

geriatric rehabilitation, postural balance, vestibular dysfunction, vestibular rehabilitation

Project Number

Yoktur.

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