Postural Stability, Fall Risk, and Effects of Balance-Based Exercise in Acromegaly

Area of Science:

• Endocrinology
• Neurology
• Physical Therapy

Background:

• Acromegaly, a disorder caused by excess growth hormone, is associated with potential balance impairments and an elevated risk of falls.
• Understanding these deficits is crucial for developing targeted interventions.

Purpose of the Study:

• To evaluate postural stability, fall risk, and vestibulo-ocular reflex (VOR) function in acromegaly patients.
• To assess the efficacy of a balance-oriented exercise program in improving these parameters.

Main Methods:

• A case-control study involving 32 acromegaly patients (active and inactive) and 32 healthy controls.
• Balance was assessed using computerized dynamic posturography and clinical scales (Berg Balance Scale, International Falls Efficacy Scale, Dizziness Handicap Inventory-Short Form).
• VOR function was evaluated using the video head impulse test. Fifteen patients completed an 8-week exercise program.

Main Results:

• Acromegaly patients demonstrated significantly poorer balance scores and higher fall risk, fear-of-falling, and dizziness compared to controls.
• Increased sway amplitudes were observed in patients, suggesting central sensory integration issues.
• Active acromegaly patients showed greater balance impairment than inactive patients.
• Vestibulo-ocular reflex gains were comparable between groups.
• The exercise program led to significant improvements in balance and clinical outcomes.

Conclusions:

• Balance impairment and increased fall risk are prevalent in acromegaly, likely stemming from impaired central sensory integration.
• Balance-oriented rehabilitation offers a promising approach to enhance postural control and mitigate fall risk in individuals with acromegaly.