An Intraprofessional Collaboration to Optimize Patient-Centered Care for Urgency Urinary Incontinence, Benign Paroxysmal Positional Vertigo, and Falls: A Case Study

Background: Urgency urinary incontinence (UUI) and benign paroxysmal positional vertigo (BPPV) more commonly affect postmenopausal women and increase risk of falls, yet screening for these conditions in this population is not a routine consideration for physical therapists. This case study presents findings from screening and treatment of 1 postmenopausal woman for UUI, BPPV, and fall risk and discusses benefits of providing more comprehensive management of conditions commonly affecting this population and contributing to fall risk. Case Description: The patient was a 74-year-old postmenopausal woman referred to physical therapy for orthopedic complaints and history of falls. Bladder symptoms, fall risk, and dizziness were screened using validated outcome measures. The patient was diagnosed with overactive bladder (OAB), bilateral posterior canal BPPV, and increased risk of falls. Balance deficits were addressed with functional strengthening and balance training, BPPV was treated with canalith repositioning maneuvers, and the patient denied treatment related to bladder symptoms. Outcomes: Clinically meaningful improvements were noted in balance confidence and functional mobility and strength indicating a reduction in fall risk. Bilateral posterior canal BPPV was treated with complete resolution of dizziness. The patient was subsequently enrolled in a clinical trial related to bladder symptoms. Discussion: Intraprofessional screening for UUI and BPPV in postmenopausal women may be beneficial in the comprehensive management of symptoms of OAB and dizziness potentially leading to reduction in fall risk. Additionally, interdisciplinary collaboration between physicians and physical therapists specializing in pelvic health and neurology could improve overall function and quality of life in postmenopausal women.