Effect of Vitamin D on balance performance in elderly fallers.

Patients found to have impaired balance and vitamin D deficiency after assessment in The Nepean Hospital falls and fracture prevention clinic are recruited. Sixty patients (30 cases and 30 controls) fitting the inclusion criteria will be recruited at the Falls and Fractures Clinic, Nepean Hospital. The following parameters will be evaluated at baseline: balance performance measured by our balance rehabilitation unit (BRU), gait parameters (GaitRITE), serum levels of vitamin D, calcium, albumin and parathyroid Hormone (PTH). Patients with poor balance performance and low levels of vitamin D will be then randomised to receive either one intramuscular injection dose of vitamin D3 of 50,000 International Units or 1 ml (Arachitol, Solvay Pharma, India) or one intramuscular injection dose of placebo (1 mL of normal saline). All patients will receive calcium 1,200 mg orally once daily for the duration of the study ( 9 weeks) and commences immediately after the vitamin D3/placebo injection. After three weeks of randomization and treatment, all subjects will attend the standard balance rehabilitation program for six weeks. The program is run by a physiotherapist trained in using the balance rehabilitation unit machine. The program consists of two half hour sessions per week and runs for 6 weeks. Once patients complete 6 weeks of BRU, new balance, gait and serological assessment will be performed. Patients will be unblinded when all patients have completed the 6-week assessment. Patients in the placebo will then be supplemented with high dose vitamin D.