Andrés Soto-Varela1,2, Marcos Rossi-Izquierdo3, María Del-Río-Valeiras4, Ana Faraldo-García4, Isabel Vaamonde-Sánchez-Andrade4, Antonio Lirola-Delgado4, Sofía Santos-Pérez5,6. 1. Division of Neurotology, Department of Otorhinolaryngology, Complexo Hospitalario Universitario, Santiago de Compostela, Spain. andres.soto@usc.es. 2. Department of Surgery and Medical-Surgical Specialities, University of Santiago de Compostela, Santiago de Compostela, Spain. andres.soto@usc.es. 3. Department of Otorhinolaryngology, University Hospital Lucus Augusti, Lugo, Spain. 4. Department of Otorhinolaryngology, Complexo Hospitalario Universitario, Santiago de Compostela, Spain. 5. Division of Neurotology, Department of Otorhinolaryngology, Complexo Hospitalario Universitario, Santiago de Compostela, Spain. 6. Department of Surgery and Medical-Surgical Specialities, University of Santiago de Compostela, Santiago de Compostela, Spain.
Abstract
BACKGROUND:Vestibular rehabilitation (VR), specifically, VR with dynamic computerized posturography (CDP) has proven to be useful to improve balance and reduce the risk of falling in old patients. Its major handicap is probably its cost, which has hindered its generalisation. One solution to reduce this cost is performing VR with mobile posturography systems, which allow assessment of stability at the center of body mass in daily-life conditions. Also, rehabilitation with vibrotactile neurofeedback training could be used in dynamic tasks. OBJECTIVE: To assess whether two different protocols of vestibular rehabilitation (using CDP and the Vertiguard system) show significant differences in the improvement of balance among older persons with imbalance METHODS: A clinical trial comparing VR with CDP exercises and VR with mobile posturography (Vertiguard) exercises, was designed. The participants were people over 65 years, with imbalance. The composite (average balance) in the sensory organization test (SOT) of the CDP was the main outcome measure; it was compared before and 3 weeks after VR, and between both intervention groups. RESULTS:40 patients were included in the study (19 in the CDP-VR group and 21 in the Vertiguard-VR group). Average balance was significantly improved in both intervention groups (51% pre-VR vs 60% post-VR, p = 0.002, CDP-VR group; 49% pre-VR vs 57% post-VR, p = 0.008, Vertiguard-VR group); no significant differences in this improvement were found comparing both groups (p = 0.580). DISCUSSION AND CONCLUSIONS: VR using mobile posturography is useful to improve stability in old people with instability, showing similar improvement rates to those of VR using CDP. UNIQUE IDENTIFIER: NCT03034655 www.clinicaltrials.gov Registered on 25 January 2017.
RCT Entities:
BACKGROUND: Vestibular rehabilitation (VR), specifically, VR with dynamic computerized posturography (CDP) has proven to be useful to improve balance and reduce the risk of falling in old patients. Its major handicap is probably its cost, which has hindered its generalisation. One solution to reduce this cost is performing VR with mobile posturography systems, which allow assessment of stability at the center of body mass in daily-life conditions. Also, rehabilitation with vibrotactile neurofeedback training could be used in dynamic tasks. OBJECTIVE: To assess whether two different protocols of vestibular rehabilitation (using CDP and the Vertiguard system) show significant differences in the improvement of balance among older persons with imbalance METHODS: A clinical trial comparing VR with CDP exercises and VR with mobile posturography (Vertiguard) exercises, was designed. The participants were people over 65 years, with imbalance. The composite (average balance) in the sensory organization test (SOT) of the CDP was the main outcome measure; it was compared before and 3 weeks after VR, and between both intervention groups. RESULTS: 40 patients were included in the study (19 in the CDP-VR group and 21 in the Vertiguard-VR group). Average balance was significantly improved in both intervention groups (51% pre-VR vs 60% post-VR, p = 0.002, CDP-VR group; 49% pre-VR vs 57% post-VR, p = 0.008, Vertiguard-VR group); no significant differences in this improvement were found comparing both groups (p = 0.580). DISCUSSION AND CONCLUSIONS: VR using mobile posturography is useful to improve stability in old people with instability, showing similar improvement rates to those of VR using CDP. UNIQUE IDENTIFIER: NCT03034655 www.clinicaltrials.gov Registered on 25 January 2017.
Entities:
Keywords:
Chronic dizziness; Computerized dynamic posturography; Falls in old people; Mobile posturography; Vestibular rehabilitation
Authors: Andrea Ungar; Martina Rafanelli; Iacopo Iacomelli; Maria Angela Brunetti; Alice Ceccofiglio; Francesca Tesi; Niccolò Marchionni Journal: Clin Cases Miner Bone Metab Date: 2013-05