What is the optimal number of treatment sessions of vestibular rehabilitation? (original) (raw)
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European Archives of Oto-Rhino-Laryngology, 2011
Vestibular rehabilitation has been found to be eVective and safe in patients with instability. There is insuYcient evidence, however, for distinguishing between the eYcacies of diVerent rehabilitation techniques. The objective of this study is to verify whether there are diVerences between two instrumental vestibular rehabilitation techniques, computerised dynamic posturography (CDP) and optokinetic stimulation (OKN), in order to establish the optimal strategy for each patient. We conducted a prospective, comparative study of the two techniques (CDP and OKN) in patients with instability due to chronic unilateral peripheral vestibular disorder. We randomly included 12 patients in each group, performing the evaluation with the Dizziness Handicap Inventory and the CDP with the sensorial organisation test (SOT), rhythmic weight shift and limits of stability (LOS). We found a statistically signiWcant improvement in both groups in average balance score according to the SOT. In the OKN group, however, improvement was greater in visual preference. The CDP group showed greater beneWts in the visual and vestibular input and LOS. Patients with poor vestibular and visual input or with reduced LOS will beneWt more from an exercise protocol with CDP. Patients with poor visual preference, however, are ideal candidates for rehabilitation with OKN.
Romanian Journal of Rhinology, 2015
OBJECTIVE. To evaluate the importance of computerized dynamic posturography in vestibular rehabilitation of patients with unilateral peripheral vestibular deficiency syndrome.MATERIAL AND METHODS. The study was conducted on a group of 30 patients (33-78 years; mean age (± SD) = 55.8 ± 12.12) diagnosed with unilateral peripheral vestibular deficiency syndrome, which benefited from VR on a posturography platform. Assessment of the patients was made using the Sensory Organization Test before and after eight sessions of rehabilitation. We analyzed the results obtained with eyes open (EO) and eyes closed (EC) on static and foam platform. The following variables were evaluated: Romberg coefficient, statokinesigram (SKG), maximum amplitude of the degree of deviation in anterior/posterior and medial/lateral planes, SKG and the time interval of the game rehabilitation program.RESULTS. The statistical analysis of the data revealed a strong correlation (p<0.05) for the studied parameters, e...
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2017
Balance becomes more precarious with age, and even without pathological disorders, the physiological decline in balance that occurs with age is a factor that also favors falls. So the aim of the present study is to assess the short-term effectiveness of three different methods of vestibular rehabilitation, compared to a control group, in improving balance in elderly patients with postural instability. 139 elderly patients with high risk of falls were included and randomized to one of the following study arms: computer dynamic posturography (CDP) training, optokinetic stimulus, exercises at home, or control group. Patients were assessed with objective and subjective outcome measures. The individuals that trained using CDP improved significantly more than the control group on the average balance score (p < 0.001) and reducing the number of falls in the sensorial organization test (p < 0.001). In addition, the analysis showed a statistically significant effect in the limits of st...
Clinical Interventions in Aging
Purpose: Vestibular rehabilitation (VR) using posturography systems has proved useful in improving balance among elderly patients with postural instability. However, its high cost hinders its use. The objective of this study is to assess whether two different protocols of VR with posturography, one of them longer (ten sessions) and the other shorter (five sessions), show significant differences in the improvement of balance among old patients with instability. Patients and Methods: This is a prospective, experimental, single-center (Department of Otorhinolaryngology of a tertiary referral hospital), randomized (into balanced patient blocks) study with two parallel arms, in 40 people over 65 years of age, with instability and at a high risk of falling. The percentage of the average balance (composite) in the sensory organization test (SOT) of the CDP (main outcome measure), other CDP scores, time and steps in the "timed up and go" test, scores of Dizziness Handicap Inventory (DHI), short Falls Efficacy Scale-International (short FES-I), and Vertiguard were compared before and 3 weeks after VR between both intervention groups. Results: The two treatment groups (20 patients per group) were comparable in age, sex, and pre-VR balance evaluation. In both groups, we observed a significant improvement in global balance (composite) after VR (49±11.34 vs 57±13.48, p=0.007, in the group undergoing 10 sessions; 51±12.55 vs 60±12.99, p=0.002, 5 sessions). In both groups, we also observed improvements in other posturographic parameters (in the SOT and limits of stability) but not in the timed up and go scores or in the questionnaires. Comparison of the improvement level achieved in both groups revealed no significant differences between them. Conclusion: The protocols of vestibular rehabilitation by posturography of 5 sessions in elderly patients with postural instability are as effective as those of 10 sessions for improving balance among elderly patients with postural instability. Trial Registration: ClinicalTrials.gov identifier: NCT03034655. Registered on
Clinical Interventions in Aging, 2020
Purpose: Vestibular rehabilitation (VR) using posturography systems has proved useful in improving balance among elderly patients with postural instability. However, its high cost hinders its use. The objective of this study is to assess whether two different protocols of VR with posturography, one of them longer (ten sessions) and the other shorter (five sessions), show significant differences in the improvement of balance among old patients with instability. Patients and Methods: This is a prospective, experimental, single-center (Department of Otorhinolaryngology of a tertiary referral hospital), randomized (into balanced patient blocks) study with two parallel arms, in 40 people over 65 years of age, with instability and at a high risk of falling. The percentage of the average balance (composite) in the sensory organization test (SOT) of the CDP (main outcome measure), other CDP scores, time and steps in the "timed up and go" test, scores of Dizziness Handicap Inventory (DHI), short Falls Efficacy Scale-International (short FES-I), and Vertiguard were compared before and 3 weeks after VR between both intervention groups. Results: The two treatment groups (20 patients per group) were comparable in age, sex, and pre-VR balance evaluation. In both groups, we observed a significant improvement in global balance (composite) after VR (49±11.34 vs 57±13.48, p=0.007, in the group undergoing 10 sessions; 51±12.55 vs 60±12.99, p=0.002, 5 sessions). In both groups, we also observed improvements in other posturographic parameters (in the SOT and limits of stability) but not in the timed up and go scores or in the questionnaires. Comparison of the improvement level achieved in both groups revealed no significant differences between them. Conclusion: The protocols of vestibular rehabilitation by posturography of 5 sessions in elderly patients with postural instability are as effective as those of 10 sessions for improving balance among elderly patients with postural instability. Trial Registration: ClinicalTrials.gov identifier: NCT03034655. Registered on
Romanian Journal of Neurology
Objectives. To evaluate the importance of computerized dynamic posturography in vestibular rehabilitation (VR) of patients with central vestibular syndrome. Methods. The study included 30 patients with central vestibular syndrome with mean age (± SD) = 72.96 ± 11.97 which benefited from VR on a posturography platform between 2012-2014. All patients were evaluated using sensory integration tests. The parameters studied were: Romberg coefficient, statokinesigram (SKG), maximum amplitude of the degree of deviation in anterior-posterior and medial-lateral planes, SKG and the time interval of the rehabilitation program. Results. All of the analyzed parameters showed statistically significant results (p <0.05). The anterior-posterior and medio-lateral balance improved significantly at the end of the vestibular rehabilitation program and the parameters decreased to values close to normal. Conclusions. For patients with central vestibular syndrome, the vestibular rehabilitation improves ...
Balance deficits increase the risk of falls and compromise quality of life. This single group, interventional study assesses a computerized vestibular retraining protocol in patients with objectively determined unilateral peripheral vestibular deficits. Participants received twelve twice-weekly sessions of vestibular retraining guided by an interactive display. Objective posturography tests and questionnaires were administered before and after retraining. We enrolled 13 participants (5 females and 8 males) with a median age of 51 years (range 18 to 67). After retraining, the median change in sensory organization test (SOT) composite scores was 8.8 (95% CI, 0.6 to 19.1). The SOT visual (median change of 0.12 [-0.09 to 0.30]) and vestibular (0.10 [-0.06 to 0.25]) ratios improved but there was no change in the somatosensory or visual preference ratios. Participants with moderate-to-severe disability at baseline (n=7), as measured by Dizziness Handicap Inventory, had a larger magnitude ...
Rehabilitation after acute vestibular disorders
The Journal of Laryngology & Otology, 2008
Objectives:To assess the efficacy of rehabilitation for dizzy patients after recent acute vestibular disturbance.Methods:Forty patients recently hospitalised for an acute episode of rotational vertigo which lasted days were randomly divided into two groups. The first group (20 patients; group R) underwent active rehabilitation, while the second group (20 patients; group C) were told only to ‘perform their daily activities’. Group R subjects underwent a total of 10 sessions of rehabilitation, including exercises on a stabilometric platform, point de mire and a series of five exercises repeated five times daily. All patients performed static stabilometry (posturography), undertook the dynamic gait index test, and completed a dizziness handicap questionnaire and a visual analogue scale for anxiety, at baseline and on completion.Results:At 25 days, the rehabilitated patients obtained better results for all recorded outcomes, compared with the control group. The greatest difference in th...
Aging Clinical and Experimental Research, 2018
Background Our previous study had shown the effectiveness of vestibular rehabilitation (VR) in improving balance in elderly patients, assessed immediately afterwards. Aims The main goal of the present study is to consider whether this improvement in balance assessment turns out in a reduction of the number of falls. Methods 139 elderly patients with high risk of falls were included and randomized to one of the following study arms: computerized dynamic posturography (CDP) training, optokinetic stimulus, exercises at home or control group. Patients were assessed with objective outcome measures (sensorial organization test and limits of stability of CDP, number of falls and number of hospital admissions due to falls) and subjective outcome measures (dizziness handicap inventory and short falls efficacy scale-international) during a 12-month follow-up period. Results Average number of falls significantly declined from 10.96 (before VR) to 3.03 (12-month follow-up) in the intervention group (p < 0.001); meanwhile, in the control group, the average number of falls changed from 3.36 to 2.61 during a 12-month follow-up period (p = 0.166). Discussion The present study provides evidence that VR can decisively improve balance in elderly patients with instability, which can lead in turn to a significant reduction of falls. Conclusion We recommend performing VR in any older person with high risk of falls.