Vestibular Rehabilitation Using Dynamic Posturography: Objective and Patient-Reported Outcomes from a Randomized Trial.
Otolaryngol Head Neck Surg
; 2024 Jul 06.
Article
in En
| MEDLINE
| ID: mdl-38971974
ABSTRACT
OBJECTIVE:
Balance deficits are common and debilitating. Standard treatments have limitations in addressing symptoms and restoring dynamic balance function. This study compares a rehabilitative computerized dynamic posturography (CDP) protocol, computerized vestibular retraining therapy (CVRT), with a home exercise program (HEP) for patients with objectively confirmed unilateral vestibular deficits (UVDs). STUDYDESIGN:
Single-center, randomized, interventional trial, with 1-sided crossover.SETTING:
A tertiary neurotology clinic.METHODS:
Patients with UVDs and Dizziness Handicap Inventory (DHI) score >30 were randomized to receive either CVRT or HEP. After completion of treatment, the HEP group was crossed over to CVRT. Outcome measures were the sensory organization test (SOT) and 3 participants reported dizziness disabilitymeasures:
the DHI, Activity-Specific Balance Confidence Scale (ABC) scale, and Falls Efficacy Score-International (FES-I).RESULTS:
We enrolled 37 patients 18 participants completed CVRT and 12 completed HEP, 11 of whom completed the crossover. Seven participants withdrew. The CVRT group demonstrated a greater improvement in SOT composite score than the HEP group (P = .04). Both groups demonstrated improvement in participant-reported measures but there were no differences between groups (DHI P = .2604; ABC P = .3627; FES-I P = .96). Following crossover to CVRT after HEP, SOT composite (P = .002), DHI (P = .03), and ABC (P = .006) improved compared to HEP alone.CONCLUSION:
CVRT and HEP were both associated with improved participant-reported disability outcomes. CVRT was associated with greater improvement in objective balance than HEP. Adding CVRT after HEP was superior to HEP alone. Multimodal CDP-based interventions, such as CVRT, should be considered as an adjunct to vestibular physiotherapy for patients with UVD.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
Otolaryngol Head Neck Surg
Year:
2024
Document type:
Article