Brugnera Cibele, Bittar Roseli Saraiva Moreira, Greters Mário Edvin, Basta Dietmar
Otoneurology Outpatient Clinic, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.
Braz J Otorhinolaryngol. 2015 Nov-Dec;81(6):616-21. doi: 10.1016/j.bjorl.2015.08.013. Epub 2015 Sep 8.
Some patients with severe impairment of body balance do not obtain adequate improvement from vestibular rehabilitation (VR).
To evaluate the effectiveness of Vertiguard™ biofeedback equipment as a sensory substitution (SS) of the vestibular system in patients who did not obtain sufficient improvement from VR.
This was a randomized prospective clinical study. Thirteen patients without satisfactory response to conventional VR were randomized into a study group (SG), which received the vibrotactile stimulus from Vertiguard™ for ten days, and a control group (CG), which used equipment without the stimulus. For pre- and post-treatment assessment, the Sensory Organization Test (SOT) protocol of the Computerized Dynamic Posturography (CDP) and two scales of balance self-perception, Activities-specific Balance Confidence (ABC) and Dizziness Handicap Inventory (DHI), were used.
After treatment, only the SG showed statistically significant improvement in C5 (p=0.007) and C6 (p=0.01). On the ABC scale, there was a significant difference in the SG (p=0.04). The DHI showed a significant difference in CG and SG with regard to the physical aspect, and only in the SG for the functional aspect (p=0.04).
The present findings show that sensory substitution using the vibrotactile stimulus of the Vertiguard™ system helped with the integration of neural networks involved in maintaining posture, improving the strategies used in the recovery of body balance.
一些身体平衡严重受损的患者在前庭康复治疗(VR)后未获得充分改善。
评估Vertiguard™生物反馈设备作为前庭系统感觉替代(SS)对VR治疗效果不佳的患者的有效性。
这是一项随机前瞻性临床研究。13例对传统VR治疗无满意反应的患者被随机分为研究组(SG),接受Vertiguard™的振动触觉刺激,为期10天;以及对照组(CG),使用无刺激的设备。治疗前后评估采用计算机动态姿势描记术(CDP)的感觉组织测试(SOT)方案以及两种平衡自我感知量表,即特定活动平衡信心量表(ABC)和头晕残障量表(DHI)。
治疗后,仅SG组在C5(p = 0.007)和C6(p = 0.01)上有统计学显著改善。在ABC量表上,SG组有显著差异(p = 0.04)。DHI量表显示,在身体方面CG组和SG组有显著差异,在功能方面仅SG组有显著差异(p = 0.04)。
目前的研究结果表明,使用Vertiguard™系统的振动触觉刺激进行感觉替代有助于参与维持姿势的神经网络整合,改善身体平衡恢复中使用的策略。