Division of Neurotology, Department of Otorhinolaryngology, Complexo Hospitalario Universitario, Santiago de Compostela, Spain.
Department of Surgery and Medical-Surgical Specialities, University of Santiago de Compostela, Santiago de Compostela, Spain.
Aging Clin Exp Res. 2021 Oct;33(10):2807-2819. doi: 10.1007/s40520-021-01813-2. Epub 2021 Mar 7.
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.
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.
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).
VR using mobile posturography is useful to improve stability in old people with instability, showing similar improvement rates to those of VR using CDP.
NCT03034655 www.clinicaltrials.gov Registered on 25 January 2017.
前庭康复（VR），特别是结合动态计算机测姿仪（CDP）的 VR，已被证明有助于改善老年人的平衡能力和降低跌倒风险。其主要障碍可能是成本较高，这阻碍了其推广。降低成本的一种解决方案是使用移动测姿系统进行 VR，该系统可以在日常生活条件下评估质心稳定性。此外，还可以使用振动触觉神经反馈训练进行动态任务康复。
评估使用 CDP 和 Vertiguard 系统进行两种不同的前庭康复方案是否能显著改善有平衡障碍的老年人的平衡能力。
设计了一项比较使用 CDP 练习和移动测姿（Vertiguard）练习的 VR 的临床试验。参与者为 65 岁以上、有平衡障碍的人群。CDP 感觉组织测试（SOT）的综合（平均平衡）是主要的观察指标；在 VR 前后 3 周进行比较，并在两组干预组之间进行比较。
共有 40 名患者纳入研究（CDP-VR 组 19 例，Vertiguard-VR 组 21 例）。两组干预组的平均平衡均显著改善（CDP-VR 组：51%预 VR 与 60%后 VR，p=0.002；Vertiguard-VR 组：49%预 VR 与 57%后 VR，p=0.008）；但两组之间的改善程度无显著差异（p=0.580）。
使用移动测姿的 VR 有助于改善不稳定老年人的稳定性，其改善率与使用 CDP 的 VR 相似。
NCT03034655，www.clinicaltrials.gov，注册于 2017 年 1 月 25 日。
