Clinical Interventions in Aging (Jun 2020)
Vestibular Rehabilitation Using Posturographic System in Elderly Patients with Postural Instability: Can the Number of Sessions Be Reduced?
Abstract
Andrés Soto-Varela,1,2 Marcos Rossi-Izquierdo,3 María del-Río-Valeiras,4 Isabel Vaamonde-Sánchez-Andrade,4 Ana Faraldo-García,4 Antonio Lirola-Delgado,4 Sofía Santos-Pérez1,2 1Division of Neurotology, Department of Otorhinolaryngology, Complexo Hospitalario Universitario, Santiago de Compostela, Spain; 2Department of Surgery and Medical-Surgical Specialities, University of Santiago de Compostela, Santiago de Compostela, Spain; 3Department of Otorhinolaryngology, University Hospital Lucus Augusti, Lugo, Spain; 4Department of Otorhinolaryngology, Complexo Hospitalario Universitario, Santiago de Compostela, SpainCorrespondence: Andrés Soto-VarelaDivision of Neurotology, Department of Otorhinolaryngology, Complexo Hospitalario Universitario de Santiago, Travesía da Choupana, s/n, Santiago de Compostela 15706, SpainTel +34981951155Email [email protected]: 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 25 January 2017.Keywords: instability, balance, old people, computerized dynamic posturography, mobile posturography, vertiguard
