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Vestibular rehabilitation with mobile posturography as a “low-cost” alternative to vestibular rehabilitation with computerized dynamic posturography, in old people with imbalance: a randomized clinical trial

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Abstract

Background

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.

Objective

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.

Results

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).

Discussion and conclusions

VR using mobile posturography is useful to improve stability in old people with instability, showing similar improvement rates to those of VR using CDP.

Unique identifier

NCT03034655 www.clinicaltrials.gov Registered on 25 January 2017.

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Data availability

The datasets generated for this study are available on request to the corresponding author.

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Acknowledgements

To Andrés Blanco-Hortas, expert in biostatistics at the Health Research Institute of Santiago de Compostela (IDIS), for his help in the statistical analysis

Funding

This study was funded by the project PI1500329, integrated into the Spanish State Plan for R + D + I and funded by the Instituto de Investigación en Salud Carlos III- ISCIII -Subdirección general de Evaluación y Fomento de la Investigación and the Fondo Europeo de Desarrollo regional (FEDER).

Author information

Authors and Affiliations

  1. Division of Neurotology, Department of Otorhinolaryngology, Complexo Hospitalario Universitario, Santiago de Compostela, Spain

    Andrés Soto-Varela & Sofía Santos-Pérez

  2. Department of Surgery and Medical-Surgical Specialities, University of Santiago de Compostela, Santiago de Compostela, Spain

    Andrés Soto-Varela & Sofía Santos-Pérez

  3. Department of Otorhinolaryngology, University Hospital Lucus Augusti, Lugo, Spain

    Marcos Rossi-Izquierdo

  4. Department of Otorhinolaryngology, Complexo Hospitalario Universitario, Santiago de Compostela, Spain

    María del-Río-Valeiras, Ana Faraldo-García, Isabel Vaamonde-Sánchez-Andrade & Antonio Lirola-Delgado

Authors
  1. Andrés Soto-Varela
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  2. Marcos Rossi-Izquierdo
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  3. María del-Río-Valeiras
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Contributions

AS-V, MR-I, MD-R-V, AF-G, IV-S-A, AL-D and SS-P have contributed to the conception and design of this manuscript, revised it critically, approved the final version and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All authors have read and approved the manuscript. AS-V and MR-I have written the manuscript. AF-G, SS-P and AL-D have performed the clinical assessment of the patients. MD-R-V has collected the data. AS-V and MR-I have developed the statistical analysis. IV-S-A and SS-P have revised critically the manuscript.

Corresponding author

Correspondence to Andrés Soto-Varela.

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Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Ethics approval and consent to participate

The protocol has been approved by the Independent Ethics Committee of Galicia (protocol 2014/411). The study was conducted according to ICH Good Clinical Practices and the Declaration of Helsinki and Law 14/2007 on July 3, on Biomedical Research. All participants gave their written consent to participate in the study.

Statement of human and animal rights

The study was performed according to the protocol approved by the Independent Ethics Committee of Galicia (Protocol 2014/411). The study was conducted according to ICH Good Clinical Practices and the Declaration of Helsinki and Law 14/2007 on July 3, on Biomedical Research.

Informed consent

Signed informed consent was obtained from all the participants.

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Soto-Varela, A., Rossi-Izquierdo, M., del-Río-Valeiras, M. et al. Vestibular rehabilitation with mobile posturography as a “low-cost” alternative to vestibular rehabilitation with computerized dynamic posturography, in old people with imbalance: a randomized clinical trial. Aging Clin Exp Res 33, 2807–2819 (2021). https://doi.org/10.1007/s40520-021-01813-2

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