What is the most effective vestibular rehabilitation technique in patients with unilateral peripheral vestibular disorders?
Vestibular rehabilitation has been found to be effective and safe in patients with instability. There is insufficient evidence, however, for distinguishing between the efficacies of different rehabilitation techniques. The objective of this study is to verify whether there are differences between two instrumental vestibular rehabilitation techniques, computerised dynamic posturography (CDP) and optokinetic stimulation (OKN), in order to establish the optimal strategy for each patient. We conducted a prospective, comparative study of the two techniques (CDP and OKN) in patients with instability due to chronic unilateral peripheral vestibular disorder. We randomly included 12 patients in each group, performing the evaluation with the Dizziness Handicap Inventory and the CDP with the sensorial organisation test (SOT), rhythmic weight shift and limits of stability (LOS). We found a statistically significant improvement in both groups in average balance score according to the SOT. In the OKN group, however, improvement was greater in visual preference. The CDP group showed greater benefits in the visual and vestibular input and LOS. Patients with poor vestibular and visual input or with reduced LOS will benefit more from an exercise protocol with CDP. Patients with poor visual preference, however, are ideal candidates for rehabilitation with OKN.
KeywordsComputerised dynamic posturography Optokinetic stimulation Vestibular rehabilitation Instability Unilateral peripheral vestibular disorders
Conflict of interest
The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.
- 1.Santos S, Soto A, Rossi M, Elhendi W, Labella T (2007) Tratamiento rehabilitador de los trastornos del equilibrio. Diseño de un protocolo general con la posturografía dinámica computerizada. An Otorrinolaringol Ibero Am 34(5):465–484Google Scholar
- 2.Hillier SL, Hollohan V (2007) Vestibular rehabilitation for unilateral peripheral vestibular dysfunction. Cochrane Database Syst Rev 4:CD005397Google Scholar
- 8.Jongkees LBW, Maas JPM, Philipszoon AJ (1962) Clinical nystagmography. A detailed study of electronystagmography in 341 patients with vertigo. Pract Otorhinolaryng 24:65–93Google Scholar
- 9.Bartual Pastor J (1998) Pruebas calóricas. In: Bartual Pastor J, Pérez Fernández N (eds) El sistema vestibular y sus alteraciones. Masson, Barcelona, pp 221–237Google Scholar
- 11.Nashner LM (2001) Computerize dynamic posturography. In: Goebel JA (ed) Practical management of the dizzy patient. Lippincott Williams & Wilkins, Philadelphia, pp 143–170Google Scholar
- 12.Rossi Izquierdo M, Soto Varela A, Santos Pérez S, Labella Caballero L (2008) Análise prospectivo dos resultados da reabilitação vestibular mediante posturografía dinâmica computorizada em pacientes com instabilidade. Clin Inves Otorri 2(1):12–16Google Scholar