Dynamic posturography after computerized vestibular retraining for stable unilateral vestibular deficits

Abstract

Background

Balance deficits increase the risk of falls and compromise quality of life. Current treatment modalities do not resolve symptoms for many patients.

Aims/objectives

To measure changes in objective posturography after a computerized vestibular retraining therapy protocol.

Materials and methods

This was a single-arm interventional study of individuals with a stable unilateral vestibular deficit present for greater than six months. Participants underwent 12 twice-weekly sessions of computerized vestibular retraining therapy. Objective response was measured by the Sensory Organization Test and questionnaires were administered to measure subjective changes.

Results

We enrolled 13 participants (5 females and 8 males) with a median age of 51 years (range 18 to 67). After retraining, the Sensory Organization Test composite score improved by 8.8 (95% CI 0.6 to 19.1) and this correlated with improvement in the Falls Efficacy Scale-International questionnaire (r_s −0.6472; 95% CI −0.8872 to − 0.1316). Participants with moderate-to-severe disability at baseline (n = 7) demonstrated greater improvement in the composite score (14.6; 95% CI 7.0 to 36.9).

Conclusions and significance

Computerized vestibular retraining therapy for stable unilateral vestibular deficits is associated with improvement in dynamic balance performance. Posturography improvements correlated with a reduction in perceived fall risk. Trial Registration Information Clinicaltrials.gov registration NCT04875013; 04/27/2021

Chinese abstract

背景：平衡缺陷会增加跌倒风险并影响生活质量。 当前的治疗方式无法解决许多患者的症状。

目的：测量计算机化的前庭再训练治疗方案后客观姿势图的变化。

材料和方法：这是一项单臂干预研究, 针对患有稳定的单侧前庭功能障碍超过六个月的患者。 参与者接受了 12个每周两次的计算机化前庭再训练治疗阶段。 客观反应是通过感官组织测试来测量的, 通过问卷调查来测量主观的变化。

结果：我们招募了 13 名参与者（5 名女性和 8 名男性）, 中位年龄为 51 岁（范围18 至 67岁）。 通过再训练后, 感官组织测试综合得分提高了 8.8（95% CI 0.6 - 19.1）, 这与跌倒效能量表-国际调查问卷显示的改善（r_s -0.6472；95% CI -0.8872 至 - 0.1316）相吻合。 中度至重度基线残疾参与者(n=7)表现出综合评分的较大改善 (14.6; 95% CI 7.0 - 36.9）。

结论和意义：针对稳定单侧前庭功能障碍的计算机化前庭再训练疗法与动态平衡表现的改善有关。 姿势图改善与感知跌倒风险的降低相关。

Keywords:

• Posturography
• vestibular
• rehabilitation
• retraining
• balance
• dizziness

Acknowledgements

The authors acknowledge Chris Cochrane, PhD, for contributions to study design, data analysis, and manuscript preparation; and Alex Gouvea, M. Aud, for technical help with participant assessments.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

De-identified data on vestibular diagnosis and sensory organization test scores are available from the corresponding author on reasonable request, for a period of five years after publication. In order to protect the privacy of participants, data on age and sex will not be shared.