The importance of computerized dynamic posturography in vestibular rehabilitation of patients with unilateral peripheral vestibular deficiency

Abstract

OBJECTIVE. To evaluate the importance of computerized dynamic posturography in vestibular rehabilitation of patients with unilateral peripheral vestibular deficiency syndrome.

MATERIAL AND METHODS. The study was conducted on a group of 30 patients (33-78 years; mean age (± SD) = 55.8 ± 12.12) diagnosed with unilateral peripheral vestibular deficiency syndrome, which benefited from VR on a posturography platform. Assessment of the patients was made using the Sensory Organization Test before and after eight sessions of rehabilitation. We analyzed the results obtained with eyes open (EO) and eyes closed (EC) on static and foam platform. The following variables were evaluated: Romberg coefficient, statokinesigram (SKG), maximum amplitude of the degree of deviation in anterior/posterior and medial/lateral planes, SKG and the time interval of the game rehabilitation program.

RESULTS. The statistical analysis of the data revealed a strong correlation (p<0.05) for the studied parameters, especially when the test was performed with the eyes closed on foam platform. The analysis of the Romberg coefficient did not show statistically significant results (p>0.05) and the measured values were outside the range of normality even at the end of the rehabilitation program. SKG and the time interval reference of the game showed significant improvement of the parameters (p<0.05); at the end of the rehabilitation sessions, 93.33% of the patients showed full recovery of their deficit.

CONCLUSION. Computerized dynamic posturography has a particularly important role in the evaluation, monitoring and rehabilitation of the patients with peripheral vestibular deficiency.

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  • 1. Furman J.M. - Posturography: uses and limitations. Baillieres Clin Neurol., 1994;3(3):501-513.

  • 2. Mirka A., Black F.O. - Clinical application of dynamic posturography for evaluating sensory integration and vestibular dysfunction. Neurol Clin., 1990;8(2):351-359.

  • 3. Furman J.M. - Role of posturography in the management of vestibular patients. Otolaryngol Head Neck Surg., 1995;112(1):8-15.

  • 4. Luchikhin L.A. - Posturography: efficacy and prospects in Otorhinolaryngology. Vestn Otorinolaringol., 1997;(1):19-23.

  • 5. Weber P.C. , Cass S.P. - Clinical assessment of postural stability. Am J Otol., 1993;14(6):566-569.

  • 6. Cohen H.S., Kimball K.T. - Increased independence and decreased vertigo after vestibular rehabilitation. Otolaryngol Head Neck Surg., 2003;128(1):60-70.

  • 7. Tran Ba Huy P. - Schwannoma and other CPA lesions. Barcelona. Ed. E Garcia-Ibanez, Medimond, 2007;pp.105-110.

  • 8. Mbongo F., Qu’hen C., Vidal P.P., Tran Ba Huy P., Waele C. - Role of vestibular input in triggering and modulating postural responses in unilateral and bilateral vestibular loss patients. Audiol Neurootol., 2009;14(2):130-138. doi: 10.1159/000162665.

  • 9. Shepard N.T., Telian S.A., Smith-Wheelock M., Raj A. - Vestibular and balance rehabilitation therapy. Ann Otol Rhinol Laryngol., 1993;102:198-205.

  • 10. Asai M., Watanabe Y., Ohashi N., Mizukoshi K. - Evaluation of vestibular function by dynamic posturography and other equilibrium examinations. Acta Otolaryngol Suppl., 1993;504:120-124.

  • 11. Curthoys I.S., Halmagyi M. - Vestibular compensation: clinical changes in vestibular function with time after unilateral vestibular loss. In: Herdman S.J. - Vestibular Rehabilitation. 3rd ed. Philadelphia: F.A. Davis Co., 2007;pp.172-194.

  • 12. Shumway-Cook A., Horak F.B., Yardley L., Bronstein A.M. - Rehabilita¬tion of balance disorders in the patient with vestibular pathology. In: Bronstein A.M., Brandt T., Woollacott M. - Clinical Disorders of Balance Posture and Gait. London: Arnold, 1996;pp.211-235.

  • 13. Horak F.B. - Postural compensation for vestibular loss and implications for rehabilitation. Restor Neurol Neurosci., 2010;28(1):57-68. doi: 10.3233/RNN-2010-0515.

  • 14. Brandt T., Dieterich M. - Postural imbalance in peripheral and central vestibular disorders. In: Bronstein A.M., Brandt T., Woollacott M.H., Nutt J.G. - Clinical Disorders of Balance, Posture and Gait. 2nd ed. London: Arnold, 2004;pp.146-162.

  • 15. Badaracco C., Labini F.S., Meli A., De Angelis E., Tufarelli D. - Vestibular rehabilittion outcomes in chronic vertiginous patients through computerized dynamic visual acuity and Gaze stabilization test. Otol Neurotol., 2007;28(6):809-813.

  • 16. Cakrt O., Chovanec M., Funda T.., et al. - Exercise with visual feedback improves postural stability after vestibular schwannoma surgery. Eur Arch Otorhinolaryngol., 2010;267(9):1355-1360. doi: 10.1007/s00405-010-1227-x.

  • 17. Nardone A., Godi M., Artuso A., Schieppati M. - Balance rehabilitation by moving platform and exercises in patients with neuropathy or vestibular deficit. Arch Phys Med Rehabil., 2010;91(12):1869-1877. doi: 10.1016/j. apmr.2010.09.011.

  • 18. Rossi-Isquierdo M., Soto-Varela A., Santos-Perez S., et al. - Vestibular rehabilitation with computerised dynamic posturography in patients with Parkinson’s disease: improving balance impairment. Disab Rehabil., 2009;31(23):1907-1916. doi: 10.1080/09638280902846384.

  • 19. Musat G. - Computerized posturography in the diagnosis and treatment of the instability of the elderly. Romanian Journal of Neurology, 2013;12(2):58-62.

  • 20. Black F.O., Angel C.R., Pesznecker S.C., Gianna C. - Outcomes analysis of individualized vestibular rehabilitation protocols. Am J Otol., 2000;21(4):543-551.

  • 21. Badke M.B., Miedaner J.A., Shea T.A., Grove C.R., Pyle G.M. - Effects of vestibular and balance rehabilitation on sensory organization and dizziness handicap. Ann Otol Rhinol Laryngol., 2005;114(1 Pt 1):48-54.

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