Vestibular Rehabilitation in Postural Control of the Elderly

Abstract

Objective: Analyze the effectiveness of personalized vestibular rehabilitation therapy (VRT) associated with body balance training in postural control of elderly patients with chronic peripheral vestibular disorders assessing the Dynamic Gait Index (DGI) and static posturography (Balance Rehabilitation Unit-BRUTM) before and after the treatment.

Method: Prospective study of 20 elderly with chronic peripheral vestibulopathy. The BRUT M parameters were the limit of stability and the area of body center of pressure in the followed conditions(C): C1-stable surface/open eyes; C2-stable surface/closed eyes; C3-unstable surface/closed eyes; C4-5 stable surface/visual-vestibular interaction. The VRT consisted of personalized vestibular exercises associated with static and dynamic body balance training.

Results: All patients improved their symptoms after 12 to 16 sessions of VRT associated with balance training (50 minutes). The outcomes (mean; standard deviation) after therapy were: the limit of stability increased (Pre-VRT: 133.8;51.9 cm²; Post-VRT: 178.45;47.3 cm²; P = .001), the area of body center of pressure in C2 (Pre-VRT: 5.70; 6.31 cm²; Post-VRT: 2.60; 1.95 cm²; P = .01), C3 (Pre-VRT: 13.48;8.69 cm²; Post-VRT: 7.67; 3.86 cm²; P = .001) and C4 (Pre-VRT: 6.11; 4.67 cm²; Post-VRT: 4.38; 2.57 cm²; P = .053) decreased, and fall risk was reduced (DGI: Pre-VRT=19.42; 4.07 points; Post-VRT=22.21; 2.74 points; P = .003).

Conclusion: Vestibular rehabilitation therapy associated with body balance training improved the postural control of elderly patients with chronic vestibular dysfunction, increasing the value of limit of stability with reduction of body oscillation in conditions without visual inputs and with somatosensory and visual-vestibular conflicts, and reducing the fall risk.