Vestibular rehabilitation with visual stimuli in peripheral vestibular disorders

Manso, Andréa; Ganança, Mauricio Malavasi; Caovilla, Heloisa Helena

doi:10.1016/j.bjorl.2015.05.019

Acessibilidade / Reportar erro

Brasil

Brazilian Journal of Otorhinolaryngology

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

REVIEW ARTICLE • Braz. j. otorhinolaryngol. 82 (2) • Mar-Apr 2016 • https://doi.org/10.1016/j.bjorl.2015.05.019 copy

Vestibular rehabilitation with visual stimuli in peripheral vestibular disorders ^{^☆} ☆ Please cite this article as: Manso A, Ganança MM, Caovilla HH. Vestibular rehabilitation with visual stimuli in peripheral vestibular disorders. Braz J Otorhinolaryngol. 2016;82: 232-41.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

INTRODUCTION:

Visual stimuli can induce vestibular adaptation and recovery of body balance.

OBJECTIVE:

To verify the effect of visual stimuli by digital images on vestibular and body balance rehabilitation of peripheral vestibular disorders.

METHODS:

Clinical, randomized, prospective study. Forty patients aged between 23 and 63 years with chronic peripheral vestibular disorders underwent 12 sessions of rehabilitation with visual stimuli using digital video disk (DVD) (experimental group) or Cawthorne-Cooksey exercises (control group). The Dizziness Handicap Inventory (DHI), dizziness analog scale, and the sensitized Romberg static balance and one-leg stance tests were applied before and after the intervention.

RESULTS:

Before and after the intervention, there was no difference between the experimental and control groups (p > 0.005) regarding the findings of DHI, dizziness analog scale, and static balance tests. After the intervention, the experimental and control groups showed lower values (p < 0.05) in the DHI and the dizziness analog scale, and higher values (p < 0.05) in the static balance tests in some of the assessed conditions.

CONCLUSION:

The inclusion of visual stimuli by digital images on vestibular and body balance rehabilitation is effective in reducing dizziness and improving quality of life and postural control in individuals with peripheral vestibular disorders.

Keywords:
Rehabilitation; Postural balance; Dizziness; Nystagmus optokinetic

Characteristic	Experimental group (n = 20)	Control group (n = 20)	p
Mean age (minimum–maximum)	45.85 (23–63)	51.85 (32–63)	0.278^a

Gender, n (%)
Male	6 (30%)	3 (15%)	0.256^b
Female	14 (70%)	17 (85%)

Vestibular assessment findings, n (%)
Normal vestibular function	7 (35%)	9 (45%)
Directional preponderance	0 (0%)	1 (5%)
Bilateral hyperreflexia	5 (25%)	4 (20%)	0.656^b
Unilateral hypofunction	7 (35%)	6 (30%)
Bilateral hypofunction	1 (5%)	0 (0%)

Dizziness duration, n (%)
Days	1 (5%)	1 (5%)
Hours	4 (20%)	2 (10%)	0.532^b
Minutes	4 (20%)	8 (40%)
Seconds	11 (55%)	9 (45%)

Dizziness frequency, n (%)
Monthly	2 (10%)	2 (10%)
Weekly	7 (35%)	12 (60%)	0.248^b
Daily	11 (55%)	6 (30%)

Time of dizziness onset, n (%)
1 to 2 years	5 (25%)	5 (25%)
2 to 4 years	6 (30%)	9 (45%)	0.549^b
More than 5 years	9 (45%)	6 (30%)

Testes	Experimental group			Control group
	Before	After	p ¹	Before	After	p ¹	p ²	p ³
	Mean/SD (min–max)		p ¹	Mean/SD (min–max)		p ¹	p ²	p ³
DHI – total	51.30/26.54 (6–100)	24.60/23.13 (0–74)	<0.001^a	47.90/18.78 (18–98)	24.20/14.70 (2–56)	0.000^a	0.715	0.056
DHI – physical	16.80/7.06 (4–28)	6.80/6.97 (0–22)	<0.001^a	15.50/5.19 (8–28)	8.30/5.92 (0–24)	0.000^a	0.445	0.333
DHI – emotional	16.10/11.02 (0–36)	8.10/9.64 (0–30)	<0.001^a	14.80/10.63 (0–36)	6.60/7.40 (0–24)	0.002^a	0.776	0.681
DHI – functional	18.40/10.40 (0–36)	9.70/9.50 (0–28)	<0.001^a	17.60/7.72 (4–34)	9.30/5.48 (0–20)	0.000^a	0.714	0.479
Visual analog scale of dizziness	7.45/2.04 (3–10)	3.15/2.94 (0–8)	<0.001^a	6.40/1.67 (4–10)	3.90/2.00 (0–7)	0.001^a	0.071	0.293

Testes	Experimental group			Control group
	Before	After	p ¹	Before	After	p ¹	p ²	p ³
	Mean/SD (min–max)		p ¹	Mean/SD (min–max)		p ¹
SS OE left	27.90/6.55 (3–30)	29.75/1.12 (25–30)	0.109	28.75/5.59 (5–30)	28.00/6.37 (5–30)	0.317	0.311	0.515
SS OE right	27.20/7.58 (2–30)	29.75/1.12 (25–30)	0.109	25.60/9.19 (5–30)	28.40/5.30 (8–30)	0.138	0.653	0.515
SS CE left	17.25/12.03 (0–30)	23.70/10.24 (2–30)	0.005^a	16.65/11.78 (0–30)	20.60/11.50 (1–30)	0.020^a	0.813	0.558
SS CE right	13.20/11.32 (0–30)	21.45/10.58 (2–30)	0.004^a	17.15/12.44 (2–30)	20.45/10.99 (0–30)	0.244	0.260	0.619
US OE left	27.95/5.34 (10–30)	29.20/3.58 (14–30)	0.285	26.50/8.90 (0–30)	28.50/6.71 (0–30)	0.180	0.879	0.971
US OE right	27.80/6.20 (6–30)	29.60/1.79 (22–30)	0.109	27.35/7.33 (1–30)	28.55/6.03 (3–30)	0.197	0.948	0.554
US CE left	12.05/11.66 (0–30)	20.35/11.60 (1–30)	0.006^a	8.70/8.63 (0–30)	15.80/12.78 (0–30)	0.023^a	0.634	0.192
US CE right	11.60/11.09 (0–30)	17.45/11.53 (1–30)	0.001^a	8.25/8.59 (0–30)	14.60/12.12 (0–30)	0.005^a	0.423	0.381

Testes	Experimental group			Control group
	Before	After	p ¹	Before	After	p ¹	p ²	p ³
	Mean/SD (min–max)		p ¹	Mean/SD (min–max)		p ¹
SS OE left	24.20/10.49 (3–30)	25.895/8.27 (7–30)	0.068	26.00/9.00 (2–30)	26.55/7.75 (3–30)	0.799	0.929	0.711
SS OE right	21.55/11.34 (0–30)	24.25/9.25 (0–30)	0.017^a	25.35/8.95(3–30)	27.25/7.12 (2–30)	0.611	0.276	0.242
SS CE left	6.75/7.50 (1–30)	9.90/7.75 (2–30)	0.021^a	6.85/5.20 (0–20)	10.85/10.59 (0–30)	0.154	0.369	0.849
SS CE right	6.35/6.76 (0–25)	10.35/9.41 (0–30)	0.028^a	5.00/3.29 (0–13)	8.20/7.14 (0–30)	0.046^a	0.785	0.515
US OE left	22.05/11.93 (2–30)	25.10/9.04 (3–30)	0.012^a	21.75/10.85 (1–30)	23.40/9.05 (1–30)	0.505	0.744	0.333
US OE right	20.65/2.25 (0–30)	24.65/9.35 (0–30)	0.012^a	23.70/10.48 (1–30)	24.25/9.53 (2–30)	0.483	0.454	0.833
US CE left	6.35/6.69 (0–23)	4.95/3.89 (0–14)	0.459	4.45/3.40 (0–14)	6.55/5.73 (0–21)	0.146	0.828	0.446
US CE right	5.50/5.57 (0–20)	7.25/5.89 (0–19)	0.013^a	3.25/2.12 (0–8)	4.55/2.16 (0–8)	0.027^a	0.511	0.263

Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Sede da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico Facial, Av. Indianópolia, 1287, 04063-002 São Paulo/SP Brasil, Tel.: (0xx11) 5053-7500, Fax: (0xx11) 5053-7512 - São Paulo - SP - Brazil
E-mail: revista@aborlccf.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] * Corresponding author. E-mail:andreamans@gmail.com (A. Manso).

Brasil

Brasil

Vestibular rehabilitation with visual stimuli in peripheral vestibular disorders ☆ ☆ Please cite this article as: Manso A, Ganança MM, Caovilla HH. Vestibular rehabilitation with visual stimuli in peripheral vestibular disorders. Braz J Otorhinolaryngol. 2016;82: 232-41.

ABSTRACT

INTRODUCTION:

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSION:

Vestibular rehabilitation with visual stimuli in peripheral vestibular disorders ^{^☆} ☆ Please cite this article as: Manso A, Ganança MM, Caovilla HH. Vestibular rehabilitation with visual stimuli in peripheral vestibular disorders. Braz J Otorhinolaryngol. 2016;82: 232-41.