Rehabilitation after acute vestibular disorders

Teggi, Roberto; Caldirola, Daniela; Fabiano, B; Recanati, Paola; Bussi, Mario

doi:10.1017/s0022215108002983

Cited by 63 publications

(99 citation statements)

References 21 publications

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“…In that condition, vestibular rehabilitation therapy has been shown in a randomized controlled study to improve vestibulospinal function compared to those patients who did not receive therapy following an episode of neuritis [Strupp et al, 1998]. Rehabilitation therapy has also been shown to be effective during the acute phase following sudden vestibular loss [Hillier and McDonnell, 2011;Kammerlind et al, 2005;Teggi et al, 2009;Venosa and Bittar, 2007], and even in cases where the baseline vestibular function is fluctuating, as might be expected in an acutely injured ear whose native function may recover somewhat such as following implantation [Gottshall et al, 2010].…”

Section: Mitigation Of Imbalancementioning

confidence: 99%

Short-Term Risk of Falling after Cochlear Implantation

Stevens

Baudhuin

Hullar³

2014

Audiol Neurotol

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Cochlear implantation is a highly effective intervention for hearing loss, but insertion of an implant into the cochlea is often accompanied by loss of residual hearing function. Sometimes, postoperative testing also shows loss of function in the semicircular canals or otolith organs. The effect of this loss on equilibrium, particularly in the short term following surgery, and the risk of falling due to this loss is unknown. We prospectively measured balance in 16 consecutive adult cochlear implant patients before and 2 weeks after surgery. Subjects stood on a foam pad with eyes closed, feet together and arms at the side. The length of time over which this posture could be maintained was recorded up to a maximum value of 30 s indicating normal performance. Ten of 16 subjects reached a maximal time on preoperative testing. Nine of 16 subjects lost balance function after surgery. Four of the 10 subjects with normal preoperative balance function lost function. Subjects older than the age of 60 were more likely to lose balance function than younger subjects. We used previously published values relating balance performance on foam to risk of falling to calculate the fall risk among our subjects. The relative risk of falling increased after surgery by more than threefold in some patients. Imbalance after cochlear implantation may be much more common, particularly in the short term, than previously appreciated. This imbalance is accompanied by an increased risk of falling in many patients. Careful preoperative counseling before implantation and postoperative therapeutic intervention to improve comfort and reduce the chance of falling may be warranted, particularly in patients at a risk for injuries from falls (level of evidence: 2b). i 2014 S. Karger AG, Basel

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Section: Mitigation Of Imbalancementioning

confidence: 99%

Short-Term Risk of Falling after Cochlear Implantation

Stevens

Baudhuin

Hullar³

2014

Audiol Neurotol

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“…After the title and abstract screening, 28 studies were identified as potentially eligible. However, after full text screening, 19 studies were excluded due to the following reasons: sample outside the pre-specified age range (n=14) [8][9][10][11][12][13][14][15][16][17][18][19][20][21] , lack of randomization (n=4) [22][23][24][25] , and sample with no complaints or vestibular disorders (n=1) 26 . Thus, nine randomized controlled trials were eligible for inclusion in this review and had their content critically analyzed.…”

Section: Resultsmentioning

confidence: 99%

Revisão sistemática sobre os efeitos da reabilitação vestibular em adultos de meia-idade e idosos

Ricci¹,

Aratani²,

Doná³

et al. 2010

Rev. bras. fisioter.

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Objective: To summarize the results of clinical trials on vestibular rehabilitation (VR) in middle-aged and elderly people with vestibular disorders. Methods: A search for relevant trials was performed in the databases LILACS, EMBASE, MEDLINE, SciELO, Cochrane, ISI Web of Knowledge and virtual libraries of theses and dissertations. Randomized controlled trials published in the last 10 years and written in English, Portuguese or Spanish were included. The methodological quality of the studies was assessed by the PEDro scale.Results from the included studies were analyzed through a critical review of content. Results: Nine studies were included in the review.Four studies reported on participants aged over 40 years (middle-aged and elderly) and five studies consisted exclusively of elderly subjects (over 60 years). Findings of vestibular dysfunction were diverse and the most common complaints were body imbalance or postural instability (3 studies), and vertigo or dizziness (3 studies). The Visual Analogue Scale (VAS) was the most commonly used instrument to assess subjective perception of symptoms of vestibular dysfunction (4 studies). According to the PEDro scale, four studies were considered to be of good quality. The most common experimental intervention was the Cawthorne & Cooksey protocol (4 studies). For most outcome measures, the studies comparing VR with another type of intervention showed no differences between the groups after the therapy. Conclusions: The studies included in this review provide evidence for the positive effects of VR in elderly and middle-aged adults with vestibular disturbances.Key words: vestibular diseases; rehabilitation; older adults. ResumoObjetivo: Sistematizar os resultados de ensaios clínicos sobre reabilitação vestibular (RV) em indivíduos de meia-idade e idosos com distúrbios vestibulares. Métodos: A busca de publicações sobre a RV em indivíduos com distúrbios vestibulares foi realizada nas bases de dados LILACS, EMBASE, MEDLINE, SciELO, Cochrane, ISI Web of Knowledge e bibliotecas virtuais de teses e dissertações.Foram selecionados ensaios clínicos aleatórios e controlados dos últimos 10 anos em língua inglesa, portuguesa e espanhola. A qualidade metodológica dos estudos foi avaliada pela escala PEDro. A análise dos resultados dos estudos foi feita por meio de revisão crítica dos conteúdos. Resultados: Nove estudos foram revisados na íntegra, sendo a faixa etária dos participantes acima de 40 anos (n= 4) e composta exclusivamente por idosos (n=5). Os achados de disfunção vestibular foram diversificados, sendo os mais comuns queixa de desequilíbrio corporal ou instabilidade postural (n=3) e queixa de vertigem ou tontura (n=3). A Escala Visual Analógica (EVA) foi o instrumento mais utilizado para avaliar a percepção subjetiva da sintomatologia da disfunção vestibular (n=4). A escala PEDro revelou que quatro dos artigos apresentaram delineamento de boa qualidade para a condução do estudo experimental. A proposta de intervenção mais utilizada foi o protocolo de Cawthorne ...

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“…[16][17] Many studies have described an increase in postural instability in neurological, orthopedic, and otolaryngological diseases. [2][3][4] Although several works have been published in the literature describing the effects of vision on maintaining posture, few have evaluated its influence in conditions of altered binocular vision. Oderink tested postural sway and gait in 35 children with convergent strabismus, comparing the results with those of a control group.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] The term "posture" refers to the relations among skeletal segments serving to maintain a balance when standing erect (static) and when performing motor activities (kinetic). The postural system is in a continual, dynamic inter-relational equilibrium with both the external and the internal environments.…”

Section: Introductionmentioning

confidence: 99%