Combining vestibular rehabilitation with noisy galvanic vestibular stimulation for treatment of bilateral vestibulopathy.

Autor: Eder J; German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians University of Munich (LMU), University Hospital Grosshadern, Marchioninistrasse 15, 81377, Munich, Germany., Kellerer S; German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians University of Munich (LMU), University Hospital Grosshadern, Marchioninistrasse 15, 81377, Munich, Germany., Amberger T; German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians University of Munich (LMU), University Hospital Grosshadern, Marchioninistrasse 15, 81377, Munich, Germany.; Department of Neurology, Schoen Clinic Bad Aibling, Bad Aibling, Germany., Keywan A; German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians University of Munich (LMU), University Hospital Grosshadern, Marchioninistrasse 15, 81377, Munich, Germany., Dlugaiczyk J; German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians University of Munich (LMU), University Hospital Grosshadern, Marchioninistrasse 15, 81377, Munich, Germany.; Clinic for Ear, Nose, Throat and Facial Surgery, Interdisciplinary Center for Vertigo and Neurological Disorders, University of Zurich, Zurich, Switzerland., Wuehr M; German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians University of Munich (LMU), University Hospital Grosshadern, Marchioninistrasse 15, 81377, Munich, Germany., Jahn K; German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians University of Munich (LMU), University Hospital Grosshadern, Marchioninistrasse 15, 81377, Munich, Germany. klaus.jahn@med.uni-muenchen.de.; Department of Neurology, Schoen Clinic Bad Aibling, Bad Aibling, Germany. klaus.jahn@med.uni-muenchen.de.
Jazyk: angličtina
Zdroj: Journal of neurology [J Neurol] 2022 Nov; Vol. 269 (11), pp. 5731-5737. Date of Electronic Publication: 2022 Feb 25.
DOI: 10.1007/s00415-022-11033-x
Abstrakt: Objective: Noisy galvanic vestibular stimulation (nGVS) has been shown to partly restore vestibular function and to stabilize stance and gait in patients with incomplete bilateral vestibulopathy (BVP). Here, we examined potential synergistic effects of nGVS when combined with standardized vestibular rehabilitation training (VRT).
Methods: 23 patients with confirmed BVP received a 30-min vestibular rehabilitation training (VRT) program three times a week for 2 weeks. The intervention group (n = 12) was stimulated with nGVS (at individually determined optimal amplitudes) during training, whereas the control group (n = 11) received zero-amplitude nGVS (sham stimulation) during training. Outcome measurements assessed at baseline, after 2 weeks of training, and at 2-week follow-up included quantitative posturography, instrumented gait analysis, Timed Up and Go Test (TUG), Functional Gait Assessment (FGA), and clinical scores related to quality of life and balance confidence.
Results: After 2 weeks of VRT, all patients showed moderate improvement in balance. Irrespective of nGVS treatment, performance improved in the TUG (p < 0.013), and in the FGA (p < 0.040). Furthermore, base of support when walking with closed eyes was reduced after 2-week training (p < 0.003). Postural sway did not change. There was no difference between groups and thereby no evidence for an additional influence of nGVS on the VRT treatment effects.
Conclusion: nGVS does not induce synergistic treatment effects in combination with VRT in patients with BVP when applied during treatment sessions. Hence, rather than being applied in parallel, nGVS and VRT might be complementary therapeutic options with nGVS being used during postural activities in daily life, e.g., walking.
(© 2022. The Author(s).)
Databáze: MEDLINE
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