期刊论文详细信息
Trials
Effects of conventional versus multimodal vestibular rehabilitation on functional capacity and balance control in older people with chronic dizziness from vestibular disorders: design of a randomized clinical trial
Fernando Freitas Ganança1  Heloisa Helena Caovilla1  Mayra Cristina Aratani1  Natalia Aquaroni Ricci1 
[1] Department of Otorhinolaryngology and Head & Neck Surgery, Federal University of São Paulo, Otoneurology Discipline, Rua Pedro de Toledo 947, Vila Clementino, São Paulo 04025-002, Brazil
关键词: Disability evaluation;    Postural balance;    Aged;    Vestibular diseases;    Rehabilitation;    Dizziness;   
Others  :  1095025
DOI  :  10.1186/1745-6215-13-246
 received in 2012-07-16, accepted in 2012-12-04,  发布年份 2012
PDF
【 摘 要 】

Background

There are several protocols designed to treat vestibular disorders that focus on habituation, substitution, adaptation, and compensation exercises. However, protocols that contemplate not only vestibular stimulation but also other components that are essential to the body balance control in older people are rare. This study aims to compare the effectiveness of two vestibular rehabilitation protocols (conventional versus multimodal) on the functional capacity and body balance control of older people with chronic dizziness due to vestibular disorders.

Methods/design

A randomized, single-blind, controlled clinical trial with a 3 months follow-up period will be performed. The sample will be composed of older individuals with a clinical diagnosis of chronic dizziness resulting from vestibular disorders. The subjects will be evaluated at baseline, post-treatment and follow-up. Primary outcomes will be determined in accordance with the Dizziness Handicap Inventory (functional capacity) and the Dynamic Gait Index (body balance). Secondary outcomes include dizziness features, functional records, body balance control tests, and psychological information. The older individuals (minimum sample n = 68) will be randomized to either the conventional or multimodal Cawthorne&Cooksey protocols. The protocols will be performed during individual 50-minute sessions, twice a week, for 2 months (a total of 16 sessions). The outcomes of both protocols will be compared according to the intention-to-treat analysis.

Discussion

Vestibular rehabilitation through the Cawthorne&Cooksey protocol has already proved to be effective. However, the addition of other components related to body balance control has been proposed to improve the rehabilitation of older people with chronic dizziness from vestibular disorders.

Trial registration

ACTRN12610000018011

【 授权许可】

   
2012 Ricci et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150130180954177.pdf 1696KB PDF download
Figure 2. 103KB Image download
Figure 1. 50KB Image download
【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】
  • [1]Newman AB, Ferrucci L: Call for papers: aging versus disease. J Gerontol A Biol Sci Med Sci 2009, 64:1163-1164.
  • [2]Tinetti ME, Williams CS, Gill TM: Dizziness among older adults: a possible geriatric syndrome. Ann Intern Med 2000, 132:337-344.
  • [3]Sloane PD, Coeytaux RR, Beck RS, Dallara J: Dizziness: state of the science. Ann Intern Med 2001, 134:823-832.
  • [4]Whitney SL, Marchetti GF, Morris LO, Sparto PJ: The reliability and validity of the four square step test for people with balance deficits secondary to a vestibular disorder. Arch Phys Med Rehabil 2007, 88:99-104.
  • [5]Mira E: Improving the quality of life in patients with vestibular disorders: the role of medical treatments and physical rehabilitation. Int J Clin Pract 2008, 62:109-114.
  • [6]Polensek SH, Sterk CE, Tusa RJ: Screening for vestibular disorders: a study of clinicians’ compliance with recommended practices. Med Sci Monit 2008, 14:CR238-CR242.
  • [7]Marchetti GF, Whitney SL: Older adults and balance dysfunction. Neurol Clin 2005, 23:785-805.
  • [8]Hall CD, Cox LC: The role of vestibular rehabilitation in the balance disorder patient. Otolaryngol Clin N Am 2009, 42:161-169.
  • [9]Agrawal Y, Carey JP, Santina CCD, Schubert MC, Minor LB: Disorders of balance and vestibular function in US adults: data from the National Health and Nutrition Examination Survey, 2001–2004. Arch Intern Med 2009, 169:938-944.
  • [10]Katsarkas A: Dizziness in aging: the clinical experience. Geriatrics 2008, 63:18-20.
  • [11]Cohen HS, Wells J, Kimball KT, Owsley C: Driving disability and dizziness. J Safety Res 2003, 34:361-369.
  • [12]Castro ASO, Gazzola JM, Natour J, Ganança FF: Versão brasileira do dizziness handicap inventory. Pró-Fono Rev Atual Cient 2007, 19:97-104.
  • [13]Sturnieks DL, George RS, Lord SR: Balance disorders in the elderly. Neurophysiol Clin 2008, 38:467-478.
  • [14]Ricci NA, Aratani MC, Doná F, Macedo C, Caovilla HH, Ganança FF: A systematic review about the effects of the vestibular rehabilitation in middle-age and older adults. Rev Bras Fisioter 2010, 14:361-371.
  • [15]Simoceli L, Bittar RSM, Sznifer J: Eficácia dos exercícios de adaptação do reflexo vestíbulo-ocular na estabilidade postural do idoso. Arq Int Otorrinolaringol 2008, 12:183-188.
  • [16]Prasansuk S, Siriyananda C, Nakorn AN, Atipas S, Chongvisal S: Balance disorders in the elderly and the benefit of balance exercise. J Med Assoc Thai 2004, 87:1225-1233.
  • [17]Carvalho MJ, Marques E, Mota J: Training and detraining effects on functional fitness after a multicomponent training in older women. Gerontology 2009, 55:41-48.
  • [18]Kammerlind AC, Håkansson JK, Skogsberg M: Effects of balance training in elderly people with nonperipheral vertigo and unsteadiness. Clin Rehabil 2001, 15:463-470.
  • [19]Altman DG, Schulz KF, Moher D, Egger M, Davidoff F, Elbourne D, Gøtzsche PC, Lang T: The revised CONSORT statement for reporting randomized trials: explanation and elaboration. Ann Intern Med 2001, 134:663-694.
  • [20]Cohen HS, Kimball KT: Decreased ataxia and improved balance after vestibular rehabilitation. Otolaryngol Head Neck Surg 2004, 130:418-425.
  • [21]Bertolucci PH, Brucki SM, Campacci SR, Juliano Y: The Mini-Mental State Examination in a general population: impact of educational status. Arq Neuropsiquiatr 1994, 52:1-7.
  • [22]Yusuf HR, Croft JB, Giles WH, Anda RF, Casper ML, Caspersen CJ, Jones DA: Leisure-time physical activity among older adults: United States, 1990. Arch Intern Med 1996, 156:1321-1326.
  • [23]Jacobson GP, Newman CW: The development of the dizziness handicap inventory. Arch Otolaryngol Head Neck Surg 1990, 116:424-427.
  • [24]Whitney SL, Wrisley DM, Brown KE, Furman JM: Is perception of handicap related to functional performance in persons with vestibular dysfunction? Otol Neurotol 2004, 25:139-143.
  • [25]Whitney SL, Wrisley DM, Marchetti G, Furman JM: The effect of age on vestibular rehabilitation outcomes. Laryngoscope 2002, 112:1785-1790.
  • [26]Shumway-Cook A, Woollacott MH: Capther 15 – control of posture and balance. In Motor Control Theory and Practical Applications. Edited by Shumway-Cook A, Woollacott MH. Barueri: Manole; 2003:379-426.
  • [27]Castro SM, Perracini MR, Ganança FF: Versão brasileira do dynamic gait index. Rev Bras Otorrinolaringol 2006, 72:817-825.
  • [28]Whitney SL, Marchetti GF, Schade A, Wrisley DM: The sensitivity and specificity of the timed ‘Up & Go’ and the dynamic gait index for self-reported falls in persons with vestibular disorders. J Vestib Res 2004, 14:397-409.
  • [29]Powell LE, Myers AM: The activities-specific balance confidence (ABC) scale. J Gerontol Med Sci 1995, 50:M28-M34.
  • [30]Cohen HS, Kimball KT: Development of the vestibular disorders activities of daily living scale. Arch Otolaryngol Head Neck Surg 2000, 126:881-888.
  • [31]Cohen HS, Kimball KT, Adams AS: Application of the vestibular disorders activities of daily living scale. Laryngoscope 2000, 110:1204-1209.
  • [32]Podsiadlo D, Richardson S: The timed ‘Up & Go’: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991, 39:142-148.
  • [33]Lundin-Olsson L, Nyberg L, Gustafson Y: Attention, frailty, and falls: the effect of a manual task on basic mobility. J Am Geriatr Soc 1998, 46:758-761.
  • [34]Shumway-Cook A, Brauer S, Woollacott M: Predicting the probability for falls in community-dwelling older adults using the timed up & go test. Phys Ther 2000, 80:896-903.
  • [35]Vaillant J, Martigne P, Vuillerme N, Caillat-Miousse JL, Parisot J, Juvin R, Nougier V: Prediction of falls with performance on timed ‘Up-and-Go’ and one-leg-balance tests and additional cognitive tasks. Ann Readapt Med Phys 2006, 49:1-7.
  • [36]Csuka M, McCarty DJ: Simple method for measurement of lower extremity muscle strength. Am J Med 1985, 78:77-81.
  • [37]Lord SR, Murray SM, Chapman K, Munro B, Tiedemann A: Sit-to-stand performance depends on sensation, speed, balance, and psychological status in addition to strength in older people. J Am Geriatr Soc 2002, 57:M539-M543.
  • [38]Whitney SL, Wrisley DM, Marchetti GF, Gee MA, Redfern MS, Furman JM: Clinical measurement of sit-to-stand performance in people with balance disorders: validity of data for the five-times-sit-to-stand test. Phys Ther 2005, 85:1034-1045.
  • [39]Newton RA: Validity of the multi-directional reach test: a practical measure for limits of stability in older adults. J Gerontol Med Sci 2001, 56A:M248-M252.
  • [40]Lanska DJ, Goetz CG: Romberg’s sign: development, adoption, and adaptation in the 19th century. Neurology 2000, 55:1201-1206.
  • [41]Vereeck L, Wuyts F, Truijen S, Van de Heyning P: Clinical assessment of balance: normative data, and gender and age effects. Int J Audiol 2008, 47:67-75.
  • [42]Sheikh JI, Yesavage JA: Geriatric depression scale: recent evidence and development of a shorter version. Clin Gerontol 1986, 5:165-173.
  • [43]Almeida OP, Almeida SA: Short versions of the geriatric depression scale: a study of their validity for the diagnosis of a major depressive episode according to ICD-10 and DSM-IV. Int J Geriatr Psychiatry 1999, 14:858-865.
  • [44]Folstein MF, Folstein SE, McHugh PR: ‘Mini-Mental State’: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975, 12:189-198.
  • [45]Meldrun D, Herdman S, Moloney R, Murray D, Duffy D, Malone K, French H, Hone S, Conroy R, Walsh RM: Effectiveness of conventional versus virtual reality based vestibular rehabilitation in the treatment of dizziness, gait and balance impairment in adults with unilateral peripheral vestibular loss: a randomised controlled trial. BMC Ear Nose Throat Disord 2012, 12:3. BioMed Central Full Text
  • [46]Cawthorne T: The physiological basis for head exercises. J Chart Soc Physiother 1944, 29:106-107.
  • [47]Cooksey FS: Rehabilitation in vestibular injuries. Proc R Soc Med 1946, 39:273-278.
  • [48]Dix MR: The rationale and technique of head exercises in the treatment of vertigo. Acta Otorhinolaryngol Bel 1979, 33:370-384.
  文献评价指标  
  下载次数:12次 浏览次数:5次