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Effects of the Use of Anchor Systems in the Rehabilitation of Dynamic Balance and Gait in Individuals With Chronic Dizziness of Peripheral Vestibular Origin: A Single-Blinded, Randomized, Controlled Clinical Trial

Published:August 26, 2019DOI:https://doi.org/10.1016/j.apmr.2019.07.012

      Abstract

      Objective

      To assess the effectiveness of the anchors in the balance rehabilitation of participants with chronic peripheral vestibulopathy who failed to respond positively to conventional rehabilitation for dynamic balance and gait.

      Design

      Assessor-blind, randomized controlled trial.

      Setting

      Department of Otoneurology and Laboratory of Assessment and Rehabilitation of Equilibrium.

      Participants

      Women with chronic dizziness of peripheral vestibular origin (N=42), who continued to show otoneurologic symptoms for more than 6 months after starting classic vestibular rehabilitation, with no clinical improvement observed.

      Interventions

      Participants were randomly assigned to receive a clinical intervention with the anchor system, a clinical intervention without the anchor system, or no intervention or anchor system. The intervention was based on multi-sensory exercises for 6 weeks, twice a week, totaling 12 sessions, in groups of up to 4 participants, with an average time of 40 minutes per session.

      Main Outcome Measures

      The primary outcome was functional balance as assessed by the short version of the Balance Evaluation Systems Test. The secondary outcomes were gait parameters of step width in meters, step length in meters, and gait speed in meters per second. The measures were assessed preintervention and postintervention, and after a 3-month follow-up period.

      Results

      The proposed intervention was beneficial for dizziness, balance, and gait for both groups studied. At the 3-month follow-up, only the group that used anchors retained the benefits related to the physical aspects of dizziness, balance, and gait.

      Conclusions

      The present study found that the proposed intervention protocol, with or without the use of anchors, was beneficial for improving the dizziness, balance, and gait. However, retention of the benefits achieved through the exercise protocol was observed only for those using the anchor system, which promotes the use of haptic information. The use of anchors was effective, in short protocols (12wk), with maintenance of results after 3 months.

      Keywords

      List of abbreviations:

      CNS (central nervous system), DHI (Dizziness Handicap Inventory), G1 (intervention group with anchors), G2 (intervention group without anchors), G3 (control group with vestibulopathy), Mini-BESTest (short version of the Balance Evaluation Systems Test), MoCA (Montreal Cognitive Assessment), VR (vestibular rehabilitation)
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