title: Effects of vibrotactile vestibular substitution on vestibular rehabilitation - preliminary study.
abstract: BACKGROUND
  Some patients with severe impairment of body balance do not obtain adequate improvement from vestibular rehabilitation (VR).
  
  
  OBJECTIVE
  To evaluate the effectiveness of Vertiguard™ biofeedback equipment as a sensory substitution (SS) of the vestibular system in patients who did not obtain sufficient improvement from VR.
  
  
  METHODS
  This was a randomized prospective clinical study. Thirteen patients without satisfactory response to conventional VR were randomized into a study group (SG), which received the vibrotactile stimulus from Vertiguard™ for ten days, and a control group (CG), which used equipment without the stimulus. For pre- and post-treatment assessment, the Sensory Organization Test (SOT) protocol of the Computerized Dynamic Posturography (CDP) and two scales of balance self-perception, Activities-specific Balance Confidence (ABC) and Dizziness Handicap Inventory (DHI), were used.
  
  
  RESULTS
  After treatment, only the SG showed statistically significant improvement in C5 (p=0.007) and C6 (p=0.01). On the ABC scale, there was a significant difference in the SG (p=0.04). The DHI showed a significant difference in CG and SG with regard to the physical aspect, and only in the SG for the functional aspect (p=0.04).
  
  
  CONCLUSIONS
  The present findings show that sensory substitution using the vibrotactile stimulus of the Vertiguard™ system helped with the integration of neural networks involved in maintaining posture, improving the strategies used in the recovery of body balance.
authors.affiliation: Otoneurology Outpatient Clinic, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil. Electronic address: cibele.brugnera@gmail.com.
authors.forename: Cibele
authors.initials: C
authors.lastname: Brugnera
authors.affiliation: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.
authors.forename: Roseli Saraiva Moreira
authors.initials: RS
authors.lastname: Bittar
authors.affiliation: Hospital Celso Pierro, Pontifícia Universidade Católica de Campinas (PUC-Campinas), Campinas, SP, Brazil.
authors.forename: Mário Edvin
authors.initials: ME
authors.lastname: Greters
authors.affiliation: Hospital Charité, Berlin University, Berlin, Germany.
authors.forename: Dietmar
authors.initials: D
authors.lastname: Basta
mesh_terms: D000368:Aged; D001676:Biofeedback, Psychology / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D004856:Postural Balance; D016896:Treatment Outcome; D015837:Vestibular Diseases / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D014724:Vestibular Function Tests / Q000295:instrumentation*
keywords: Dizziness; Doenças vestibulares; Equilíbrio postural; Postural balance; Reabilitação; Rehabilitation; Retroalimentação sensorial; Sensory feedback; Vertigem; Vestibular diseases