title: Short-term effectiveness of vestibular rehabilitation in elderly patients with postural instability: a randomized clinical trial.
abstract: Balance becomes more precarious with age, and even without pathological disorders, the physiological decline in balance that occurs with age is a factor that also favors falls. So the aim of the present study is to assess the short-term effectiveness of three different methods of vestibular rehabilitation, compared to a control group, in improving balance in elderly patients with postural instability. 139 elderly patients with high risk of falls were included and randomized to one of the following study arms: computer dynamic posturography (CDP) training, optokinetic stimulus, exercises at home, or control group. Patients were assessed with objective and subjective outcome measures. The individuals that trained using CDP improved significantly more than the control group on the average balance score (p < 0.001) and reducing the number of falls in the sensorial organization test (p < 0.001). In addition, the analysis showed a statistically significant effect in the limits of stability only with the CDP training in comparison with the control group (p < 0.001). In our present study, supervised and customized exercises with CDP were more effective than the control group in the posturographic short-term assessment. An increased age did not affect the potential for improvement after training. So we conclude that elderly patients with high risk of falling should begin vestibular rehabilitation as soon as possible in order to avoid the potential harm of falls, mainly injuries and psychological consequences due to fear of falling again.
authors.affiliation: Department of Otolaryngology, University Hospital Lucus Augusti, Calle Dr. Ulises Romero, 1, 27003, Lugo, Spain. Marcos_Rossi@hotmail.com.
authors.forename: Marcos
authors.identifier: http://orcid.org/0000-0003-4526-5814
authors.initials: M
authors.lastname: Rossi-Izquierdo
authors.affiliation: Clinical Epidemiology Unit, Hospital Clínico Universitario. Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Gayoso-Diz
authors.affiliation: Department of Otolaryngology, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Sofía
authors.initials: S
authors.lastname: Santos-Pérez
authors.affiliation: Department of Otolaryngology, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Del-Río-Valeiras
authors.affiliation: Department of Otolaryngology, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Faraldo-García
authors.affiliation: Department of Otolaryngology, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Vaamonde-Sánchez-Andrade
authors.affiliation: Department of Otolaryngology, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Lirola-Delgado
authors.affiliation: Department of Otolaryngology, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain.
authors.forename: Andrés
authors.identifier: http://orcid.org/0000-0001-6763-329X
authors.initials: A
authors.lastname: Soto-Varela
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D004856:Postural Balance / Q000502:physiology; D018570:Risk Assessment; D015837:Vestibular Diseases / Q000534:rehabilitation*; D014724:Vestibular Function Tests / Q000379:methods
keywords: Computer dynamic posturography; Elderly; Optokinetic; Postural instability; Vestibular rehabilitation