Abstract

Background: With the increase of life expectancy and the subsequent development of otoneurologic symptoms, such as dizziness and vertigo, several intervention protocols that comprise the compensation, habituation, replacement and adaptation of the vestibular system have been elaborated. However, new protocols that use other components of postural control in patients with chronic dizziness of vestibular origin are necessary. Therefore, this study aims at evaluating the efficacy of anchor system during balance rehabilitation of patients with chronic dizziness of peripheral vestibular origin who have not responded positively to traditional vestibular rehabilitation, regarding quiet standing and dynamic postural control, gait and dizziness.
Methods/design: A randomized, single-blind, controlled trial with a three-month follow-up. The sample will consist of volunteers age 50 and over, both sexes, diagnosed with chronic dizziness of peripheral vestibular origin. Cognitive and functional assessments will be performed in all volunteers at the time of pre intervention, post intervention, and three-month follow-up. The primary outcomes will be the variables related to quiet standing and dynamic posturographic analysis based on displacement of center of pressure (COP) and limit of stability (LOS) measured by the Balance Master®, as well as functional assessments (Timed Up and Go test [TUG], sitting-rising test [SRT], Dynamic Gait Index [DGI] and Mini-BESTest). The secondary outcomes will be the data related to cognitive analysis (Mini-mental state examination, Clock Drawing Test, verbal fluency test and Trail Making Test B), dizziness evaluations and their aspects (Dizziness Handicap Inventory and Vestibular Disorders Activities of Daily Living Scale). The intervention will consist of two different protocols for the Balance Rehabilitation (BR), where the volunteers will be randomized into three groups: G1 - Proprioceptive exercises with anchors (n=20); G2 - Proprioceptive exercises with no anchors (n=20); and G3 - Control (n=20) without performing any exercise. The BR protocols will be supervised in groups, twice a week, with duration of 45 minutes and twelve sessions.
Discussion: Although the benefits of the Cawthorne-Cooksey vestibular rehabilitation protocol are well established in the literature, there is a need for new protocols which stimulate somatosensory, visual and cognitive components aimed at improving both balance and otoneurologic symptoms in patients with chronic seizures.
 

Keywords

aged, dizziness, postural balance, rehabilitation, vestibular diseases, semi-circular channels, electrical stimulation, vestibular nerve, reduction of nystagmus, caloric and rotation tests, optokinetic nystagmus, otoneurologic systems, vestibular compensation, neuroplasticity, generating adaptation, vestibular system