Vestibular rehabilitation in individuals after traumatic brain injury: case series report
DOI:
https://doi.org/10.25758/set.2201Keywords:
Vestibular rehabilitation, Postural stability, Disability, Traumatic brain injuryAbstract
Introduction – After suffering a traumatic brain injury (TBI) many individuals experience vertigo and imbalance. Vestibular rehabilitation (VR) aims to increase postural stability (PS) and decrease symptomatology and is considered the most important treatment for individuals with vestibular complaints after TBI. Aim of the study – To describe the effects of a personalized VR program on PS and on perceived disability in individuals after TBI. Methods – Retrospective study of consecutive series of 5 individuals (between 48 and 66 years) with complaints of vertigo and imbalance after TBI referenced for VR. At the beginning and at the end of the treatment, PS was evaluated through the modified clinical test sensory interaction in balance (mCTSIB) on Neurocom® Basic Balance Master platform and perceived disability through the Dizziness Handicap Inventory. Six sessions of were performed, consisting of: gaze stability exercises, balance exercises with multisensory stimulation, and in platform with visual biofeedback and optokinetic stimulation. Results – After RV, three individuals presented improved PS and four individuals had a decrease in perceived disability. Discussion – Similar RV programs have been used in post-TBI individuals with positive results, increasing stability and in decreasing symptomatology and disability. Considering the improvements observed in the individuals in this study, the application of an RV program with longer durability may present better results. Conclusions – In most of those individuals, VR decreased perceived disability and increased postural stability, which may contribute to an earlier social and labor reinsertion.
Downloads
References
Oliveira E, Lavrador JP, Santos MM, Lobo Antunes J. Traumatismo crânio-encefálico: abordagem integrada [Traumatic brain injury: integrated approach]. Acta Med Port. 2012;25(3):179-92. Portuguese
Kaufman KR, Brey RH, Chou LS, Rabatin A, Brown AW, Basford JR. Comparison of subjective and objective measurements of balance disorders following traumatic brain injury. Med Eng Phys. 2006;28(3):234-9.
Norup A, Perrin PB, Cuberos-Urbano G, Anke A, Andelic N, Doyle ST, et al. Family needs after brain injury: a cross cultural study. NeuroRehabilitation. 2015;36(2):203-14.
Maskell F, Chiarelli P, Isles R. Dizziness after traumatic brain injury: results from an interview study. Brain Inj. 2007;21(7):741-52.
Gay RK. Neurocognitive measures in the assessment of vestibular disturbance in patients with brain injury. NeuroRehabilitation. 2013;32(3):473-82.
Basford JR, Chou LS, Kaufman KR, Brey RH, Walker A, Malec JF, et al. An assessment of gait and balance deficits after traumatic brain injury. Arch Phys Med Rehabil. 2003;84(3):343-9.
Gottshall K. Vestibular rehabilitation after mild traumatic brain injury with vestibular pathology. NeuroRehabilitation. 2011;29(2):167-71.
Motin M, Keren O, Groswasser Z, Gordon CR. Benign paroxysmal positional vertigo as the cause of dizziness in patients after severe traumatic brain injury: diagnosis and treatment. Brain Inj. 2005;19(9):693-7.
Straudi S, Severini G, Charabati AS, Pavarelli C, Gamberini G, Scotti A, et al. The effects of video game therapy on balance and attention in chronic ambulatory traumatic brain injury: an exploratory study. BMC Neurol. 2017;17:86.
Fausti SA, Wilmington DJ, Gallun FJ, Myers PJ, Henry JA. Auditory and vestibular dysfunction associated with blast-related traumatic brain injury. J Rehabil Res Dev. 2009;46(6):797-810.
Lacour M, Bernard-Demanze L. Interaction between vestibular compensation mechanisms and vestibular rehabilitation therapy: 10 recommendations for optimal functional recovery. Front Neurol. 2014;5:285.
Brennan M. Visual-vestibular interaction and treatment of dizziness: a case report. J Behav Optom. 2012;23(3):68-72.
Badke MB, Shea TA, Miedaner JA, Grove CR. Outcomes after rehabilitation for adults with balance dysfunction. Arch Phys Med Rehabil. 2004;85(2):227-33.
Rossi-Izquierdo M, Santos-Pérez S, Soto-Varela A. What is the most effective vestibular rehabilitation technique in patients with unilateral peripheral vestibular disorders? Eur Arch Otorhinolaryngol. 2011;268(11):1569-74.
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. Braz J Phys Ther. 2010;14(5):361-71.
Humphriss RL, Baguley DM, Peerman S, Mitchell TE, Moffat DA. Clinical outcomes of vestibular rehabilitation. Physiother. 2001;87(7):368-73.
Deveze A, Bernard-Demanze L, Xavier F, Lavieille JP, Elziere M. Vestibular compensation and vestibular rehabilitation: current concepts and new trends. Neurophysiol Clin. 2014;44(1):49-57.
Garcia FV, Veiga VG, Santos C. Reeducação vestibular: estratégias de intervenção. Rev Port ORL. 1999;37(4):307-25.
Meli A, Zimatore G, Badaracco C, De Angelis E, Tufarelli D. Vestibular rehabilitation and 6-month follow up using objective and subjective measures. Acta Otolaryngol. 2006;126(3):259-66.
Rossi Izquierdo M, Soto Varela A, Santos Pérez S, Labella Caballero T. Análisis prospectivo de los resultados de la rehabilitación vestibular mediante posturografía dinámica computerizada en pacientes con inestabilidad. Clin Inves Otorri. 2008;2(1):12-6.
Carrick FR, McLellan K, Brock JB, Randall C, Oggero E. Evaluation of the effectiveness of a novel brain and vestibular rehabilitation treatment modality in PTSD patients who have suffered combat related traumatic brain injuries. Front Public Health. 2015;3:15.
Alsalaheen BA, Whitney SL, Mucha A, Morris LO, Furman JM, Sparto PJ. Exercise prescription patterns in patients treated with vestibular rehabilitation after concussion. Physiother Res Int. 2013;18(2):100-8.
Garcia FV, Luzio CS, Benzinho TA, Veiga VG. Validação e adaptação do DHI para a língua e população portuguesa de Portugal [Validation and adaptation of Dizziness Handicap Inventory to the portuguese language and population]. Acta ORL. 2008;26(2):128-32. Portuguese
Jacobson GP, Newman CW. The development of the Dizziness Handicap Inventory. Arch Otolaryngol Head Neck Surg. 1990;116(4):424-7.
Alsalaheen BA, Mucha A, Morris LO, Whitney SL, Furman JM, Camiolo-Reddy CE, et al. Vestibular rehabilitation for dizziness and balance disorders after concussion. J Neurol Phys Ther. 2010;34(2):87-93.
Branco PS. Avaliação e modificação do risco de queda em idosos com recurso à posturografia dinâmica computorizada [Evaluation and modification of the risk of falling in the elderly by means of computerized dynamic posturography]. Rev SPMFR. 2012;21(1):16-24. Portuguese
Loughran S, Gatehouse S, Kishore A, Swan IR. Does patient-perceived handicap correspond to the modified clinical test for the sensory interaction on balance? Otol Neurotol. 2006;27(1):86-91.
Pickett TC, Radfar-Baublitz LS, McDonald SD, Walker WC, Cifu DX. Objectively assessing balance deficits after TBI: role of computerized posturography. J Rehabil Res Dev. 2007;44(7):983-90.
Badaracco C, Labini FS, Meli A, Tufarelli D. Oscillopsia in labyrinthine defective patients: comparison of objective and subjective measures. Am J Otolaryngol. 2010;31(6):399-403.
Schubert MC, Migliaccio AA, Clendaniel RA, Allak A, Carey JP. Mechanism of dynamic visual acuity recovery with vestibular rehabilitation. Arch Phys Med Rehabil. 2008;89(3):500-7.
Akiduki H, Nishiike S, Watanabe H, Matsuoka K, Kubo T, Takeda N. Visual-vestibular conflict induced by virtual reality in humans. Neurosci Lett. 2003;340(3):197-200.
Benzinho T, Luzio CS. O papel das plataformas móveis na reabilitação vestibular: a nossa experiência com a StatitestTM [Internet]. In: 1º Curso Teórico-prático do Serviço ORL dos HUC/Coimbra. Lisboa: Associação Portuguesa de Otoneurologia; 2003 [cited 2017 Dec 1]. Available from: http://www.otoneuro.pt/index.php/artigos/artigos-para-discussao/110-o-papel-das-plataformas-moveis-em-reabilitacao-vestibular
Allison IK, Fuller K. Disfunções vestibulares e do equilíbrio. In: Umphred DA, editor. Reabilitação neurológica. 5ª ed. Rio de Janeiro: Elsevier; 2010. p. 654-94. ISBN 9788535246179
Fife TD, Kalra D. Persistent vertigo and dizziness after mild traumatic brain injury. Ann N Y Acad Sci. 2015;1343:97-105.
Arshad Q, Roberts RE, Ahmad H, Lobo R, Patel M, Ham T, et al. Patients with chronic dizziness following traumatic head injury typically have multiple diagnoses involving combined peripheral and central vestibular dysfunction. Clin Neurol Neurosurg. 2017;155:17-9.
Pavlou M, Quinn C, Murray K, Spyridakou C, Faldon M, Bronstein AM. The effect of repeated visual motion stimuli on visual dependence and postural control in normal subjects. Gait Posture. 2011;33(1):113-8.
Huygen PL, Verhagen WI. Optokinetic response in patients with vestibular areflexia. J Vestib Res. 2011;21(4):219-25.
Tasseel-Ponche S, Le Liepvre H, Colle F, Andriantsifanetra C, Vidal PP, Bonan IV, et al. Rod and frame test and posture under optokinetic stimulation used to explore two complementary aspects of the visual influence in postural control after stroke. Gait Posture. 2017;58:171-5.
Kleffelgaard I, Soberg HL, Bruusgaard KA, Tamber AL, Langhammer B. Vestibular rehabilitation after traumatic brain injury: case series. Phys Ther. 2016;96(6):839-49.
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Saúde e Tecnologia
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The journal Saúde & Tecnologia offers immediate free access to its content, following the principle that making scientific knowledge available to the public free of charge provides greater worldwide democratization of knowledge.
The journal Saúde & Tecnologia does not charge authors any submission or article processing charges (APC).
All content is licensed under a Creative Commons CC-BY-NC-ND license. Authors have the right to: reproduce their work in physical or digital form for personal, professional, or teaching use, but not for commercial use (including the sale of the right to access the article); deposit on their website, that of their institution or in a repository an exact copy in electronic format of the article published by Saúde & Tecnologia, provided that reference is made to its publication in Saúde & Tecnologia and its content (including symbols identifying the journal) is not altered; publish in a book of which they are authors or editors the total or partial content of the manuscript, provided that reference is made to its publication in Saúde & Tecnologia.
