Balance Rehabilitation with Virtual Games in Elderly with Vestibular Disorders

Abstract

Objectives: Evaluate the effectiveness of balance rehabilitation protocol with virtual games in elderly with vestibular disorders. Method: Pilot prospective clinical trial at a university center for balance disorders. Nine older patients of both genders diagnosed with vestibular disorder were elected. Their symptoms, static posturography parameters (functional reserve and velocity of oscillation (VOS) in ten visual-vestibular interaction and somatosensory conflicts) and the Dynamic Gait Index were evaluated before and after vestibular rehabilitation. The virtual games rehabilitation program used the Wii Balance Board. Patients were put in situations causing dizziness and postural instability, such as walking with eyes open and closed on a stable and unstable surface, beyond optokinetic stimuli, saccadic, and pursuit eye visuovestibular interaction. Sessions lasted 60 minutes, two times per week for eight weeks. Results: After treatment, there was significant reduction of the following symptoms: dizziness ( P < 0.01), motion sickness ( P < 0.05), postural instability ( P < 0.01), and fear of falling ( P < 0.05).The Dynamic Gait Index increased in all subjects and was above the cutoff score for high risk of falling. Mean values of functional reserve and VOS improved in all conditions after vestibular rehabilitation ( P < 0.05), exception in conditions 2,4,9, and 10 of VOS. Conclusions: Preliminary results suggest that balance rehabilitation program using virtual games is effective in improving symptoms and clinical parameters related to static and dynamic balance in older patients with balance disorders.