Combining Vestibular Rehabilitation and Noisy Galvanic Vestibular Stimulation for Treatment of Unilateral Vestibulopathy: A Randomized Controlled Trial

Bahare  Khavarghazalani; Mansoureh Adel Ghahraman; Reza Hoseinabadi; Shohreh   Jalaie; Ali Kouhi; Nasrin Yazdani

doi:10.18502/avr.v32i4.13591

Bahare Khavarghazalani Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
Mansoureh Adel Ghahraman Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
Reza Hoseinabadi Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
Shohreh Jalaie School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
Ali Kouhi Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
Nasrin Yazdani Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/avr.v32i4.13591

Abstract

Background and Aim: Vestibular Rehabilitation (VR) is a well-accepted treatment for Unilateral Vestibulopathy (UVP). Since noisy Galvanic Vestibular Stimulation (nGVS) improves the processing of vestibular inputs, we assessed the synergistic effects of adding nGVS to vestibular rehabilitation for the treatment of UVP.

Methods: Patients with UVP were randomly assigned into two groups receiving either VR for four weeks (VR group, n=12) or VR for four weeks combined with nGVS for three sessions (VR+nGVS group; n=12). Outcome measurements were postural control parameters measured with eyes open/closed conditions on hard/soft surfaces, Vestibulo-Ocular Reflex (VOR) gain, and Dizziness Handicap Inventory (DHI) scores that were assessed at baseline and after four weeks.

Results: All postural control parameters, mean total and subscale scores of DHI, and mean VOR gain in directions of affected canals significantly improved in both groups after interventions (p<0.05) except mean mediolateral displacement in conditions with eyes closed on hard surface and with eyes open on soft surface, mean mediolateral velocity in conditions with eyes closed on hard surface, ability to stance with eye closed condition on soft surface and mean emotional subscale of DHI in VR group. Improvements were significantly higher in postural control outcomes measured in stances with eyes closed on hard surface and with eyes open and closed on soft surface, mean VOR gains in directions of affected horizontal and anterior canals, and mean total, physical, and functional scores of DHI in VR+nGVS group (p<0.05).

Conclusion: When combined with VR, nGVS shows additional therapeutic effects in UVP patients.

Keywords: Unilateral peripheral vestibulopathy; vestibular compensation; galvanic vestibular stimulation; vestibular rehabilitation; postural control