Efeitos da reabilitação vestibular na capacidade funcional de idosos vestibulopatas crônicos: ensaio clínico randomizado

Abstract

Purpose: To compare the effectiveness of two vestibular rehabilitation protocols (Conventional versus Multimodal) on the functional capacity of older people with chronic vestibulopathy. Methods: A randomized, single blind, controlled clinical trial, with a tree month follow-up was performed. The sample was composed of older individuals with a clinical diagnosis of chronic dizziness resulting from vestibular disorders. The individuals were subjected to questionnaires that assessed the impact of dizziness on quality of life, ability and confidence to perform activities of daily living and mood at baseline, post-treatment, and at follow-up. The primary outcome measure was the Dizziness Handicap Inventory. Secondary outcomes included the Vestibular Disorders Activities of Daily Living, Activities-specific Balance Confidence Scale and Geriatric Depression Scale. The older individuals were randomized to either the Conventional or Multimodal Cawthorne & Cooksey protocols. The protocols were performed during individual 50-minute sessions, twice a week, for two months. The outcomes of both protocols were compared according to the intention-to-treat analysis. Results: 82 older individuals were randomized into either Conventional (n=40) or Multimodal (n=42) protocols. There were significant increases in the primary and second outcomes at post-treatment that was maintained on follow-up period, with no significant difference between groups, nor any interaction concerning the treatment protocol. Conclusions: The vestibular rehabilitation, regardless of the treatment protocol, resulted in improvement on elderlies? functional capacity, which was maintained during a short-term period.

Objetivo: Comparar a eficácia de protocolos de Reabilitação Vestibular (RV) sobre a capacidade funcional de idosos vestibulopatas crônicos. Método: Ensaio clínico aleatório, cego e controlado, com seguimento de três meses. Amostra constituída por idosos com tontura crônica de origem vestibular. Foram realizadas avaliações nos períodos de pré e pós-intervenção e seguimento de três meses. O desfecho primário foi o Dizziness Handicap Inventory. Os desfechos secundários incluíram o Vestibular Disorders Activities of Daily Living, Activities-specific Balance Confidence Scale, Geriatric Depression Scale. Os idosos foram randomizados entre os grupos de RV pelos protocolos convencional e modificado. Os protocolos foram ministrados em sessões individuais, duas vezes por semana, com 50 minutos de duração, durante dois meses. Para avaliar a eficácia da RV foi aplicada a análise por intenção de tratar. Resultados: 82 idosos foram randomizados entre Grupo Convecional (n=40) e Grupo Modificado (n=42). Para os desfechos primário e secundários, houve melhora significativa após a RV e manutenção no seguimento, sem diferença entre os protocolos. Conclusão: A RV, independente do protocolo, produziu resultados positivos na capacidade funcional de idosos vestibulopatas e os ganhos obtidos foram mantidos a curto prazo.