Effect of noisy galvanic vestibular stimulation in community-dwelling elderly people: a randomised controlled trial

Maybe you want your therapists to try this for your balance problems. They cherry picked participants so this research will need to be repeated for stroke survivors. Ask your doctor to followup with their chosen researchers.
https://jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-018-0407-6

• Yasuto InukaiEmail authorView ORCID ID profile,
• Mitsuhiro Masaki,
• Naofumi Otsuru,
• Kei Saito,
• Shota Miyaguchi,
• Sho Kojima and
• Hideaki Onishi

Journal of NeuroEngineering and Rehabilitation201815:63

https://doi.org/10.1186/s12984-018-0407-6

©  The Author(s). 2018

Received: 13 March 2018

Accepted: 19 June 2018

Published: 3 July 2018

Abstract

Background

Balance disorders are a risk factor for falls in the elderly. Although noisy galvanic vestibular stimulation (nGVS) has been reported to improve balance in young people, randomised control trials targeting community-dwelling elderly people have not been conducted to date. We aimed to assess the influence of nGVS on COP sway in the open-eye standing posture among community-dwelling elderly people in a randomised controlled trial.

Methods

A randomised controlled trial of 32 community-dwelling elderly people randomly assigned to control (sham stimulation) and an nGVS groups. All participants underwent centre of pressure (COP) sway measurements while standing with open eyes at baseline and during stimulation. The control group underwent sham stimulation and the nGVS group underwent noise stimulation (0.4 mA; 0.1–640 Hz).

Results

In the nGVS group, sway path length, mediolateral mean velocity and anteroposterior mean velocity decreased during stimulation compared with baseline (P < 0.01). The effect of nGVS was large in participants with a high COP sway path length at baseline, but there was no significant difference in COP sway in the control group.

Conclusions

We conclude that nGVS decreases the COP sway path length and mean velocity of community-dwelling elderly people when standing with open eyes. This suggests that nGVS could be effective for treating balance dysfunction in the elderly.

Keywords

Community-dwelling elderly peopleFallsNoisy galvanic vestibular stimulationCentre of pressurePostural sway

Background

Falls are a leading cause of injury and death among the elderly and are a significant public health issue. It has been reported that one in three elderly people aged 65 years or older and half of those aged 80 years and older will fall once a year [1], with balance disorders being a major risk factor [2]. The visual, proprioceptive and vestibular sensory systems provide feedback from the environment and contribute to balance control by facilitating interaction with the external world [3, 4]. Among these, the vestibular system primarily functions to detect motion and head position. Specifically, three semicircular canals can perceive angular acceleration and velocity of the head, and the otolith organs (utricle and saccule) can sense linear acceleration of the head and head tilt [5]. However, vestibular system function declines with increasing age [6], and this can increase the risk of falls [7, 8].

To date, no effective treatment methods other than physical therapy have been established for the dysfunction of the vestibular system [9]. However, recently, noisy galvanic vestibular stimulation (nGVS) has shown some promise in this regard. This treatment acts by stimulating the vestibular organ with a weak noise current and has been shown to enhance vestibular perception and vestibulo-spinal reflex function [10, 11]. In a previous studies, nGVS was shown to enhance cognitive abilities in healthy subjects [12], to improve motor responsiveness in patients with central neurodegenerative disorders [13], and to improve gait parameters and standing balance in patients with vestibular disorders [14, 15]. Moreover, nGVS in the frequency band 0.1–640 Hz has been reported to improve postural sway in young subjects maintaining an open-eye standing posture and to produce a large stimulation effect in those with a long centre of pressure (COP) sway path [16]. In contrast, nGVS may decrease COP sway in the elderly [17]; however, because COP sway was measured in a closed-eye standing position on foam rubber in previous research, the influence on COP sway while on a firm surface remains unclear. The lack of a control group in the previous study also meant that we could not deny the effects of arousal, motor learning, and other factors than nGVS.

The purpose of this research was to clarify the effect of nGVS in the open-eye standing posture by performing a randomised controlled trial of community-dwelling elderly people. We also aimed to recognize individuals who responded to nGVS.

Methods

Subjects

We conducted a randomised controlled trial among community-dwelling elderly people. The inclusion criteria were that participants needed to be living independently, that they could maintain a standing position with their eyes open and legs together for 30 s without developing dizziness, and that they had no orthopedic or neurological disease. We excluded all potential participants who had previously undergone orthopedic surgery or who had neurological disease. Participants were randomly assigned to a control group or an nGVS group after being fully informed of the nature of the research and providing written informed consent. The study was performed in accordance with the Declaration of Helsinki and was approved by the ethics committee of Niigata University of Health and Welfare (17750e161007).

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