Efeitos da fisioterapia vestibular no equilíbrio estático e dinâmico de pacientes com disfunções vestibulares

Abstract

Background: Vestibular dysfunctions result from lesions in the vestibular system of the inner ear, in the processing centers of the central nervous system, or both. The maintenance of postural balance depends on the integration of three main systems: the vestibular, visual, and proprioceptive systems. Alterations in any of these systems may compromise the performance of daily activities and are strongly associated with an increased risk of falls, especially in older adults. Objectives: This study aimed to analyze the effects of vestibular physiotherapy on the intensity of the dizziness/vertigo symptom and on static and dynamic balance in patients with vestibular dysfunctions of central and peripheral origin. Methods: This is cross sectional and retrospective study conducted from 2018 to 2024, involving patients from the clinical extension project “Vestibular Rehabilitation in Otoneurological Dysfunctions,” carried out by the Department of Physiotherapy at the Federal University of Rio Grande do Norte (UFRN). Participants were aged 18 years or older and had a medical diagnosis of peripheral or central vestibular dysfunction. Clinical-functional and sociodemographic data were collected, along with the intensity of the dizziness/vertigo symptom measured by the NRS, static balance assessed using the CTSIB-m, and dynamic balance assessed using the DGI. Results: A total of 41 individuals were evaluated, 82.9% of whom were female, with a high prevalence of postural imbalance (92.7%) in the studied sample. Peripheral vestibulopathies were predominant (85.4%), with BPPV being the most frequent (34.1%). The median treatment period was 11 weeks, after which an improvement in dizziness/vertigo symptom intensity was observed, from NRS = 4 (pre-treatment) to NRS = 0 (post-intervention). Moreover, an improvement in static balance was observed in the 4th task of the CTSIB-m, where the median increased from 7 seconds to 30 seconds (post-intervention), and significant improvement in dynamic balance was noted in the DGI score, which increased by 4 points, from 18 to 22 points (post-intervention). Conclusion: Vestibular physiotherapy has shown to be effective in reducing dizziness/vertigo symptom intensity and improving static and dynamic balance, with significant results after an average of 11 weeks of treatment. However, further studies with greater methodological rigor are necessary to deepen the understanding of its effectiveness and its influence on postural balance