Efficacy of a Vibrotactile Neurofeedback Training in Stance and Gait Conditions for the Treatment of Balance Deficits: A Double-Blind, Placebo-Controlled Multicenter Study *Dietmar Basta, †Marcos Rossi-Izquierdo, ‡Andre ´s Soto-Varela, §Mario Edwin Greters, §Roseli Saraiva Bittar, kElisabeth Steinhagen-Thiessen, kRahel Eckardt, ¶Tatsuhiko Harada, #Fumiyuki Goto, **Kaoru Ogawa, and *Arne Ernst *Department of Otolaryngology at UKB, Hospital of the University of Berlin, Charite ´ Medical School, Berlin, Germany; ÞDepartment of Otolaryngology, University Hospital Lucus Augusti, Lugo; þDepartment of Otolaryngology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain; §Department of Otolaryngology, Faculdade de Medicina, Universidade de Sa ˜o Paulo, Sa ˜o Paulo, Brazil; kGeriatrics Research Group, Charite ´ Medical School, Berlin, Germany; ¶Department of Otolaryngology, International University of Health and Welfare, Atami; #Department of Otolaryngology, Hino Municipal Hospital; and **Department of Otolaryngology, Keio University, School of Medicine, Tokyo, Japan Objective: Vestibular rehabilitation strategies mostly require a long-lasting training in stance conditions, which is finally not always successful. The individualized training in everyday- life conditions with an intuitive tactile neurofeedback stimulus seems to be a more promising approach. Hence, the present study was aimed at investigating the efficacy of a new vibro- tactile neurofeedback system for vestibular rehabilitation. Study Design: Double-blinded trial. Patients: One hundred five patients who experience one of the following balance disorders for more than 12 months were included in the study: canal paresis, otolith disorder, removal of an acoustic neuroma, microvascular compression syndrome, Parkinson’s disease, and presbyvertigo. Interventions: Vibrotactile neurofeedback training was per- formed daily (15 min) over 2 weeks with the Vertiguard system in those 6 tasks of the Standard Balance Deficit Test with the most prominent deviations from the normative values. Main Outcome Measures: Trunk and ankle sway, dizziness handicap inventory, and vestibular symptom score were mea- sured in the verum and placebo group before the training, on the last training day and 3 months later. Results: A significant reduction in trunk and ankle sway as well as in the subjective symptom scores were observed in the verum group. Such an effect could not be found in any of the outcome parameters of the placebo group. Conclusion: The vibrotactile neurofeedback training applied in the present study is a highly efficient method for the reduction of body sway in different balance disorders. Because the reha- bilitation program is easy to perform, not exhausting, and time saving, elderly patients and those with serious, long-lasting bal- ance problems also can participate successfully. Key Words: NeurofeedbackVPostural controlVVestibular rehabilitationV Vibrotactile. Otol Neurotol 32:1492Y1499, 2011. Numerous diseases are accompanied by balance defi- cits, which are frequently characterized by an increase in body sway and a higher risk to fall. Different strategies in the conservative management of those balance defi- cits have been applied successfully over the last few decades to improve central compensation of the tonus imbalance within the vestibular system and to facilitate substitution (1) in different types of peripheral or cen- tral vestibular disorders (2,3). Various exercise programs (home or supervised) have been described, including physical training (4), Cawthorne-Cooksey interventions (5), and alternative strategiesVsuch as Tai Chi (6). Address correspondence and reprint requests to Dietmar Basta, Ph.D., Department of Otolaryngology at UKB, Warener Str. 7, 12683 Berlin, Germany; E-mail: dietmar.basta@ukb.de This study was supported by a grant from the German Ministry of Education and Research (BMBF-01EZ0754). Otology & Neurotology 32:1492Y1499 Ó 2011, Otology & Neurotology, Inc. 1492 Copyright © 2011 Otology & Neurotology, Inc. Unauthorized reproduction of this article is prohibited.