Vol.:(0123456789) 1 3 Eur Arch Otorhinolaryngol DOI 10.1007/s00405-017-4472-4 OTOLOGY Short-term efectiveness of vestibular rehabilitation in elderly patients with postural instability: a randomized clinical trial Marcos Rossi-Izquierdo 1  · Pilar Gayoso-Diz 2  · Sofía Santos-Pérez 3  · María Del-Río-Valeiras 3  · Ana Faraldo-García 3  · Isabel Vaamonde-Sánchez-Andrade 3  · Antonio Lirola-Delgado 3  · Andrés Soto-Varela 3   Received: 4 September 2016 / Accepted: 18 January 2017 © Springer-Verlag Berlin Heidelberg 2017 in comparison with the control group (p < 0.001). In our present study, supervised and customized exercises with CDP were more efective than the control group in the pos- turographic short-term assessment. An increased age did not afect the potential for improvement after training. So we conclude that elderly patients with high risk of falling should begin vestibular rehabilitation as soon as possible in order to avoid the potential harm of falls, mainly inju- ries and psychological consequences due to fear of falling again. Keywords Elderly · Postural instability · Computer dynamic posturography · Optokinetic · Vestibular rehabilitation Introduction Balance becomes more precarious with age and balance disorders become more common. Even without patho- logical disorders, the physiological decline in balance that occurs with age, due to the aging of the diferent body sys- tems involved (visual, vestibular and proprioceptive) [1], is a factor that also leads to falls [2]. Accidental falls especially in such elderly patients are a very important public health problem from both a clini- cal and an economic perspective [3]. Nearly a third of all people who fall three or more times a year are hos- pitalized, admitted to a residential facility or die in the following year [4]. Repeated falls are therefore a prog- nostic factor for greater morbidity–mortality. Falls also have signifcant social and psychological consequences, as patients tend to lose self-confdence and limit their physical activity due to a fear of falling again [5]. This Abstract Balance becomes more precarious with age, and even without pathological disorders, the physiologi- cal decline in balance that occurs with age is a factor that also favors falls. So the aim of the present study is to assess the short-term efectiveness of three diferent methods of vestibular rehabilitation, compared to a control group, in improving balance in elderly patients with postural insta- bility. 139 elderly patients with high risk of falls were included and randomized to one of the following study arms: computer dynamic posturography (CDP) training, optokinetic stimulus, exercises at home, or control group. Patients were assessed with objective and subjective out- come measures. The individuals that trained using CDP improved signifcantly more than the control group on the average balance score (p < 0.001) and reducing the num- ber of falls in the sensorial organization test (p < 0.001). In addition, the analysis showed a statistically signifcant efect in the limits of stability only with the CDP training Presented at the 29th Bárány Society meeting, at Seoul (South Korea), June 2016 as an oral presentation. Electronic supplementary material The online version of this article (doi:10.1007/s00405-017-4472-4) contains supplementary material, which is available to authorized users. * Marcos Rossi-Izquierdo Marcos_Rossi@hotmail.com 1 Department of Otolaryngology, University Hospital Lucus Augusti, Calle Dr. Ulises Romero, 1, 27003 Lugo, Spain 2 Clinical Epidemiology Unit, Hospital Clínico Universitario. Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain 3 Department of Otolaryngology, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain