ROSELI SARAIVA MOREIRA BITTAR
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
3 resultados
Resultados de Busca
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- Effects of vibrotactile vestibular substitution on vestibular rehabilitation - preliminary study(2015) BRUGNERA, Cibele; BITTAR, Roseli Saraiva Moreira; GRETERS, Mario Edvin; BASTA, DietmarIntroduction: Some patients with severe impairment of body balance do not obtain adequate improvement from vestibular rehabilitation (VR). Objective: To evaluate the effectiveness of Vertiguard (TM) biofeedback equipment as a sensory substitution (SS) of the vestibular system in patients who did not obtain sufficient improvement from VR. Methods: This was a randomized prospective clinical study. Thirteen patients without satisfactory response to conventional VR were randomized into a study group (SG), which received the vibrotactile stimulus from Vertiguard (TM) for ten days, and a control group (CG), which used equipment without the stimulus. For pre- and post-treatment assessment, the Sensory Organization Test (SOT) protocol of the Computerized Dynamic Posturography (CDP) and two scales of balance self-perception, Activities-specific Balance Confidence (ABC) and Dizziness Handicap Inventory (DHI), were used. Results: After treatment, only the SG showed statistically significant improvement in C5 (p=0.007) and C6 (p=0.01). On the ABC scale, there was a significant difference in the SG (p=0.04). The DHI showed a significant difference in CG and SG with regard to the physical aspect, and only in the SG for the functional aspect (p=0.04). Conclusion: The present findings show that sensory substitution using the vibrotactile stimulus of the Vertiguard (TM) system helped with the integration of neural networks involved in maintaining posture, improving the strategies used in the recovery of body balance.
- Efficacy of a Vibrotactile Neurofeedback Training in Stance and Gait Conditions for the Treatment of Balance Deficits: A Double-Blind, Placebo-Controlled Multicenter Study(2011) BASTA, Dietmar; ROSSI-IZQUIERDO, Marcos; SOTO-VARELA, Andres; GRETERS, Mario Edwin; BITTAR, Roseli Saraiva; STEINHAGEN-THIESSEN, Elisabeth; ECKARDT, Rahel; HARADA, Tatsuhiko; GOTO, Fumiyuki; OGAWA, Kaoru; ERNST, ArneObjective: 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 vibrotactile 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 performed 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 measured 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 rehabilitation program is easy to perform, not exhausting, and time saving, elderly patients and those with serious, long-lasting balance problems also can participate successfully.
- Individualized Vibrotactile Neurofeedback Training in Patients with Chronic Bilateral Vestibulopathy(2023) BASTA, Dietmar; ROSSI-IZQUIERDO, Marcos; WONNEBERGER, Kai; BRUGNERA, Cibele; BITTAR, Roseli Saraiva Moreira; GRETERS, Mario Edvin; ERNST, Arne; SOTO-VARELA, AndresPatients with bilateral vestibulopathy (BVP) suffer from postural imbalance during daily life conditions, which in turn leads to a high frequency of falls. Unfortunately, vestibular rehabilitation has only modest and somewhat inconsistent effects in this patient group. Approximately 50% of BVP patients show an improved postural control after conventional vestibular rehabilitation training. New and more promising approaches are required. The individualized vibrotactile neurofeedback training (IVNT) in stance and gait conditions has already been described as highly effective in patients with various vestibular disorders. The purpose of the present multicenter study was to determine the efficacy of the IVNT in improving balance, reducing self-perceived disability, and improving gait in patients with confirmed BVP. In total, 22 patients performed the IVNT with the Vertiguard (R) system for 10 daily sessions. The dizziness handicap inventory (DHI), the stance stability score of the sensory organization test (SOT) and the score for everyday life mobility in stance and gait tasks (SBDT) were obtained immediately before and after the rehabilitation training period, as well as 3 and 12 months later. All measures improved significantly after the IVNT. Between 77.3% and 94.4% of patients showed an individual benefit (depending on outcome measure). The effect was not significantly reduced within the follow-up period of 12 months. The results demonstrate a high efficacy of the IVNT for vestibular rehabilitation in BVP patients.