Vol.102 No.7 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 102 No. 7 July 2009
Clinical Application of Sensory Substitution for Balance Control
Toshiaki Yamanaka and Hiroshi Hosoi
(Nara Medical University School of Medicine)
Kim Skinner
(Wicab. Inc.)
Paul Bach-y-Rita
(Wicab. Inc., University of Wisconsin Medical School)
This clinical trial investigated whether a new rehabilitation therapy using the sensory substitution system was an effective treatment for severe balance disorder in subjects with bilateral vestibular loss.
The device which substitutes for vestibular input by transmitting information on head position to the tongue, consists of a tilt sensor for detecting head position, a 10×10 electrode array for interfacing with tongue, and a controller for processing information. Subjects who placed the electrode array on the tongue were trained to maintain a centered body position by keeping the signals on the middle of tongue using the electrode array. All subjects completed 5-20 minute training sessions 2-3 times per day for 8 weeks. Dynamic stability and gait function were tested using the Sensory Organization Test (SOT) and Dynamic Gait Index (DGI), respectively, before and after all training sessions.
All subjects showed pronounced improvements in their balance performance. The average of SOT score and DGI had significantly decreased after the last training. Improvements were also noted in quality of life assessments such as the Dizziness Handicap Inventory (DHI) and the Activities-specific Balance Confidence (ABC) Scale.
These results suggest that alternative sensory input through the tongue could substitute for vestibular function and the vestibular substitution device is a possible new rehabilitation tool for subjects with a persistent balance disorder who have a long term history of bilateral peripheral vestibular etiologies.
Key words :sensory substitution, balance, rehabilitation, vestibular loss, tongue