Effects of photobiomodulation associated with vestibular rehabilitation in the treatment of patients with vestibular symptoms and tinnitus: a triple-blind randomized clinical trial

TL;DR

This study found that combining light therapy with vestibular rehab significantly reduced tinnitus discomfort and improved balance more than rehab alone.

Contribution

Demonstrates that photobiomodulation combined with vestibular rehabilitation outperforms rehabilitation alone in tinnitus and balance improvement.

Findings

Photobiomodulation plus rehab significantly reduced tinnitus discomfort compared to placebo.

The treatment improved vestibular function and postural balance more effectively than rehab alone.

No significant difference was found in dizziness handicap scores between the groups.

Abstract

To analyze the effects of photobiomodulation (PBM) associated with vestibular rehabilitation (VR) in adults with vestibular symptoms and tinnitus, compared to VR combined with placebo PBM, regarding the reduction of tinnitus discomfort and improvements in vestibular function, postural balance, and dynamic visual acuity.

Randomized, triple-blind clinical trial with 20 volunteers diagnosed with vestibular hypofunction and chronic tinnitus. Participants were allocated into two groups: research group (RG), which received VR combined with active PBM; and control group (CG), which received VR combined with placebo PBM. Both groups underwent ten intervention sessions, twice a week, over five weeks. Pre- and post-intervention assessments included: Tinnitus Handicap Inventory (THI), Dizziness Handicap Inventory (DHI), Visual Analog Scale (VAS), dynamic visual acuity (DVA) test, and posturography. Data were analyzed using Student's t-test and the Mann-Whitney test (p<0.05).

In the post-intervention comparison between groups, the RG showed significant improvement in VAS for tinnitus (p=0.046), and in the functional (p=0.003), emotional (p=0.002), and total (p=0.000) scores of the THI. The Sensory Organization Test parameter showed a significant pre- and post-treatment difference (p=0.003) only in the RG. VAS for vestibular symptoms, DHI scores, and the Composite Equilibrium Score improved in both groups, with no significant difference between them.

PBM combined with VR significantly reduced tinnitus discomfort and showed superior performance in vestibular function analysis. VR alone did not demonstrate any effect on tinnitus reduction.

Analisar os efeitos da Fotobiomodulação (FBM) associada à Reabilitação Vestibular (RV) em adultos com sintomas vestibulares e zumbido, em comparação com a RV associada à FBM placebo, quanto à redução do incômodo do zumbido e à melhora da função vestibular, equilíbrio postural e acuidade visual dinâmica.

Ensaio clínico randomizado, triplo-cego, com 20 voluntários diagnosticados com hipofunção vestibular e zumbido crônico. Os participantes foram alocados em dois grupos: grupo pesquisa (GP), submetido à RV com FBM ativa; e grupo controle (GC), submetido à RV com FBM placebo. Cada grupo realizou dez sessões, duas vezes por semana, durante cinco semanas. As avaliações pré e pós-intervenção incluíram: Tinnitus Handicap Inventory (THI), Dizziness Handicap Inventory (DHI), Escala Visual Analógica (EVA), teste de Acuidade Visual Dinâmica (AVD) e posturografia. Os dados foram analisados pelos testes t de Student e Mann-Whitney (p<0,05).

Na comparação entre os grupos no momento pós- intervenção , O GP apresentou melhora significativa na EVA para zumbido (p=0,046), nos domínios funcional (p=0,003), emocional (p=0,002) e total (p=0,000) do THI. O parâmetro Análise Sensorial da Função Vestibular mostrou diferença significante nos momentos pré e pós- terapia (p=0,003) apenas no GP. A EVA Sintomas Vestibulares, os escores do DHI e o Índice de Equilíbrio Composto apresentaram melhora nos dois grupos, sem diferença estatística.

A FBM associada à RV reduziu significativamente o incômodo do zumbido e apresentou um desempenho superior na Análise Sensorial da Função Vestibular . A RV isolada não demonstrou efeito na redução do zumbido.

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