Electrical vestibular stimulation to improve static balance in older adults: a randomized control trial

Background Falls are the leading cause of injury-related hospitalizations among older adults, often linked to vestibular dysfunction. While vestibular rehabilitation therapy is a standard intervention, designed to compensate for vestibular impairment with proprioceptive and visual ques, potential cumulative effects of Electrical Vestibular Stimulation (EVS) on balance improvement in older adults are not well understood. Objective This study evaluated the efficacy of cumulative EVS dosing in improving static balance, its potential mechanisms, and clinical significance. Methods A single-blind, randomized controlled trial enrolled 40 older adults (mean age: 77.7 ± 11.8 years). Participants were randomly assigned to a Stimulation group (EVS intervention) or Sham group. The EVS regimen included low-amplitude wideband stimulation (± 0.35 mA, 0–300 Hz) for 20 minutes, three times weekly for six weeks. Balance performance was assessed using a head-mounted sensor to measure postural sway (‘phybrata’) power in four static conditions: Floor EO, Floor EC, Foam EO, and Foam EC. Follow-ups occurred at 3 months and 6 months post-intervention. Results The Stimulation group exhibited significant and sustained reductions in phybrata power, particularly in Foam EO and Foam EC conditions, with improvements observed as early as Day 3 and persisting through 6 months. Additionally, the Sham group demonstrated smaller reductions in phybrata power, potentially reflecting a learning effect. Conclusion EVS is a safe and effective intervention for improving balance in older adults. Its benefits in addressing age-related deficits in balance and sensory integration highlight its potential for fall prevention and rehabilitation.