Rehabilitación vestibular en personas mayores con disfunción vestibular
Resumen Introducción y objetivo: El mareo y el desequilibrio son síntomas comunes en el anciano y tienen un gran impacto en su calidad de vida. Método: Revisión narrativa. Resultados: Se revisan los principales factores que condicionan la inestabilidad en el anciano, el impacto de las caídas y las exploraciones más rentables desde el punto de vista diagnóstico y terapéutico en estos pacientes. Por último, se incide en la necesidad de un abordaje multidisciplinar destacando la importancia de la rehabilitación vestibular en el tratamiento de estos trastornos. Conclusiones: La inestabilidad en el anciano es de origen multifactorial y no obedece solamente a razones fisiológicas. De ahí la necesidad de identificar los factores precipitantes, tratarlos si es posible y realizar un abordaje multidisciplinar que minimice la morbimortalidad asociada a este proceso y mejorando su calidad de vida. La rehabilitación vestibular puede mejorar significativamente el equilibrio de los ancianos con inestabilidad lo cual conduciría a una reducción significativa de las caídas.
- Referencias
- Cómo citar
- Del mismo autor
- Métricas
Baloh RW, Jacobson KM, Socotch TM. The effect of aging on visual-vestibuloocular responses. Exp Brain Res. 1993; 95:509-16.
Basta D, Rossi-Izquierdo M, Soto-Varela A, Greters ME, Bittar RS, Steinhagen-Thiessen E,et al. Efficacy of a vibrotactile neurofeedback training in stance and gait conditions for the treatment of balance deficits: a double-blind, placebo-controlled multicenter study. Otol Neurotol. 2011;32:1492-9. doi: 10.1097/MAO.0b013e31823827ec
Bracchi E, Rizzo S, Longari F, Bernardini M, Bizzotti C, Frenguelli A. Balance disorders in the elderly. Acta Otorhinolaryngol Ital. 2002; 22: 263-7.
Bronstein A, Lempert T. Dizziness, imbalance and falls in the elderly. En: Bronstein A, Lempert T, editores. Dizziness. A practical approach to diagnosis and management 2a Edición. Cambridge (United Kingdom): Cambridge University Press; 2017.p. 147-66.
Brosel S, Strupp M. The Vestibular System and Ageing. Subcell Biochem. 2019;91:195-225. doi: 10.1007/978-981-13-3681-2_8.
Cabrero-García J, Muñoz-Mendoza CL, Cabañero-Martínez MJ, González-Llopís L, Ramos-Pichardo JD, Reig-Ferrer A. Valores de referencia de la Short Physical Performance Battery para pacientes de 70 y más años en atención primaria de salud. Aten Primaria. 2012;44:540-8. doi: 10.1016/j.aprim.2012.02.007.
Cuevas-Trisan R. Balance Problems and Fall Risks in the Elderly. Clin Geriatr Med. 2019 ;35:173-183.
Eibling D. Balance Disorders in Older Adults. Clin Geriatr Med. 2018;34:175-181. doi: 10.1016/j.cger.2018.01.002.
Faraldo García A. Paciente con presbivértigo y riesgo de caídas. En Rosssi- Izquierdo M, Soto Varela A, Santos Pérez S, editores. Rehabilitación vestibular [ Internet]. Santiago de Compostela: Sociedad Gallega de Otorrinolaringología; 2016 [acceso 8 de junio de 2018].p. 195- 202. Disponible en: http://www.sgorl.org/images/Ponencias/Ponencia_SGORL_Rehabilitación_Vestibular_.pdf.
Gabriel Trinidad Ruíz. Ejercicios de rehabilitiación domiciliaria. . En Rosssi- Izquierdo M, Soto Varela A, Santos Pérez S, editores. Rehabilitación vestibular [ Internet]. Santiago de Compostela: Sociedad Gallega de Otorrinolaringología;2016 [acceso 8 de junio de 2018].p. 169- 177. Disponible en: http://www.sgorl.org/images/Ponencias/Ponencia_SGORL_Rehabilitación_Vestibular_.pdf.
Hall CD, Herdman SJ, Whitney SL, Cass SP, Clendaniel RA, Fife TD, et al. Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Evidence-Based Clinical Practice Guideline: FROM THE AMERICAN PHYSICAL THERAPY ASSOCIATION NEUROLOGY SECTION. J Neurol Phys Ther. 2016 Apr;40(2):124-55. doi: 10.1097/NPT.0000000000000120.
Ishiyama G. Imbalance and vertigo: the aging human vestibular periphery. Semin Neurol. 2009; 29: 491-9. doi: 10.1055/s-0029-1241039.
Jahn K. The Aging Vestibular System: Dizziness and Imbalance in the Elderly. Adv Otorhinolaryngol. 2019; 82:143-149. doi: 10.1159/000490283.
Jeka JJ, Allison LK, Kiemel T. The dynamics of visual reweighting in healthy and fall-prone older adults. J Mot Behav. 2010;42:197-208. doi: 10.1080/00222895.2010.481693.
Judge JO, King MB, Whipple R, Clive J, Wolfson LI. Dynamic balance in older persons: effects of reduced visual and proprioceptive input. J Gerontol A Biol Sci Med Sci. 1995;50:M263-70.
Kearney FC, Harwood RH, Gladman JR, Lincoln N, Masud T. The relationship between executive function and falls and gait abnormalities in older adults: a systematic review. Dement Geriatr Cogn Disord. 2013;36:20-35.
Krager R. Assessment of vestibular function in elderly patients. Curr Opin Otolaryngol Head Neck Surg. 2018;26:302-306. doi: 10.1097/MOO.0000000000000476.
Lin CC, Barker JW, Sparto PJ, Furman JM, Huppert TJ. Functional near-infrared spectroscopy (fNIRS) brain imaging of multi-sensory integration during computerized dynamic posturography in middle-aged and older adults. Exp Brain Res. 2017;235:1247-1256. doi: 10.1007/s00221-017-4893-8.
Lord SR, McLean D, Stathers G. Physiological factors associated with injurious falls in older people living in the community. Gerontology. 1992;38:338-46.
Manchester D, Woollacott M, Zederbauer-Hylton N, Marin O.Visual, vestibular and somatosensory contributions to balance control in the older adult. J Gerontol. 1989;44:M118-27.
McMurdo ME, Gaskell A. Dark adaptation and falls in the elderly.Gerontology. 1991;37(4):221-4.
Osoba MY, Rao AK, Agrawal SK, Lalwani AK. Balance and gait in the elderly: A contemporary review. Laryngoscope Investig Otolaryngol. 2019;4:143-153. doi: 10.1002/lio2.252. eCollection 2019 Feb.
Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society. Summary of the Updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc. 2011;59:148-57. doi: 10.1111/j.1532-5415.2010.03234.x.
Panzer VP, Bandinelli S, Hallett M. Biomechanical assessment of quiet standing and changes associated with aging. Arch Phys Med Rehabil. 1995;76:151-7.
Patel M, Magnusson M, Kristinsdottir E, Fransson PA The contribution of mechanoreceptive sensation on stability and adaptation in the young and elderly. Eur J Appl Physiol. 2009;105:167-73. doi: 10.1007/s00421-008-0886-4.
Peterka RJ, Black FO, Schoenhoff MB. Age-related changes in human vestibulo-ocular reflexes: sinusoidal rotation and caloric tests. J Vestib Res. 1990-1991;1(1):49-59.
Pyykkö I, Jäntti P, Aalto H. Postural control in elderly subjects. Age Ageing. 1990;19:215-21.
Pollock AS, Durward BR, Rowe PJ, Paul JP. What is balance?. Clin Rehabil. 2000; 14:402-6.
Robbins S, Waked E, McClaran J. Proprioception and stability: foot position awareness as a function of age and footwear. Age Ageing. 1995;24:67-72.
Rossi-Izquierdo M, Gayoso-Diz P, Santos-Pérez S, Del-Río-Valeiras M, Faraldo-García A, Vaamonde-Sánchez-Andrade I, et al. Prognostic factors that modify outcomes of vestibular rehabilitation in elderly patients with falls. Aging Clin Exp Res. 2019 Apr 11. doi: 10.1007/s40520-019-01185-8. [Epub ahead of print].
Rossi-Izquierdo M, Gayoso-Diz P, Santos-Pérez S, Del-Río-Valeiras M, Faraldo-García A, Vaamonde-Sánchez-Andrade I,et al. Vestibular rehabilitation in elderly patients with postural instability: reducing the number of falls-a randomized clinical trial. Aging Clin Exp Res. 2018 ;30:1353-1361.
Rossi-Izquierdo M, Santos-Pérez S, Rubio-Rodríguez JP, Lirola-Delgado A, Zubizarreta-Gutiérrez A, San Román-Rodríguez E, et al. What is the optimal number of treatment sessions of vestibular rehabilitation? Eur Arch Otorhinolaryngol. 2014;271:275-80.
Rossi-Izquierdo M, Santos-Pérez S, Soto-Varela A. What is the most effective vestibular rehabilitation technique in patients with unilateral peripheral vestibular disorders? Eur Arch Otorhinolaryngol. 2011;268:1569-74. doi: 10.1007/s00405-011-1532-z.
Sharpe JA, Sylvester TO. Effect of aging on horizontal smooth pursuit. Invest Ophthalmol Vis Sci. 1978;17:465-8.
Shaw FE, Bond J, Richardson DA, Dawson P, Steen IN, McKeith IG, et al. Multifactorial intervention after a fall in older people with cognitive impairment and dementia presenting to the accident and emergency department: randomised controlled trial. BMJ. 2003;326:73.
Shen DC, Wu SL, Shi YZ, Wang S, Zhang YM, Wang CX. The correlation between white matter hyperintensity and balance disorder and fall risk: An observational, prospective cohort study. Chronic Dis Transl Med. 2016;15:173-180. doi: 10.1016/j.cdtm.2016.11.008.
Sherrington C, Michaleff ZA, Fairhall N, Paul SS, Tiedemann A, Whitney J, et al. Exercise to prevent falls in older adults: an updated systematic review and meta-analysis. Br J Sports Med. 2017 Dec;51(24):1750-1758. doi: 10.1136/bjsports-2016-096547. Epub 2016 Oct 4.
Shumway-Cook A, Woollacott M, Kerns KA, Baldwin M. The effects of two types of cognitive tasks on postural stability in older adults with and without a history of falls. J Gerontol A Biol Sci Med Sci. 1997;52:M232-40.
Soto-Varela A, Faraldo-García A, Del-Río-Valeiras M, Rossi-Izquierdo M, Vaamonde-Sánchez-Andrade I, Gayoso-Diz P, et al. Adherence of older people with instability in vestibular rehabilitation programmes: prediction criteria. J Laryngol Otol. 2017;131:232-238.
Soto-Varela A, Faraldo-García A, Rossi-Izquierdo M, Lirola-Delgado A, Vaamonde-Sánchez-Andrade I, del-Río-Valeiras M, et al. Can we predict the risk of falls in elderly patients with instability? Auris Nasus Larynx. 2015; 42:8-14. doi: 10.1016/j.anl.2014.06.005.
Soto-Varela A, Rossi-Izquierdo M, Faraldo-García A, Vaamonde-Sánchez-Andrade I, Gayoso-Diz P, Del-Río-Valeiras M et al. Balance Disorders in the Elderly: Does Instability Increase Over Time? Ann Otol Rhinol Laryngol. 2016; 125(7):550-8.
Spooner JW, Sakala SM, Baloh RW. Effect of aging on eye tracking. Arch Neurol. 1980 ;37:575-6.
Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of fatal and non-fatal falls among older adults. Inj Prev. 2006;12(5):290-5.
Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319:1701-7.
Verghese J, Ayers E, Barzilai N, Bennett DA, Buchman AS, Holtzer R, et al. Motoric cognitive risk syndrome: Multicenter incidence study. Neurology. 2014;83:2278-84. doi: 10.1212/WNL.0000000000001084.
Whitney SL, Marchetti GF. Physical therapy management of the older person with vestibular rehabilitation. In Herdman SJ, Clendaniel RA, editores. Vestibular rehabilitation. 4ªEdición. Philadelphia: F.A. Davis Company;2014;p.480-503.
Xie Y, Anson ER, Simonsick EM, Studenski SA, Agrawal Y. Compensatory Saccades Are Associated With Physical Performance in Older Adults: Data From the Baltimore Longitudinal Study of Aging. Otol Neurotol. 2017;38:373-378. doi: 10.1097/MAO.0000000000001301.
Zwergal A, Linn J, Xiong G, Brandt T, Strupp M, Jahn K. Aging of human supraspinal locomotor and postural control in fMRI. Neurobiol Aging. 2012;33:1073-84. doi: 10.1016/j.neurobiolaging.2010.09.022.
Basta D, Rossi-Izquierdo M, Soto-Varela A, Greters ME, Bittar RS, Steinhagen-Thiessen E,et al. Efficacy of a vibrotactile neurofeedback training in stance and gait conditions for the treatment of balance deficits: a double-blind, placebo-controlled multicenter study. Otol Neurotol. 2011;32:1492-9. doi: 10.1097/MAO.0b013e31823827ec
Bracchi E, Rizzo S, Longari F, Bernardini M, Bizzotti C, Frenguelli A. Balance disorders in the elderly. Acta Otorhinolaryngol Ital. 2002; 22: 263-7.
Bronstein A, Lempert T. Dizziness, imbalance and falls in the elderly. En: Bronstein A, Lempert T, editores. Dizziness. A practical approach to diagnosis and management 2a Edición. Cambridge (United Kingdom): Cambridge University Press; 2017.p. 147-66.
Brosel S, Strupp M. The Vestibular System and Ageing. Subcell Biochem. 2019;91:195-225. doi: 10.1007/978-981-13-3681-2_8.
Cabrero-García J, Muñoz-Mendoza CL, Cabañero-Martínez MJ, González-Llopís L, Ramos-Pichardo JD, Reig-Ferrer A. Valores de referencia de la Short Physical Performance Battery para pacientes de 70 y más años en atención primaria de salud. Aten Primaria. 2012;44:540-8. doi: 10.1016/j.aprim.2012.02.007.
Cuevas-Trisan R. Balance Problems and Fall Risks in the Elderly. Clin Geriatr Med. 2019 ;35:173-183.
Eibling D. Balance Disorders in Older Adults. Clin Geriatr Med. 2018;34:175-181. doi: 10.1016/j.cger.2018.01.002.
Faraldo García A. Paciente con presbivértigo y riesgo de caídas. En Rosssi- Izquierdo M, Soto Varela A, Santos Pérez S, editores. Rehabilitación vestibular [ Internet]. Santiago de Compostela: Sociedad Gallega de Otorrinolaringología; 2016 [acceso 8 de junio de 2018].p. 195- 202. Disponible en: http://www.sgorl.org/images/Ponencias/Ponencia_SGORL_Rehabilitación_Vestibular_.pdf.
Gabriel Trinidad Ruíz. Ejercicios de rehabilitiación domiciliaria. . En Rosssi- Izquierdo M, Soto Varela A, Santos Pérez S, editores. Rehabilitación vestibular [ Internet]. Santiago de Compostela: Sociedad Gallega de Otorrinolaringología;2016 [acceso 8 de junio de 2018].p. 169- 177. Disponible en: http://www.sgorl.org/images/Ponencias/Ponencia_SGORL_Rehabilitación_Vestibular_.pdf.
Hall CD, Herdman SJ, Whitney SL, Cass SP, Clendaniel RA, Fife TD, et al. Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Evidence-Based Clinical Practice Guideline: FROM THE AMERICAN PHYSICAL THERAPY ASSOCIATION NEUROLOGY SECTION. J Neurol Phys Ther. 2016 Apr;40(2):124-55. doi: 10.1097/NPT.0000000000000120.
Ishiyama G. Imbalance and vertigo: the aging human vestibular periphery. Semin Neurol. 2009; 29: 491-9. doi: 10.1055/s-0029-1241039.
Jahn K. The Aging Vestibular System: Dizziness and Imbalance in the Elderly. Adv Otorhinolaryngol. 2019; 82:143-149. doi: 10.1159/000490283.
Jeka JJ, Allison LK, Kiemel T. The dynamics of visual reweighting in healthy and fall-prone older adults. J Mot Behav. 2010;42:197-208. doi: 10.1080/00222895.2010.481693.
Judge JO, King MB, Whipple R, Clive J, Wolfson LI. Dynamic balance in older persons: effects of reduced visual and proprioceptive input. J Gerontol A Biol Sci Med Sci. 1995;50:M263-70.
Kearney FC, Harwood RH, Gladman JR, Lincoln N, Masud T. The relationship between executive function and falls and gait abnormalities in older adults: a systematic review. Dement Geriatr Cogn Disord. 2013;36:20-35.
Krager R. Assessment of vestibular function in elderly patients. Curr Opin Otolaryngol Head Neck Surg. 2018;26:302-306. doi: 10.1097/MOO.0000000000000476.
Lin CC, Barker JW, Sparto PJ, Furman JM, Huppert TJ. Functional near-infrared spectroscopy (fNIRS) brain imaging of multi-sensory integration during computerized dynamic posturography in middle-aged and older adults. Exp Brain Res. 2017;235:1247-1256. doi: 10.1007/s00221-017-4893-8.
Lord SR, McLean D, Stathers G. Physiological factors associated with injurious falls in older people living in the community. Gerontology. 1992;38:338-46.
Manchester D, Woollacott M, Zederbauer-Hylton N, Marin O.Visual, vestibular and somatosensory contributions to balance control in the older adult. J Gerontol. 1989;44:M118-27.
McMurdo ME, Gaskell A. Dark adaptation and falls in the elderly.Gerontology. 1991;37(4):221-4.
Osoba MY, Rao AK, Agrawal SK, Lalwani AK. Balance and gait in the elderly: A contemporary review. Laryngoscope Investig Otolaryngol. 2019;4:143-153. doi: 10.1002/lio2.252. eCollection 2019 Feb.
Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society. Summary of the Updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc. 2011;59:148-57. doi: 10.1111/j.1532-5415.2010.03234.x.
Panzer VP, Bandinelli S, Hallett M. Biomechanical assessment of quiet standing and changes associated with aging. Arch Phys Med Rehabil. 1995;76:151-7.
Patel M, Magnusson M, Kristinsdottir E, Fransson PA The contribution of mechanoreceptive sensation on stability and adaptation in the young and elderly. Eur J Appl Physiol. 2009;105:167-73. doi: 10.1007/s00421-008-0886-4.
Peterka RJ, Black FO, Schoenhoff MB. Age-related changes in human vestibulo-ocular reflexes: sinusoidal rotation and caloric tests. J Vestib Res. 1990-1991;1(1):49-59.
Pyykkö I, Jäntti P, Aalto H. Postural control in elderly subjects. Age Ageing. 1990;19:215-21.
Pollock AS, Durward BR, Rowe PJ, Paul JP. What is balance?. Clin Rehabil. 2000; 14:402-6.
Robbins S, Waked E, McClaran J. Proprioception and stability: foot position awareness as a function of age and footwear. Age Ageing. 1995;24:67-72.
Rossi-Izquierdo M, Gayoso-Diz P, Santos-Pérez S, Del-Río-Valeiras M, Faraldo-García A, Vaamonde-Sánchez-Andrade I, et al. Prognostic factors that modify outcomes of vestibular rehabilitation in elderly patients with falls. Aging Clin Exp Res. 2019 Apr 11. doi: 10.1007/s40520-019-01185-8. [Epub ahead of print].
Rossi-Izquierdo M, Gayoso-Diz P, Santos-Pérez S, Del-Río-Valeiras M, Faraldo-García A, Vaamonde-Sánchez-Andrade I,et al. Vestibular rehabilitation in elderly patients with postural instability: reducing the number of falls-a randomized clinical trial. Aging Clin Exp Res. 2018 ;30:1353-1361.
Rossi-Izquierdo M, Santos-Pérez S, Rubio-Rodríguez JP, Lirola-Delgado A, Zubizarreta-Gutiérrez A, San Román-Rodríguez E, et al. What is the optimal number of treatment sessions of vestibular rehabilitation? Eur Arch Otorhinolaryngol. 2014;271:275-80.
Rossi-Izquierdo M, Santos-Pérez S, Soto-Varela A. What is the most effective vestibular rehabilitation technique in patients with unilateral peripheral vestibular disorders? Eur Arch Otorhinolaryngol. 2011;268:1569-74. doi: 10.1007/s00405-011-1532-z.
Sharpe JA, Sylvester TO. Effect of aging on horizontal smooth pursuit. Invest Ophthalmol Vis Sci. 1978;17:465-8.
Shaw FE, Bond J, Richardson DA, Dawson P, Steen IN, McKeith IG, et al. Multifactorial intervention after a fall in older people with cognitive impairment and dementia presenting to the accident and emergency department: randomised controlled trial. BMJ. 2003;326:73.
Shen DC, Wu SL, Shi YZ, Wang S, Zhang YM, Wang CX. The correlation between white matter hyperintensity and balance disorder and fall risk: An observational, prospective cohort study. Chronic Dis Transl Med. 2016;15:173-180. doi: 10.1016/j.cdtm.2016.11.008.
Sherrington C, Michaleff ZA, Fairhall N, Paul SS, Tiedemann A, Whitney J, et al. Exercise to prevent falls in older adults: an updated systematic review and meta-analysis. Br J Sports Med. 2017 Dec;51(24):1750-1758. doi: 10.1136/bjsports-2016-096547. Epub 2016 Oct 4.
Shumway-Cook A, Woollacott M, Kerns KA, Baldwin M. The effects of two types of cognitive tasks on postural stability in older adults with and without a history of falls. J Gerontol A Biol Sci Med Sci. 1997;52:M232-40.
Soto-Varela A, Faraldo-García A, Del-Río-Valeiras M, Rossi-Izquierdo M, Vaamonde-Sánchez-Andrade I, Gayoso-Diz P, et al. Adherence of older people with instability in vestibular rehabilitation programmes: prediction criteria. J Laryngol Otol. 2017;131:232-238.
Soto-Varela A, Faraldo-García A, Rossi-Izquierdo M, Lirola-Delgado A, Vaamonde-Sánchez-Andrade I, del-Río-Valeiras M, et al. Can we predict the risk of falls in elderly patients with instability? Auris Nasus Larynx. 2015; 42:8-14. doi: 10.1016/j.anl.2014.06.005.
Soto-Varela A, Rossi-Izquierdo M, Faraldo-García A, Vaamonde-Sánchez-Andrade I, Gayoso-Diz P, Del-Río-Valeiras M et al. Balance Disorders in the Elderly: Does Instability Increase Over Time? Ann Otol Rhinol Laryngol. 2016; 125(7):550-8.
Spooner JW, Sakala SM, Baloh RW. Effect of aging on eye tracking. Arch Neurol. 1980 ;37:575-6.
Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of fatal and non-fatal falls among older adults. Inj Prev. 2006;12(5):290-5.
Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319:1701-7.
Verghese J, Ayers E, Barzilai N, Bennett DA, Buchman AS, Holtzer R, et al. Motoric cognitive risk syndrome: Multicenter incidence study. Neurology. 2014;83:2278-84. doi: 10.1212/WNL.0000000000001084.
Whitney SL, Marchetti GF. Physical therapy management of the older person with vestibular rehabilitation. In Herdman SJ, Clendaniel RA, editores. Vestibular rehabilitation. 4ªEdición. Philadelphia: F.A. Davis Company;2014;p.480-503.
Xie Y, Anson ER, Simonsick EM, Studenski SA, Agrawal Y. Compensatory Saccades Are Associated With Physical Performance in Older Adults: Data From the Baltimore Longitudinal Study of Aging. Otol Neurotol. 2017;38:373-378. doi: 10.1097/MAO.0000000000001301.
Zwergal A, Linn J, Xiong G, Brandt T, Strupp M, Jahn K. Aging of human supraspinal locomotor and postural control in fMRI. Neurobiol Aging. 2012;33:1073-84. doi: 10.1016/j.neurobiolaging.2010.09.022.
Franco-Gutiérrez, V., & Perez-Vázquez, P. (2019). Rehabilitación vestibular en personas mayores con disfunción vestibular. Revista ORL, 11(1), 67–78. https://doi.org/10.14201/orl.20953
Artículos más leídos del mismo autor/a
- José Ignacio Benito-Orejas, María Poncela-Blanco, Laura Diez-González, Rafael Álvarez-Otero, Gabriel Aguilera-Aguilera, Jean Franco Intraprendente-Martini, Erwin Racines-Alava, Ramón Martínez, Maria Marco-Carmona, Hortensia Sánchez-Gómez, Raquel Yáñez-González, Rocío González-Aguado, Virginia Franco-Gutiérrez, Gloria Guerra-Jiménez, Angel Mazón-Gutierrez, Silvia Gancedo, Rafael Pérez, Pablo Santos-Gorjón, Carmen Sánchez-Blanco, Francisco José García-Purriños, Cristina Gascón-Rubio, Fernando Salazar, Michael Bauer, José Valda-Rodrigo, Eduardo Mena-Domínguez, Gabriel Trinidad-Ruiz, Angel Batuecas-Caletrío, Guía práctica del vértigo posicional paroxístico , Revista ORL: Vol. 8 Núm. 3 (2017)
- Paz Pérez-Vázquez, Virginia Franco-Gutiérrez, La prueba calórica , Revista ORL: Vol. 9 Núm. 3 (2018)
- José Ignacio Benito-Orejas, Marta Alonso-Mesonero, Rafael Álvarez-Otero, Mª José Aylagas-Andrés, Michael Bauer, Cristina Cordero-Civantos, Enrique Coscarón-Blanco, Sara Fernández-Cascón, Virginia Franco-Gutiérrez, María Martín-Bailón, Guía de rehabilitación vestibular , Revista ORL: Vol. 13 Núm. S2 (2022): XXVIII Congreso de la Sociedad Otorrinolaringológica de Castilla y León, Cantabria y La Rioja Valladolid 2, 3 y 4 de junio de 2022
Descargas
Los datos de descargas todavía no están disponibles.
+
−