Treatment Devices
This information is intended as a general introduction to this topic. As each person is affected differently by balance and dizziness problems, speak with your health care professional for individual advice.
A number of devices available in Canada may be helpful to some people with vestibular disorders:
Brain stimulation devices
There is some evidence that stimulation of the brain through the tongue in combination with physical therapy helps it heal from neurological trauma or learn to compensate for balance impairment. Exactly how tongue-based neuromodulation stimulates neuroplasticity in the brain is not clear.
This type of therapy is costly – it may be a final option to consider for patients who have reached a plateau after extensive conventional therapy.
Two different devices have been approved for use in Canada:
BrainPort Balance Plus®
According to the developer, BrainPort Technologies, this device is suggested for use with individuals with vestibular dysfunction for the improvement of balance, gait, posture and related symptoms. It gives the user immediate biofeedback about head and body position via gentle electro-tactile impulses on the tongue during balance training.
Lifemark Physiotherapy is the only North American distributor of this device. To learn more, read Lifemark's FAQ about BrainPort Balance Plus® [PDF] or contact Lifemark directly.
PoNS® device
According to the developer, Heuro® Canada, the Portable Neuromodulation Stimulator (PoNS®) is an investigational, non-invasive, wearable medical device designed to deliver neuro-stimulation through the tongue. It is essentially a newer and more sophisticated iteration of the BrainPort® device.
The PoNS® delivers mild, high frequency electrical impulses while the patient follows a rigorous, daily physiotherapy for over 14 weeks. The treatment program costs $30,000. It is not covered by the BC Medical Services Plan or most extended healthcare plans.
Clinical research has shown that electrical stimulation of the tongue activates two major cranial nerves – the trigeminal nerve (5th cranial nerve) and the facial nerve (7th cranial nerve). Electrical stimulation of these nerves creates a flow of neural impulses that are then delivered directly into the brain stem and cerebellum.
The PoNS® device been used successfully in double-blind clinical trials involving people with impaired neuro motion from: mild-to moderate traumatic brain injury, multiple sclerosis, bilateral vestibulopathy, balance impairment and spinal cord injury.
Health Canada certified the PoNS® device for use in Canada in 2018. It is available through two neuroplasticity clinics set up by Heuro® Canada - Surrey Neuroplasticity Clinic in BC and Neurotherapy Montreal in Quebec. If you are interested in learning more about treatment options with this device, contact these clinics directly.
Weighted vest
A weighted vest is a non-invasive and wearable counter-balancing device worn on the trunk. It is used for people with balance and mobility issues that are a side effect of a wide variety of neurologic and orthopaedic disorders including multiple sclerosis, Parkinson’s disease, ataxia, stroke, and spinal disc dysfunction. A weighted vest gives information to the proprioceptive (joints and muscles) system that helps control balance.
A physiotherapist trained in their use will place very light weights strategically on one or more locations to enhance trunk stability and counter-balance the body. When postural control is improved and greater stability achieved, gait and balance may be improved. In such cases, improvement is immediate.
More information: BalanceWear®
Sources
Kaczmarek KA. The portable neuromodulation stimulator (PoNS) for neurorehabilitation. Scientia Iranica, September 2017. Available from: http://bit.ly/2TZ6sMs
Leonard G, Lapierre Y, Chen JK, Wardini R, Crane J, Ptito A. Noninvasive tongue stimulation combined with intensive cognitive and physical rehabilitation induces neuroplastic changes in patients with multiple sclerosis: A multimodal neuroimaging study. Mult Scler J Exp Transl Clin. 2017 Feb 1;3(1):2055217317690561. Available from: https://bit.ly/2VYKGp9
Roman-Naranjo P, Gallego-Martinez A, Lopez-Escamez JA. Genetics of vestibular syndromes. Curr Opin Neurol. 2018 Feb;31(1):105-110. Available from: https://bit.ly/2IaN
BalanceWear®. Published clinical research. Available from: https://bit.ly/2Mh7wGq
Page updated September, 2019.
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