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Ebenezer A, Kumar K, Kalaiah MK, Dosemane D, Malik MR, Hrithik, Suresh EM. Development and Validation of a Questionnaire to Assess the Effect of Vestibular Rehabilitation Therapy. Indian J Otolaryngol Head Neck Surg 2024; 76:734-738. [PMID: 38440595 PMCID: PMC10908654 DOI: 10.1007/s12070-023-04264-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/04/2023] [Indexed: 03/06/2024] Open
Abstract
Vestibular rehabilitation therapy (VRT) is an effective treatment for individuals experiencing imbalance and dizziness, helps to improve the quality of life. Lack of culturally valid questionnaires to assess the outcome from VRT necessitates the development of reliable and culturally valid questionnaire to measure the outcomes of VRT. Hence, the current study aimed to develop a culturally valid and reliable questionnaire for measuring the outcome of VRT in Indian population and to translate it into Malayalam and Kannada. This cross-sectional study was conducted at the department of Audiology and Speech Language Pathology of a tertiary care hospital. The questionnaire was constructed based on thorough literature search of existing questionnaires related to dizziness and vestibular disorders in relevant to the Indian context. Content validity was assessed by expert reviewers using a rating scale, and the questionnaire was translated into two south Indian languages (Malayalam and Kannada). The questionnaire was then administered on 12 patients undergoing VRT to assess its initial validation. The questionnaire was named as 'Effect of Vestibular Rehabilitation Therapy Questionnaire (EVRT-Q)', consisted of 25 questions divided into three domains: symptom, function, and emotion. The questionnaire demonstrated good content validity with a Content Validity Index greater than 0.8 for each question in all domains. The questionnaire possesses a high internal consistency when measured using Cronbach's alpha. Hence, the EVRT-Q appears to be a valid and reliable tool to assess the outcome from VRT in Indian population.
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Affiliation(s)
- Anupriya Ebenezer
- Department of Audiology and Speech Language Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka 575001 India
| | - Kaushlendra Kumar
- Department of Audiology and Speech Language Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka 575001 India
| | - Mohan Kumar Kalaiah
- Department of Audiology and Speech Language Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka 575001 India
| | - Deviprasad Dosemane
- Department of Otorhinolaryngology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - M. Ramiz Malik
- Department of Audiology and Speech Language Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka 575001 India
| | - Hrithik
- Department of Audiology and Speech Language Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka 575001 India
| | - Els Marry Suresh
- Department of Audiology and Speech Language Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka 575001 India
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García-Muñoz C, Cortés-Vega MD, Hernández-Rodríguez JC, Fernández-Seguín LM, Escobio-Prieto I, Casuso-Holgado MJ. Immersive Virtual Reality and Vestibular Rehabilitation in Multiple Sclerosis: Case Report. JMIR Serious Games 2021; 10:e31020. [PMID: 34766551 PMCID: PMC8892276 DOI: 10.2196/31020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/07/2021] [Accepted: 10/12/2021] [Indexed: 02/06/2023] Open
Abstract
Background Dizziness and imbalance are common and disabling symptoms in patients with multiple sclerosis (MS) and are caused by a central, peripheral, or mixed vestibulopathy. Central vestibular disorder is the most frequently reported vestibular problem in the MS population due to demyelination. Vestibular rehabilitation ameliorates these symptoms and their repercussions and improves quality of life. Immersive virtual reality (VRi) is an emerging tool in this field; however, no previous research has been performed studying its effects in MS. Objective The aim of this study was to apply a VRi vestibular training protocol to a patient with MS and assess the effects induced by the experimental intervention. Methods This case study included a 54-year-old woman with relapsing-remitting MS. We developed a standardized VRi exercise protocol for vestibular rehabilitation based on the gold-standard Cawthorne-Cooksey vestibular training protocol. The 20-session intervention was made up of 10 initial sessions and 10 advanced sessions. Each 50-minute session was performed two to three times per week for 7 weeks. Four evaluations were carried out over the study period: at baseline (T0), between initial and advances phases (T1), postintervention (T2), and 1 month after the experimental procedure (T3). The research outcomes were dizziness, balance, gait, impact of fatigue, quality of life, repercussions in muscular tone, and usability of the head-mounted display device. Results After implementing the VRi vestibular protocol, improvements were seen in the following patient parameters: Dizziness Handicap Inventory score (62 points at T0; 4 points at T2); Berg Balance Scale score (47 points at T0; 54 points at T2); instrumented Timed Up and Go time (8.35 seconds at T0; 5.57 seconds at T2); muscular tone of the erector spinae, rectus femoris, and soleus; Modified Fatigue Impact Scale score (61 points at T0; 37 points at T2); and Multiple Sclerosis Quality of Life-54 values (67.16% in the physical health area at T2; 33.56% in the mental health area at T2). The patient rated the usability of the system as 90%, based on the System Usability Scale, and gave the system a grade of A. Conclusions Although further research is needed, this study provided initial evidence that the first VRi vestibular protocol for the MS population can improve dizziness, balance, gait, impact of fatigue, quality of life, and muscular tone through an exergame intervention. This study may help establish a standardized VRi protocol for vestibular rehabilitation.
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Affiliation(s)
- Cristina García-Muñoz
- Physiotherapy Department. Faculty of Nursing, Physiotherapy and Podiatry., University of Seville, C/ Avicena S/N, Seville, ES
| | - María-Dolores Cortés-Vega
- Physiotherapy Department. Faculty of Nursing, Physiotherapy and Podiatry., University of Seville, C/ Avicena S/N, Seville, ES
| | | | - Lourdes M Fernández-Seguín
- Physiotherapy Department. Faculty of Nursing, Physiotherapy and Podiatry., University of Seville, C/ Avicena S/N, Seville, ES
| | - Isabel Escobio-Prieto
- Physiotherapy Department. Faculty of Nursing, Physiotherapy and Podiatry., University of Seville, C/ Avicena S/N, Seville, ES
| | - María Jesús Casuso-Holgado
- Physiotherapy Department. Faculty of Nursing, Physiotherapy and Podiatry., University of Seville, C/ Avicena S/N, Seville, ES
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Xavier F, Chouin E, Montava M, Tighilet B, Lavieille JP, Chabbert C. Status of rehabilitation of the dizzy patient in France: focus on vestibular physiotherapy. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2021. [DOI: 10.1080/21679169.2021.1969427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Frédéric Xavier
- Laboratoire de Neurosciences Cognitives, LNC UMR 7291; Unit GDR2074 CNRS, Team Pathophysiology and Therapy of Vestibular Disorders, Aix Marseille Université-CNRS, Marseille, France
| | - Emmanuelle Chouin
- Laboratoire de Neurosciences Cognitives, LNC UMR 7291; Unit GDR2074 CNRS, Team Pathophysiology and Therapy of Vestibular Disorders, Aix Marseille Université-CNRS, Marseille, France
| | - Marion Montava
- Assistance Publique des Hôpitaux de Marseille, Otorhinolaryngology and Head Neck Surgery Department, Conception University Hospital, Marseille, France
- Aix Marseille Univ, CNRS UMR 7051, INP, Institut NeuroPhysiopathologie, Marseille, France
| | - Brahim Tighilet
- Laboratoire de Neurosciences Cognitives, LNC UMR 7291; Unit GDR2074 CNRS, Team Pathophysiology and Therapy of Vestibular Disorders, Aix Marseille Université-CNRS, Marseille, France
| | - Jean-Pierre Lavieille
- Laboratoire de Neurosciences Cognitives, LNC UMR 7291; Unit GDR2074 CNRS, Team Pathophysiology and Therapy of Vestibular Disorders, Aix Marseille Université-CNRS, Marseille, France
- Assistance Publique des Hôpitaux de Marseille, Otorhinolaryngology and Head Neck Surgery Department, Conception University Hospital, Marseille, France
| | - Christian Chabbert
- Laboratoire de Neurosciences Cognitives, LNC UMR 7291; Unit GDR2074 CNRS, Team Pathophysiology and Therapy of Vestibular Disorders, Aix Marseille Université-CNRS, Marseille, France
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Morisod B, Mermod M, Maire R. Posturographic pattern of patients with chronic subjective dizziness before and after vestibular rehabilitation. J Vestib Res 2018; 27:305-311. [PMID: 29125531 DOI: 10.3233/ves-170628] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Chronic subjective dizziness (CSD) is frequently encountered in neurotology clinics. This diagnosis is mainly clinical, but computerized dynamic posturography (CDP) could be a helpful instrumental tool in the identification of these patients and validation of the treatment. This study was aimed to look for a specific posturographic pattern among patients diagnosed with CSD, and to eventually visualize improvement after vestibular rehabilitation. METHODS Single center, retrospective review from 2009 to 2014. We included patients diagnosed with CSD who underwent CDP in their neurotologic assessment. For those patients who benefited from vestibular rehabilitation, we compared their pre- and post-rehabilitation posturographies. RESULTS We included 114 patients, of whom 74% had known anxiety disorders and 33% a history of past vestibular disorder. 62% of the assessment posturographies were abnormal. The most affected sub-items were limit of stability, composite score of sensory organization tests and condition 5 in respectively 34%, 23% and 20% of the cases. In univariate analysis, only pathologic videonystagmography and history of unilateral vestibular dysfunction were significantly related to abnormal posturography. In the 42 patients who had vestibular rehabilitation and a post rehabilitation posturography, the proportion of abnormal posturography significantly dropped from 79% to 33% (p < 0.001). When it was assessed, 79% of the patients reported a subjective improvement. CONCLUSION Patients with CSD have a high rate of abnormal posturography, but without a specific pattern. Vestibular rehabilitation is an effective tool in the therapeutic armamentarium.
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Affiliation(s)
- Benoît Morisod
- Department of Otorhinolaryngology, Head and Neck Surgery, Neurotology Unit, Lausanne University Hospital, Switzerland
| | - Maxime Mermod
- Department of Otorhinolaryngology, Head and Neck Surgery, Neurotology Unit, Lausanne University Hospital, Switzerland
| | - Raphaël Maire
- Department of Otorhinolaryngology, Head and Neck Surgery, Neurotology Unit, Lausanne University Hospital, Switzerland
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Santos CF, Belinha J, Gentil F, Parente M, Areias B, Jorge RN. A computational framework to simulate the endolymph flow due to vestibular rehabilitation maneuvers assessed from accelerometer data. Comput Methods Biomech Biomed Engin 2018; 21:461-469. [DOI: 10.1080/10255842.2018.1479745] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Carla F. Santos
- University of Porto, Faculty of Engineering, INEGI, Porto, Portugal
| | - Jorge Belinha
- Department of Mechanical Engineering, School of Engineering, Polytechnic of Porto, Portugal
| | - Fernanda Gentil
- Clínica ORL - Dr. Eurico Almeida, Escola Superior de Saúde, Porto, Portugal
| | - Marco Parente
- University of Porto, Faculty of Engineering, INEGI, Porto, Portugal
| | - Bruno Areias
- University of Porto, Faculty of Engineering, INEGI, Porto, Portugal
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Prasad S. A Window to the Brain: Neuro-Ophthalmology for the Primary Care Practitioner. Am J Med 2018; 131:120-128. [PMID: 29079403 DOI: 10.1016/j.amjmed.2017.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 10/03/2017] [Accepted: 10/03/2017] [Indexed: 10/18/2022]
Abstract
Visual symptoms, including acute monocular visual loss, papilledema, visual field deficits, anisocoria, limitations of eye movements, and nystagmus, can be the presenting feature of a wide range of important neurologic diseases. It is important for primary care clinicians to be to be able to direct appropriate initial diagnostic assessment, treatment, and referral for further evaluation of these conditions.
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Affiliation(s)
- Sashank Prasad
- Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.
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Hondebrink MS, Mert A, van der Lint R, de Ru JA, van der Wurff P. Motion-based equilibrium reprocessing therapy a novel treatment method for chronic peripheral vestibulopathies: A pilot study. Medicine (Baltimore) 2017; 96:e7128. [PMID: 28614234 PMCID: PMC5478319 DOI: 10.1097/md.0000000000007128] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Rehabilitation for vestibular disease is a safe method to partially alleviate symptoms of vertigo. It was hypothesized that principles of military aviation vestibular desensitization procedures that have a success rate of more than 80% can be extrapolated to chronic vestibular disease as well.The virtual reality motion base computer-assisted rehabilitation environment was used as treatment modality in 17 patients. They were exposed to sinusoidal vertical passive whole body motion in increasing intensity for a maximum of 12 sessions. The Dizziness Handicap Inventory (DHI) was used for assessment of the subjective complaints of vertigo.The median DHI scores of 50 points at baseline dropped to 22 points (P <.001) at follow-up. Post hoc analysis showed significant differences in outcome between measurements at baseline and at the end of the treatment, between baseline and follow-up, but not between end of treatment and follow-up.This pilot study concerning motion-based equilibrium reprocessing therapy (MERT) shows that it is a simple, quick, and well-tolerated treatment option to alleviate symptoms in patients with chronic peripheral vestibulopathies.
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Affiliation(s)
| | | | | | - J. Alexander de Ru
- Department of Otolaryngology, Central Military Hospital, Utrecht, The Netherlands
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Santos CF, Belinha J, Gentil F, Parente M, Areias B, Jorge RN. Biomechanical Study of the Vestibular System of the Inner Ear Using a Numerical Method. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.piutam.2017.08.040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Maheu M, Fournier P, Landry SP, Houde MS, Champoux F, Saliba I. Structural and functional changes of cortical and subcortical structures following peripheral vestibular damage in humans. Eur Arch Otorhinolaryngol 2016; 274:65-70. [PMID: 26994901 DOI: 10.1007/s00405-016-3986-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 03/11/2016] [Indexed: 12/14/2022]
Affiliation(s)
- Maxime Maheu
- Faculty of Medicine, School of Speech Language Pathology and Audiology, University of Montreal, Montreal, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Raymond-Dewar Institute, Montreal, QC, Canada.,International Laboratory for Research on Brain, Music, and Sound (BRAMS), University of Montreal, Montreal, QC, Canada
| | - Philippe Fournier
- Faculty of Medicine, School of Speech Language Pathology and Audiology, University of Montreal, Montreal, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Raymond-Dewar Institute, Montreal, QC, Canada.,International Laboratory for Research on Brain, Music, and Sound (BRAMS), University of Montreal, Montreal, QC, Canada
| | - Simon P Landry
- Faculty of Medicine, School of Speech Language Pathology and Audiology, University of Montreal, Montreal, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Raymond-Dewar Institute, Montreal, QC, Canada.,International Laboratory for Research on Brain, Music, and Sound (BRAMS), University of Montreal, Montreal, QC, Canada
| | - Marie-Soleil Houde
- Faculty of Medicine, School of Speech Language Pathology and Audiology, University of Montreal, Montreal, QC, Canada
| | - François Champoux
- Faculty of Medicine, School of Speech Language Pathology and Audiology, University of Montreal, Montreal, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Raymond-Dewar Institute, Montreal, QC, Canada.,International Laboratory for Research on Brain, Music, and Sound (BRAMS), University of Montreal, Montreal, QC, Canada
| | - Issam Saliba
- Department of Surgery, Division of Otorhinolaryngology-Head and Neck Surgery, University of Montreal, Montreal, QC, Canada. .,Division of Otolaryngology Head and Neck Surgery, Montreal University Hospital Center (CHUM), Notre-Dame Hospital, 1560 Sherbrooke street East, Montreal, QC H2L 4M1, Canada.
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Arnold SA, Stewart AM, Moor HM, Karl RC, Reneker JC. The Effectiveness of Vestibular Rehabilitation Interventions in Treating Unilateral Peripheral Vestibular Disorders: A Systematic Review. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2015; 22. [DOI: 10.1002/pri.1635] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 12/01/2014] [Accepted: 04/25/2015] [Indexed: 02/04/2023]
Affiliation(s)
- Scott A. Arnold
- Division of Physical Therapy; Walsh University; North Canton OH USA
| | - Aaron M. Stewart
- Division of Physical Therapy; Walsh University; North Canton OH USA
| | - Heather M. Moor
- Division of Physical Therapy; Walsh University; North Canton OH USA
| | - Rita C. Karl
- Division of Physical Therapy; Walsh University; North Canton OH USA
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Kao CL, Tsai KL, Cheng YY, Kuo CH, Lee SD, Chan RC. Vestibular rehabilitation ameliorates chronic dizziness through the SIRT1 axis. Front Aging Neurosci 2014; 6:27. [PMID: 24624081 PMCID: PMC3941041 DOI: 10.3389/fnagi.2014.00027] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 02/13/2014] [Indexed: 02/05/2023] Open
Abstract
Dizziness is a common clinical symptom frequently referred to general neurologists and practitioners. Exercise intervention, in the form of vestibular rehabilitation, is known as an effective clinical management for dizziness. This intervention is reported to have a functional role in correcting dizziness, improving gaze stability, retraining balance and gait, and enhancing physical fitness. Dizziness is known to be highly related to inflammation and oxidative stress. SIRT1 is a major molecule for the regulation of inflammation and mitigation of oxidative stress in chronic diseases such as atherosclerosis and chronic obstructive pulmonary disease. However, the bio-molecular roles of SIRT1 involved in the pathogenesis of dizziness are still largely unclear. In this study, a total of 30 subjects were recruited (15 patients with chronic dizziness, and 15 age/gender matched non-dizzy control subjects). The dizzy subjects group received 18 sessions of 30-min vestibular training. We found that the mRNA and protein expression levels of SIRT1 in the blood samples of chronic dizzy patients were repressed compared with those of healthy controls. After vestibular training, the dizzy patients had significant symptomatic improvements. The SIRT1 expression and its downstream genes (PPAR-γ and PGC-1α) were upregulated after vestibular exercises in dizzy subjects. Notably, the catalytic activity of SIRT1, NADPH and antioxidant enzyme activities were also activated in dizzy patients after vestibular training. Furthermore, vestibular exercise training reduced oxidative events and p53 expression in patients with dizziness. This study demonstrated that vestibular exercise training improved dizziness symptoms, and mechanisms for alleviation of chronic dizziness may partly involve the activation of the SIRT1 axis and the repression of redox status.
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Affiliation(s)
- Chung-Lan Kao
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital Taipei, Taiwan ; School of Medicine, National Yang-Ming University Taipei, Taiwan ; Department of Physical Therapy and Assistive Technology, School of Biomedical Science and Engineering, National Yang-Ming University Taipei, Taiwan
| | - Kun-Ling Tsai
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital Taipei, Taiwan ; School of Medicine, National Yang-Ming University Taipei, Taiwan
| | - Yuan-Yang Cheng
- School of Medicine, National Yang-Ming University Taipei, Taiwan ; Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital Taichung, Taiwan
| | - Chia-Hua Kuo
- Laboratory of Exercise Biochemistry, Department of Sport Sciences, University of Taipei Taipei, Taiwan
| | - Shin-Da Lee
- Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University Taichung, Taiwan
| | - Rai-Chi Chan
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital Taipei, Taiwan ; School of Medicine, National Yang-Ming University Taipei, Taiwan
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King WM. Getting ahead of oneself: anticipation and the vestibulo-ocular reflex. Neuroscience 2013; 236:210-9. [PMID: 23370320 DOI: 10.1016/j.neuroscience.2012.12.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 12/12/2012] [Accepted: 12/13/2012] [Indexed: 10/27/2022]
Abstract
Compensatory counter-rotations of the eyes provoked by head turns are commonly attributed to the vestibulo-ocular reflex (VOR). A recent study in guinea pigs demonstrates, however, that this assumption is not always valid. During voluntary head turns, guinea pigs make highly accurate compensatory eye movements that occur with zero or even negative latencies with respect to the onset of the provoking head movements. Furthermore, the anticipatory eye movements occur in animals with bilateral peripheral vestibular lesions, thus confirming that they have an extra vestibular origin. This discovery suggests the possibility that anticipatory responses might also occur in other species including humans and non-human primates, but have been overlooked and mistakenly identified as being produced by the VOR. This review will compare primate and guinea pig vestibular physiology in light of these new findings. A unified model of vestibular and cerebellar pathways will be presented that is consistent with current data in primates and guinea pigs. The model is capable of accurately simulating compensatory eye movements to active head turns (anticipatory responses) and to passive head perturbations (VOR induced eye movements) in guinea pigs and in human subjects who use coordinated eye and head movements to shift gaze direction in space. Anticipatory responses provide new evidence and opportunities to study the role of extra vestibular signals in motor control and sensory-motor transformations. Exercises that employ voluntary head turns are frequently used to improve visual stability in patients with vestibular hypofunction. Thus, a deeper understanding of the origin and physiology of anticipatory responses could suggest new translational approaches to rehabilitative training of patients with bilateral vestibular loss.
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Affiliation(s)
- W M King
- Department of Otolaryngology and the Kresge Hearing Research Institute, University of Michigan, Ann Arbor, MI 48109, USA.
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[The evaluation of the efficiency of kinesitherapy in the patients with mixed-type vertigo]. Otolaryngol Pol 2012; 66:337-41. [PMID: 23036123 DOI: 10.1016/j.otpol.2012.06.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 05/08/2012] [Accepted: 06/26/2012] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The aim of this work was to evaluate the efficiency of kinesitherapy in the patients with mixed-type vertigo. MATERIAL AND METHODS The study was conducted on a randomized group of 35 patients, 21 women and 14 men aged 24-75 years (mean age 42.5 years), who were treated at the Department of Otolaryngology and Laryngological Oncology Medical University Teaching Hospital in Lodz for mixed-type vertigo. The inclusion criteria were an interview, physical and otorhinolaryngological examinations, laboratory investigations, complete audiological and otoneurological examinations, including BERA and VNG, USG examination of the blood vessels to the cranium, and CT of the cervical spine. Each patient underwent an individually selected set of habituation exercises, corrective exercises for posture and its orientation in space through 2 months. The efficiency of the implemented therapy was evaluated after two weeks, one month and two months with the use of the complete videonystagmographic test and Silvoniemi's criteria. RESULTS The mean excitability of the labyrinths was 25.38 degrees/s before rehabilitation and 22.26 degrees/s after rehabilitation, absolute directional preponderance was 7.62 degrees/s and 1.92 degrees/s respectively, relative directional preponderance was 31.36 degrees/s and 12.57 degrees/s, and unilateral deficit 32.12 degrees/s and 14.34 degrees/s. The subjective evaluation of the vertigo intensification based on the 5 stages of Silvoniemi's scale indicates that the mean point-based evaluation reported by the patients at the beginning of the therapy was 3.85 points, whereas after the therapy was 2.91 points after two weeks, 2.35 points after one month, and 1.2 points after two months. CONCLUSIONS Kinesitherapy is an alternative and very effective method for treating mixed-type vertigo.
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Nardone A, Godi M, Artuso A, Schieppati M. Balance Rehabilitation by Moving Platform and Exercises in Patients With Neuropathy or Vestibular Deficit. Arch Phys Med Rehabil 2010; 91:1869-77. [DOI: 10.1016/j.apmr.2010.09.011] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2010] [Revised: 08/13/2010] [Accepted: 09/09/2010] [Indexed: 11/30/2022]
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Rougier PR. What insights can be gained when analysing the resultant centre of pressure trajectory? Neurophysiol Clin 2008; 38:363-73. [DOI: 10.1016/j.neucli.2008.09.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2008] [Accepted: 09/21/2008] [Indexed: 01/18/2023] Open
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