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Nucci RAB, Busse AL, de Souza RR, Maifrino LBM, Pasqualucci CA, Anaruma CA, Leite REP, Rodriguez RD, Suemoto CK, Jacob-Filho W. Smoking Intensity Increases Diaphragm Muscle Injury: A Clinicopathologic Study. J Clin Med 2023; 12:jcm12113823. [PMID: 37298016 DOI: 10.3390/jcm12113823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 05/06/2023] [Accepted: 05/09/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Studying the effects of smoking intensity is important to evaluate the risk of tobacco use on a range of illnesses, such as as sarcopenia among the elderly. Thus, this study aimed to analyze the effects of pack-years of cigarette smoking on the diaphragm muscle (DIAm) histopathology of postmortem samples. METHODS Subjects were divided into three groups: never-smoker (n = 46); less than 30 pack-years of smoking (n = 12); and more than 30 pack-years of smoking (n = 30). Diaphragm samples were stained with Picrosirius red and hematoxylin and eosin stain for general structure. RESULTS Participants with more than 30 pack-years of cigarette smoking had a significant increase in adipocytes, blood vessels and collagen deposit, as well as an increase in histopathological alterations. CONCLUSIONS Pack-years of smoking was associated with DIAm injury. However, further clinicopathological studies are needed to confirm our findings.
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Affiliation(s)
- Ricardo Aparecido Baptista Nucci
- Department of Pathology, Faculty of Medicine, University of São Paulo, São Paulo 01246-903, Brazil
- Laboratory of Medical Research in Aging (LIM-66), Division of Geriatrics, Faculty of Medicine, University of São Paulo, São Paulo 01246-903, Brazil
| | - Alexandre Leopold Busse
- Department of Pathology, Faculty of Medicine, University of São Paulo, São Paulo 01246-903, Brazil
- Laboratory of Medical Research in Aging (LIM-66), Division of Geriatrics, Faculty of Medicine, University of São Paulo, São Paulo 01246-903, Brazil
| | - Romeu Rodrigues de Souza
- Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-000, Brazil
- Department of Anatomy, 9 de Julho University-UNINOVE, São Paulo 03155-000, Brazil
| | - Laura Beatriz Mesiano Maifrino
- Laboratory of Clinical Analysis, Faculty of Medicine of the ABC District, Santo André 09060-650, Brazil
- Dante Pazzanese Institute of Cardiology, São Paulo 04012-909, Brazil
| | | | - Carlos Alberto Anaruma
- Laboratory of Morphology and Physical Activity, Department of Physical Education, São Paulo State University "Júlio de Mesquita Filho", Rio Claro 11330-900, Brazil
| | - Renata Elaine Paraizo Leite
- Laboratory of Physiopathology in Aging (LIM-22), Department of Pathology, Faculty of Medicine, University of Sao Paulo, São Paulo 01246-903, Brazil
| | - Roberta Diehl Rodriguez
- Department of Pathology, Faculty of Medicine, University of São Paulo, São Paulo 01246-903, Brazil
| | - Claudia Kimie Suemoto
- Laboratory of Medical Research in Aging (LIM-66), Division of Geriatrics, Faculty of Medicine, University of São Paulo, São Paulo 01246-903, Brazil
| | - Wilson Jacob-Filho
- Department of Pathology, Faculty of Medicine, University of São Paulo, São Paulo 01246-903, Brazil
- Laboratory of Medical Research in Aging (LIM-66), Division of Geriatrics, Faculty of Medicine, University of São Paulo, São Paulo 01246-903, Brazil
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Alateeq M, Hafiz TA, Alnizari O. Measuring the Effect of Smoking or Tobacco Use on Vertigo Among the Adult Population in the Kingdom of Saudi Arabia. Cureus 2023; 15:e38516. [PMID: 37288209 PMCID: PMC10243229 DOI: 10.7759/cureus.38516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2023] [Indexed: 06/09/2023] Open
Abstract
Background Smoking is widespread at all ages in Saudi society. In addition, complaints of vertigo are common. A key problem is how smoking affects vertigo and, thus, quality of life. Researchers have investigated the association between smoking and vertigo and found that smoking may be a risk factor for vertigo, but this association is not clear. The current study aims to investigate the association between smoking and vertigo. Materials and methods We conducted a cross-sectional study from March 2022 to January 2023 to investigate the effect of smoking on vertigo in Saudi Arabia's adult population. Results We found that smokers were more prone to vertigo than non-smokers. In addition, the severity of vertigo increases as the number of cigarettes smoked or the length of time in years that the person has smoked increases. Conclusion The findings of the study should inspire more research into the impact of demographic factors on vertigo among smokers.
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Affiliation(s)
- Mohahmmed Alateeq
- Otolaryngology-Head and Neck Surgery, University of Hail College of Medicine, Hail, SAU
| | | | - Osama Alnizari
- Family Medicine, University of Hail College of Medicine, Hail, SAU
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Chen HL, Tan CT, Wu CC, Liu TC. Effects of Diet and Lifestyle on Audio-Vestibular Dysfunction in the Elderly: A Literature Review. Nutrients 2022; 14:nu14224720. [PMID: 36432406 PMCID: PMC9698578 DOI: 10.3390/nu14224720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/27/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The world's age-related health concerns continue to rise. Audio-vestibular disorders, such as hearing loss, tinnitus, and vertigo, are common complaints in the elderly and are associated with social and public health burdens. Various preventative measures can ease their impact, including healthy food consumption, nutritional supplementation, and lifestyle modification. We aim to provide a comprehensive summary of current possible strategies for preventing the age-related audio-vestibular dysfunction. METHODS A PubMed, Embase, and Cochrane review databases search was conducted to identify the relationship between diet, lifestyle, and audio-vestibular dysfunction. "Diet", "nutritional supplement", "lifestyle", "exercise", "physical activity", "tinnitus", "vertigo" and "age-related hearing loss" were used as keywords. RESULTS Audio-vestibular dysfunction develops and progresses as a result of age-related inflammation and oxidative stress. Diets with anti-inflammatory and antioxidant effects have been proposed to alleviate this illness. A high-fat diet may induce oxidative stress and low protein intake is associated with hearing discomfort in the elderly. Increased carbohydrate and sugar intake positively correlate with the incidence of audio-vestibular dysfunction, whereas a Mediterranean-style diet can protect against the disease. Antioxidants in the form of vitamins A, C, and E; physical activity; good sleep quality; smoking cessation; moderate alcohol consumption; and avoiding noise exposure are also beneficial. CONCLUSIONS Adequate diet or nutritional interventions with lifestyle modification may protect against developing audio-vestibular dysfunction in elderly individuals.
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Affiliation(s)
- Hsin-Lin Chen
- Department of Surgical Oncology, National Taiwan University Cancer Center Hospital, Taipei 100, Taiwan
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Ching-Ting Tan
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Chen-Chi Wu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 100, Taiwan
- Department of Medical Research, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu 302, Taiwan
- Department of Medical Genetics, National Taiwan University Hospital, Taipei 100, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei 100, Taiwan
- Correspondence: (C.-C.W.); (T.-C.L.)
| | - Tien-Chen Liu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 100, Taiwan
- Correspondence: (C.-C.W.); (T.-C.L.)
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Miwa T, Yamaguchi T, Kita SI, Osaka K, Kanai R, Maetani T, Kanemaru SI. Predictive factors of acute sensorineural hearing loss in adult Japanese patients for clinical application by primary care doctors: a cross-sectional study. BMC PRIMARY CARE 2022; 23:219. [PMID: 36042422 PMCID: PMC9429655 DOI: 10.1186/s12875-022-01830-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022]
Abstract
Background Several methods are used for hearing loss screening; however, their benefits are uncertain. In this study, we aimed to determine the predictive factors of acute sensorineural hearing loss for clinical application by primary care doctors. Methods This retrospective, cross-sectional study included 365 patients with acute sensorineural hearing loss without prior therapy. The patients’ clinical data, demographic information, and medical histories were obtained, and they were asked about comorbidities. In addition, we assessed lifestyle factors such as stress level, alcohol consumption, marital status, and socioeconomic level. Logistic regression analysis was performed to investigate the diagnostic predictive ability of the selected factors associated with acute sensorineural hearing loss. The hearing levels of all patients were evaluated using pure tone audiometry. Results We identified significant predictive factors for acute sensorineural hearing loss. The absence of hyperacusis was a predictive factor for sudden sensorineural hearing loss. Younger age, female sex, and marital status were predictive factors for acute low-tone hearing loss. High body mass index, high socioeconomic level, low alcohol consumption, high stress level, hyperacusis, and vertigo/dizziness were predictive factors for Ménière’s disease. High body mass index and ear fullness were predictive factors for perilymph fistula. Low stress level was a predictive factor for acoustic tumours. Conclusions Our findings can be used to distinguish between the types of acute sensorineural hearing loss. Symptoms, physical status, and lifestyle factors identified during this study are useful markers for predicting acute sensorineural hearing loss occurrence. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-022-01830-8.
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Smoking Is Positively Related and Alcohol Consumption Is Negatively Related to an Increased Risk of Meniere's Disease. J Clin Med 2022; 11:jcm11175007. [PMID: 36078935 PMCID: PMC9457180 DOI: 10.3390/jcm11175007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/20/2022] [Accepted: 08/24/2022] [Indexed: 12/02/2022] Open
Abstract
A few prior researchers presumed the impacts of smoking and alcohol on the risk of Meniere’s disease (MD). This study investigated the relationship between smoking, alcohol consumption, and obesity with Meniere’s disease in an adult population. The ≥40-year-old population in the Korean National Health Insurance Service-Health Screening Cohort 2002−2019 was analyzed. A total of 15,208 patients with MD were matched with 499,658 comparison participants. The current smoking, alcohol consumption, and past medical histories were collected. Body mass index (BMI) was grouped into underweight, normal, overweight, obese I, and obese II. The odds of histories of smoking and alcohol consumption and the BMI group for MD were analyzed using conditional logistic regression analysis. These associations were further analyzed in subgroups of age, sex, smoking, alcohol consumption, and BMI. In the overall adult population, smoking and alcohol consumption did not show an association with MD. Being underweight was linked with lower odds for MD (adjusted OR [aOR] = 0.80, 95% CI = 0.68−0.93, p = 0.004). In the male group, smoking was positively associated with MD (aOR = 1.08, 95% CI = 1.00−1.17, p = 0.043), while alcohol consumption was negatively related to MD (aOR = 0.87, 95% CI = 0.81−0.94, p < 0.001). Being underweight was related to a lower risk of MD. In adult men, smoking was predicted to increase, while alcohol consumption was predicted to decrease the risk of MD.
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Population-based study for the comorbidities and associated factors in Ménière's disease. Sci Rep 2022; 12:8266. [PMID: 35585157 PMCID: PMC9117186 DOI: 10.1038/s41598-022-12492-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 05/06/2022] [Indexed: 11/09/2022] Open
Abstract
To date, no study has reported the objective metabolic laboratory findings worldwide or the comorbidities for Ménière’s disease (MD) using a population-based design in Asian populations. The aim of this study was to investigate the comorbidities and associated factors for MD using the Korean National Health Insurance Service database. This retrospective population-based study was conducted using a data from the National Sample Cohort database from 2009 to 2015. We only enrolled patients whose records showed a prescription for MD medicine and audiometry findings as well as an appropriate diagnostic code. We also included a matched cohort without MD who were enrolled randomly and matched for sex, age, year of diagnosis, income level, and residential area with the MD group with a ratio of 10:1. We evaluated comorbidities including autoimmune, allergic, metabolic diseases and cancer and the health screening data including general characteristics (height, weight, waist circumference, body mass index, and blood pressure), laboratory findings (fasting glucose, cholesterol, triglyceride, high-density lipoproteintryglyceride (HDL) cholesterol, low-density lipoproteintryglyceride cholesterol, hemoglobin, creatinine, aspartate aminotransferase and alanine aminotransferase, and gamma-glutamyltrans- peptidase (rGT)), and general health behaviors (smoking, alcohol, and exercise) of the MD group, and compared these characteristics with those of the MD-free control group. A total of 2,013 and 20,130 participants were included in the MD and MD-free control groups (1,640 and 15,458 for health screening data). We found the increase in incidence of allergic rhinitis and allergic asthma, decrease in systolic blood pressure, HDL cholesterol, and rGT, and less frequent alcohol consumption and less prevalent smoking in the MD group. No significant differences were observed between the groups in the incidence of autoimmune diseases, and cerebro- and cardiovascular disease as well as health screening data and objective laboratory findings. Inconsistence with published studies, the results of this study suggest that the autoimmunity and metabolic disorder, and skeletal growth might not be associated with the onset of MD. Another well-designed study for other races will be needed to the generalization of this study results.
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Relationship between benign paroxysmal positional vertigo (BPPV) and sleep quality. Heliyon 2022; 8:e08717. [PMID: 35059515 PMCID: PMC8760439 DOI: 10.1016/j.heliyon.2022.e08717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/13/2021] [Accepted: 01/04/2022] [Indexed: 11/22/2022] Open
Abstract
Background Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo precipitated mainly by changes in head position for example during sleep. The relationship between sleep quality and BPPV has not been studied sufficiently. We decided to compare sleep quality between posterior canal BPPV patients and controls. Methods A total of 120 patients with posterior canal BPPV and 120 controls without BPPV were included. Demographic data as well as body mass index (BMI), cigarette smoking and medical history of the subjects were documented. The sleep quality of the participants was assessed using the Pittsburgh Sleep Quality Index (PSQI). Results Mean scores in subjective sleep quality (0.48 vs. 0.19; P = 0.002), sleep disturbances (2.97 vs. 1.85; P = 0.007), use of sleep medications (0.6 vs. 0.25; P = 0.001), and daytime dysfunction (0.76 vs. 0.47; P = 0.07) were significantly higher in the BPPV group than in control group. Poor sleep quality (i.e., total PSQI score >5) was found in 42 patients in the BPPV group (35%) and in 16 controls (13.3%); P < 0.001. Poor sleep quality was significantly more common in those whose vertigo attacks had been started more than 12 months earlier (19 of 33 cases, 57.6%) than the patients whose symptoms had started in the past 12 months (23 of 87 cases, 26.4%); P = 0.001. Conclusion Patients with posterior canal BPPV have poorer sleep quality when compared to controls without this condition, especially in women and those with disease duration longer than 12 months. These finding suggest that close attention should be paid to sleep quality of patients with BPPV.
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Zhang Z, Song Y, Kang J, Duan S, Li Q, Feng F, Duan J. Epidemiology of patients with central nervous system infections, mainly neurosurgical patients: a retrospective study from 2012 to 2019 in a teaching hospital in China. BMC Infect Dis 2021; 21:826. [PMID: 34404351 PMCID: PMC8369693 DOI: 10.1186/s12879-021-06561-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 08/09/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Central nervous system (CNS) infections are relatively rare but are associated with high mortality worldwide. Empirical antimicrobial therapy is crucial for the survival of patients with CNS infections, and should be based on the knowledge of the pathogen distribution and antibiotic sensitivities. The aim of this study was to investigate the features of pathogens in patients with CNS infections in North China and evaluate the risk factors for mortality and multi-drug-resistant (MDR) bacterial infections. METHODS A retrospective study was conducted with patients with positive cerebrospinal fluid (CSF) cultures in a teaching hospital from January 2012 to December 2019. The following data were collected: demographic characteristics, laboratory data, causative organisms and antimicrobial sensitivity results. Data were analyzed with SPSS 16.0. Univariate analysis and binary logistic regression analyses were performed to identify the risk factors for mortality and MDR bacterial infections. RESULTS A total of 72 patients were diagnosed with CNS infections, and 86 isolates were identified. The proportions of Gram-positive bacteria, Gram-negative bacteria and fungi were 59.3, 30.2 and 10.5%, respectively. The predominant Gram-positive bacteria was Coagulase-negative Staphylococci. Acinetobacter baumannii, Escherichia coli and Klebsiella spp. were the predominant Gram-negative bacteria. Compared to 2012-2015 years, the proportion of Gram-negative bacteria increased markedly during 2016-2019 years. Coagulase-negative Staphylococci, Streptococcus pneumoniae and Enterococcus faecium had 100% sensitivity to vancomycin, teicoplanin and linezolid. Acinetobacter baumannii and Klebsiella pneumoniae were 100% sensitive to tigecycline. Escherichia coli had 100% sensitivity to amikacin, meropenem and imipenem. The overall mortality rate in the 72 patients was 30.6%. In multivariate analysis, age > 50 years, pulmonary infections and CSF glucose level < the normal value were associated with poor outcomes. CSF adenosine deaminase level > the normal value and the presence of external ventricular drainage/lumbar cistern drainage were associated with MDR bacterial infections. CONCLUSIONS The mortality rate due to CNS infections reached 30.6% in our study. The proportion of Gram-negative bacteria has increased markedly in recent years. We should give particular attention to patients with risk factors for mortality and MDR bacterial infections mentioned above.
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Affiliation(s)
- Zheng Zhang
- Department of Pharmacy, School of Pharmacy, Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Yan Song
- Department of Pharmacy, Second Hospital of Shanxi Medical University, No 382, Wuyi Road, Xinghualing District, Taiyuan, Shanxi, People's Republic of China
| | - Jianbang Kang
- Department of Pharmacy, Second Hospital of Shanxi Medical University, No 382, Wuyi Road, Xinghualing District, Taiyuan, Shanxi, People's Republic of China
| | - Surong Duan
- Department of Information Management, Second Hospital of Shanxi Medical University, No 382, Wuyi Road, Xinghualing District, Taiyuan, Shanxi, People's Republic of China
| | - Qi Li
- Department of Pharmacy, School of Pharmacy, Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Fuqiang Feng
- Department of Neurosurgery, Second Hospital of Shanxi Medical University, No 382, Wuyi Road, Xinghualing District, Taiyuan, Shanxi, People's Republic of China.
| | - Jinju Duan
- Department of Pharmacy, Second Hospital of Shanxi Medical University, No 382, Wuyi Road, Xinghualing District, Taiyuan, Shanxi, People's Republic of China.
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Chakravarthy M, Prabhakumar D, Shivalingappa B, Rao S, Padgaonkar S, Hosur R, Harivelam C, Jawali V. Routine preoperative doppler ultrasound examination of arterial system in patients undergoing cardiac surgery is beneficial: A retrospective study. Ann Card Anaesth 2021; 23:298-301. [PMID: 32687086 PMCID: PMC7559945 DOI: 10.4103/aca.aca_18_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Presence of peripheral vascular disease enhances surgical risk in cardiac surgical patients. Prior knowledge of peripheral arterial disease may help the physician make changes in the monitoring and cardiopulmonary bypass cannulation plans. It is claimed that the incidence of peripheral vascular disease in cardiac surgical patients ranges from 11 to 30%. Aims: This study was conducted to understand the characteristics of peripheral vascular disease and their implication on cardiac surgery. Settings and Design: This was a prospective study undertaken in a tertiary referral hospital. Materials and Methods: All adult patients who underwent cardiac surgery during the period of six months were included. A Doppler examination of the neck, upper limb, abdomen and lower limb was carried out by our inhouse radiologist. The incidence of peripheral vascular disease, the implication on invasive pressure monitoring site and cannulation for cardiopulmonary bypass or intraaortic balloon pump or extracorporeal membrane oxygenation were made note of. Results: During the said period, six hundred twenty eight patients underwent cardiac surgery, of whom five hundred and sixty-one patients who underwent CABG surgery. All these were subjected to Doppler examination. We observed peripheral arterial disease in 105 patients (20%). In general men suffered from PAD more often than women. Monitoring site of invasive arterial pressure, the choice of beating heart surgery, insertion of intraaortic balloon pump, femoral arterial route for cardiopulmonary bypass were some of the decision that were altered. Conclusions: Performing Doppler examination in cardiac surgical patients may yield important data that might prevent complications and support patient safety.
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Affiliation(s)
- Murali Chakravarthy
- Department of Anesthesia, Critical Care, and Pain Relief, Fortis Hospital, Bengaluru, Karnataka, India
| | - Dattatreya Prabhakumar
- Department of Anesthesia, Critical Care, and Pain Relief, Fortis Hospital, Bengaluru, Karnataka, India
| | - Benak Shivalingappa
- Department of Anesthesia, Critical Care, and Pain Relief, Fortis Hospital, Bengaluru, Karnataka, India
| | - Sonali Rao
- Department of Anesthesia, Critical Care, and Pain Relief, Fortis Hospital, Bengaluru, Karnataka, India
| | - Sumant Padgaonkar
- Department of Anesthesia, Critical Care, and Pain Relief, Fortis Hospital, Bengaluru, Karnataka, India
| | - Rajathadri Hosur
- Department of Anesthesia, Critical Care, and Pain Relief, Fortis Hospital, Bengaluru, Karnataka, India
| | - Chidananda Harivelam
- Department of Anesthesia, Critical Care, and Pain Relief, Fortis Hospital, Bengaluru, Karnataka, India
| | - Vivek Jawali
- Department of Cardiovascular Surgery, Fortis Hospital, Bengaluru, Karnataka, India
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Lučarević J, Gaunaurd I, Clemens S, Belsky P, Summerton L, Walkup M, Wallace SP, Yokomizo L, Pasquina P, Applegate EB, Schubert MC, Gailey RS. The Relationship Between Vestibular Sensory Integration and Prosthetic Mobility in Community Ambulators With Unilateral Lower Limb Amputation. Phys Ther 2020; 100:1333-1342. [PMID: 32399552 DOI: 10.1093/ptj/pzaa091] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 09/17/2018] [Accepted: 02/11/2020] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The modified Clinical Test of Sensory Interaction and Balance (mCTSIB) is used to clinically assess vestibular sensory integration (VSI), the process by which the central nervous system integrates vestibular afference to maintain balance. The rate and effects of impaired VSI (IVSI) on prosthetic mobility in people with lower limb amputation (LLA) is unknown. The objective of this study was to use the mCTSIB to classify VSI in active community ambulators with LLA and to examine the relationship between IVSI and prosthetic mobility, as measured by the Component Timed Up and Go (cTUG) test. METHODS This was a cross-sectional study with a convenience sample of 130 community ambulators with unilateral LLA. Classification of VSI was determined based on a time-based pass/fail mCTSIB performance. Participants were classified as having normal sensory integration (NSI) if they could balance for 30 seconds in every mCTSIB condition. Participants who failed condition 4 exclusively were classified as IVSI. Prosthetic mobility, as measured by the cTUG, was compared between NSI and IVSI groups. RESULTS Of the 130 participants, 29 (22%) were classified as IVSI and 95 (73%) were classified as having NSI. Prosthetic mobility significantly differed between IVSI and NSI groups, with IVSI participants performing all components of the cTUG significantly slower. Medium to large effect sizes were found between groups during cTUG. CONCLUSIONS These results suggest that 1 in 5 community ambulators with LLA have IVSI, with associated limitations in balance confidence and prosthetic mobility. IMPACT The ability to integrate vestibular information was found to have a strong relationship with prosthetic mobility in active community ambulators with LLA, especially with performing a 180-degree step turn. Physical therapists can use the mCTSIB to classify sensory integration during prosthetic rehabilitation and develop an appropriate balance intervention. LAY SUMMARY Active adults with LLA can use information from their senses to maintain their standing balance. Adults with LLA who have difficulty balancing on foam with closed eyes were slower to get in and out of a chair, walk, and perform a 180-degree step turn.
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Affiliation(s)
- Jennifer Lučarević
- Department of Physical Therapy, Miller School of Medicine, University of Miami, Coral Gables, Florida; and California State University Dominguez Hills, Department of Orthotics and Prosthetics, Carson, California
| | - Ignacio Gaunaurd
- Miami Veterans Affairs Healthcare System, Miami, Florida; and Department of Physical Therapy, Miller School of Medicine, University of Miami
| | - Sheila Clemens
- Department of Physical Therapy, Miller School of Medicine, University of Miami; and Department of Physical Therapy, Florida International University, Miami, Florida
| | - Paulina Belsky
- Department of Physical Therapy, Miller School of Medicine, University of Miami
| | - Lauren Summerton
- Department of Physical Therapy, Miller School of Medicine, University of Miami
| | - Melody Walkup
- Department of Physical Therapy, Miller School of Medicine, University of Miami
| | | | - Lori Yokomizo
- Department of Physical Therapy, Miller School of Medicine, University of Miami
| | - Paul Pasquina
- Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - E Brooks Applegate
- Department of Educational Leadership, Research and Technology, Western Michigan University, Kalamazoo, Michigan
| | - Michael C Schubert
- Department of Otolaryngology Head Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Robert S Gailey
- Department of Physical Therapy, Miller School of Medicine, University of Miami, 5915 Ponce de Leon Boulevard, Coral Gables, FL 33146 (USA)
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