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Low Choy NL, Lucey MTM, Lewandowski SL, Panizza BJ. Impacts of small vestibular schwannoma on community ambulation, postural, and ocular control. Laryngoscope 2016; 127:1147-1152. [PMID: 27519610 DOI: 10.1002/lary.26105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 04/23/2016] [Accepted: 05/01/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS To investigate balance, community mobility, gaze instability, and dizziness handicap and assess falls risk in people who are conservatively managed with small vestibular schwannoma (VS). STUDY DESIGN Cross-sectional study with controls. METHODS The study involved 18 people (mean age 58.7 ± 12.2 years) diagnosed with VS (<12 mm) and 22 age-matched controls (mean age 56.9 ± 8.0 years). Measures included standing on firm and foam surfaces with feet apart, then together with eyes open and closed, Timed Up and Go (TUG) test and dual TUG test, Dynamic Gait Index, 6-Minute Walk Test, Halmagyi Impulse Test, Dynamic Visual Acuity Test, and the Dizziness Handicap Inventory. RESULTS The clinical group failed more trials standing feet together on foam with eyes closed (P < .05); had inferior mobility and walked more slowly with divided attention (P < .05); had more difficulty walking with head movement, negotiating obstacles, and using stairs (P < .01); and walked shorter distances (P < .001) than controls. Reduced gaze stability (P < .01) and higher total (P = .007) and subcategory dizziness handicap scores (P < .05) were revealed compared to age-matched controls. CONCLUSIONS Although outcomes for the clinical group are inferior to the control group across all measures and the dizziness impact is higher, the results fall in the low-risk category for falls. Preliminary data (level 4 evidence) support using a suite of clinical measures to monitor people with VS during conservative management. LEVEL OF EVIDENCE 4 Laryngoscope, 127:1147-1152, 2017.
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Affiliation(s)
- Nancy L Low Choy
- School of Physiotherapy, Faculty of Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia.,Department of Physiotherapy, The Prince Charles Hospital, Brisbane, Queensland, Australia.,School of Physiotherapy, University of Queensland, Brisbane, Queensland, Australia
| | - Mary-Therese M Lucey
- School of Physiotherapy, University of Queensland, Brisbane, Queensland, Australia
| | - Susan L Lewandowski
- School of Physiotherapy, Faculty of Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
| | - Benedict J Panizza
- Department of Ear Nose and Throat, Princess Alexander Hospital, Brisbane, Queensland, Australia
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Ciorba A, Bianchini C, Scanelli G, Pala M, Zurlo A, Aimoni C. The impact of dizziness on quality-of-life in the elderly. Eur Arch Otorhinolaryngol 2016; 274:1245-1250. [DOI: 10.1007/s00405-016-4222-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 07/18/2016] [Indexed: 10/21/2022]
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Rosa TSM, Moraes ABD, Santos Filha VAVD. The institutionalized elderly: sociodemographic and clinical-functional profiles related to dizziness. Braz J Otorhinolaryngol 2016; 82:159-69. [PMID: 26796471 PMCID: PMC9449063 DOI: 10.1016/j.bjorl.2014.12.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 02/02/2015] [Indexed: 11/29/2022] Open
Abstract
Introduction Dizziness is among the most common complaints in the elderly population. Objective To determine the sociodemographic and clinical-functional profiles of institutionalized elderly people related to dizziness. Methods Cross-sectional prospective study with institutionalized elderly people aged 60 or more years. A questionnaire on sociodemographic and clinical-functional characteristics was applied, and an anamnesis of occurrence of dizziness was held, as well as the Dizziness Handicap Inventory questionnaire. Results 48.9% of the elderly subjects had dizziness. The mean numbers of diseases and medications associated with dizziness were, respectively, 4.5 diseases and 7.8 medications. We found a significant association between the occurrence of dizziness and diseases of the musculoskeletal system, sub-connective tissue and genitourinary system, as well as the use of medications for the musculoskeletal system. The scores for handicap degree in functional DHI were significantly higher among elderly subjects who needed walking aids, who had suffered falls, and those manifesting anxiety. Conclusion Our sample included subjects of advanced age, primarily women, who were institutionalized less than five years, with multiple diseases and polypharmacy users. They presented long-standing short-duration mixed dizziness, that occurred more than once a month and affected mainly the functional aspect.
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Affiliation(s)
- Tábada Samantha Marques Rosa
- Postgraduate Program in Human Communication Disorders (PPGDCH), Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil.
| | - Anaelena Bragança de Moraes
- Department of Statistics, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil; Epidemiology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Valdete Alves Valentins dos Santos Filha
- Postgraduate Program in Human Communication Disorders (PPGDCH), Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil; Speech Therapy Course, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil; Postgraduate Program in Communication Sciences - Human Communication, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil
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Burle NLDO, Abreu ACPD, Santos JN, Mancini PC. The Impact of Dizziness on the Quality of Life of 235 Individuals who Completed Vestibular Testing in Brazil. Int Arch Otorhinolaryngol 2016; 20:54-60. [PMID: 26722347 PMCID: PMC4687987 DOI: 10.1055/s-0035-1556824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 05/01/2015] [Indexed: 11/17/2022] Open
Abstract
Introduction In Vestibular Testing (VT), caloric tests allow evaluation of unilateral weakness (UW) and directional preponderance (DP), where different criteria of normality are adopted in Brazil and worldwide. The Brazilian version of the Dizziness Handicap Inventory (Brazilian DHI) evaluates the impact of dizziness on the quality of life of an individual. Objectives The objective of this research is to evaluate the impact of dizziness on the quality of life of patients undergoing VT, and to relate these findings to the results obtained according to national and international criteria. Methods Cross-sectional analytic study of 235 patients referred for VT in two hospitals. The authors performed the Brazilian DHI, history, static, and dynamic balance tests, positional nystagmus, and the Dix-Hallpike maneuver, as well as vectoelectronystagmography. Subjects were divided into three groups according to UW and DP values. Descriptive statistics and comparisons between groups were performed, considering a significance level of 5% in all analyses. Results Patients groups had 20.9% men, and 79.1% women. There was no significant difference between groups for the scores obtained in the Brazilian DHI. There was, however, a statistically significant difference in the redistribution of individuals according to the UW and DP values. Conclusion There was no relationship between VT results and the impact of dizziness in the quality of life. A review of normal values for UW and DP adopted in Brazil is suggested, as well as the application of the Brazilian DHI as an additional tool to evaluate the impact of dizziness on quality of life in all patients undergoing VT.
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Affiliation(s)
| | | | - Juliana Nunes Santos
- Speech Therapy Department, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Patricia Cotta Mancini
- Speech Therapy Department, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Tsukamoto HF, Costa VDSP, Silva Júnior RAD, Pelosi GG, Marchiori LLDM, Fernandes KBP. Influência do tratamento com fármacos antivertiginosos sobre o equilíbrio postural e qualidade de vida de indivíduos com queixas de tontura. REVISTA CEFAC 2015. [DOI: 10.1590/1982-0216201517516714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo: OBJETIVO: avaliar a influência do tratamento com fármacos antivertiginosos sobre a qualidade de vida e o equilíbrio postural de adultos e idosos com queixas de tontura. MÉTODOS: estudo transversal, com amostra de 51 indivíduos portadores de queixas de tontura, divididos em dois grupos, de acordo com o uso (grupo medicado, n=25) ou não (grupo não medicado, n=26) de fármacos antivertiginosos. Foram coletadas informações sobre: caracterização dos sintomas (ficha elaborada pelos pesquisadores), autopercepção de qualidade de vida (Dizziness Handicap Inventory),intensidade de tontura (escala visual analógica de tontura) e equilíbrio postural (plataforma de força). RESULTADOS: verificou-se intensidade moderada de tontura (Média: 4,6 ± 2,8) e impacto negativo das vestibulopatias sobre a qualidade de vida (Média: 47,3 ± 22,4) na amostra total. Quando comparados os dois grupos, não houve diferença estatisticamente significante na intensidade da tontura (p=0,74) ou qualidade de vida (p=0,79), e também, nos parâmetros da estabilometria, em quatro tarefas (teste t independente, p>0,05). Contudo, após a inclusão do tempo de utilização de fármacos antivertiginosos como uma covariável do estudo, foi verificado pior desempenho nas diferentes tarefas da estabilometria no grupo medicado (ANCOVA, p<0,05). CONCLUSÃO: o uso de fármacos antivertiginosos não melhora a qualidade de vida de indivíduos com queixas de tontura e o equilíbrio postural esteve alterado no grupo medicado.
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Martins SADA, Bassi I, Mancini PC. Perfil audiológico de idosos submetidos à reabilitação vestibular. REVISTA CEFAC 2015. [DOI: 10.1590/1982-0216201511714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: caracterizar o perfil auditivo de idosos com tontura submetidos à Reabilitação Vestibular e comparar os resultados obtidos nas avaliações auditivas de idosos sem tontura. MÉTODOS: estudo observacional analítico transversal com 87 idosos, sendo 35 no grupo com tontura e 52 no grupo sem tontura. Foram realizadas anamnese, audiometria tonal limiar e vocal. Para a análise estatística foi utilizado o programa estatístico Statistical Package for the Social Sciences versão 17.0, com nível de significância de 5% nas análises. RESULTADOS: a perda auditiva neurossensorial de grau leve e moderada esteve presente em 72,4% da amostra, com piora dos limiares de audibilidade por via aérea a partir de 4000Hz em ambos os grupos. O zumbido foi a queixa mais frequente observada na amostra. CONCLUSÃO: o perfil auditivo de idosos com tontura não se diferencia daquele encontrado em idosos sem tontura, sendo observada com maior frequência a perda auditiva neurossensorial leve bilateral de configuração descendente.
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Affiliation(s)
| | - Iara Bassi
- Universidade Federal de Minas Gerais, Brazil
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Lopes AR, Moreira MD, Trelha CS, Marchiori LLDM. Association between complaints of dizziness and hypertension in non-institutionalized elders. Int Arch Otorhinolaryngol 2015; 17:157-62. [PMID: 25992007 PMCID: PMC4423284 DOI: 10.7162/s1809-97772013000200007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Accepted: 11/08/2012] [Indexed: 12/02/2022] Open
Abstract
Introduction: Advancing age increases the risk for a number of chronic diseases. Hypertension and dizziness are highly prevalent in the elderly population and represent major health problems. Objective: To verify the association between complaints of dizziness and the presence of hypertension in non-institutionalized elders. Method: This was a prospective cross-sectional cohort study of the elderly population of Londrina, Paraná in terms of aging and longevity. The required sample size was calculated, and subjects e” 60 years of age of both genders were selected at random. Data were collected using a questionnaire covering socio-demographic information and self-reported cases of hypertension and dizziness. Statistical analysis was performed using the chi-square test with p d” 0.05 as the level of significance. Results: The study included 493 elderly subjects, of whom 257 (52.1%) complained of dizziness and 308 (62.5%) reported a diagnosis of arterial systemic hypertension. Dizziness was significantly associated with hypertension (χ2 = 6.26, p = 0.01) and female sex. Conclusions: Hypertension and dizziness were both highly prevalent and were significantly associated, showing the great need for investments in preventive measures.
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Affiliation(s)
- Anália Rosário Lopes
- Student in the Master's Program in Rehabilitation Sciences associated with Universidade Estadual Londrina (UEL)/Universidade Norte do Paraná (UNOPAR), Londrina, Parana. Union of America Faculty Professor, Foz do Iguacu, Parana
| | - Michelle Damasceno Moreira
- Student in the Master's Program in Rehabilitation Sciences associated with UEL/UNOPAR, Londrina, Parana. Physiotherapist admitted after a public examination by the Family Health Program
| | - Celita Salmaso Trelha
- Doctor of Medicine and Health Sciences, University of Londrina. Professor in the Master's Program in Rehabilitation Sciences associated with UEL/UNOPAR, Londrina, Paraná
| | - Luciana Lozza de Moraes Marchiori
- Doctor of Medicine and Health Sciences, University of Londrina. Professor in the Master's Program in Rehabilitation Sciences associated with UEL/UNOPAR, Londrina, Paraná
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Weidt S, Bruehl AB, Straumann D, Hegemann SCA, Krautstrunk G, Rufer M. Health-related quality of life and emotional distress in patients with dizziness: a cross-sectional approach to disentangle their relationship. BMC Health Serv Res 2014; 14:317. [PMID: 25052136 PMCID: PMC4119060 DOI: 10.1186/1472-6963-14-317] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 07/11/2014] [Indexed: 11/10/2022] Open
Abstract
Background Dizziness is frequently encountered in medical practice, often takes a chronic course and can impair the health related quality of life (HRQoL). However results on the extent of this impairment of HRQoL are mixed. Furthermore, the relationship between dizziness and the HRQoL is only partially understood. The role of clinical symptoms of dizziness and psychosocial factors such as emotional distress on this relationship is for the most part unknown. Methods The cross-sectional study evaluated the HRQoL in 203 patients suffering from dizziness, using the Medical Outcomes Studies 36-Item Short-Form Health-Survey (SF-36). The results were correlated with the severity of dizziness, using the Dizziness Handicap-Inventory (DHI), with emotional distress, using the Hospital Anxiety and Depression-Scale (HADS) and with further clinical symptoms and psychosocial parameters. In a multivariate hierarchical regression analysis associated variables which explain significant variance of the mental and physical HRQoL (MCS-36, PCS-36) were identified. Results Patients suffering from dizziness showed a markedly reduced mental and physical HRQoL. Higher DHI and HADS scores were correlated with lower MCS-36 and PCS-36 scores. Taken together DHI and vertigo characteristics of dizziness explained 38% of the variance of PCS-36. Overall explained variance of PCS-36 was 45%. HADS and living with a significant other explained 66% of the variance of MCS-36 (overall variance explained: 69%). Conclusion Both the physical and mental HRQoL are significantly impaired in patients with dizziness. While the impairment in PCS-36 can be explained by clinical symptoms of the dizziness, MCS-36 impairment is largely associated with psychosocial factors. To improve the patient’s overall well-being significantly and permanently doctors have to keep in mind both, the clinical symptoms and the psychosocial factors. Therefore, in addition to the physical examination doctors should integrate a basic psychological examination into the daily routine with dizziness patients.
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Affiliation(s)
- Steffi Weidt
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, Culmannstrasse 8, Zurich CH-8091, Switzerland.
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Bayat A, Pourbakht A, Saki N, Zainun Z, Nikakhlagh S, Mirmomeni G. Vestibular rehabilitation outcomes in the elderly with chronic vestibular dysfunction. IRANIAN RED CRESCENT MEDICAL JOURNAL 2012; 14:705-8. [PMID: 23396380 PMCID: PMC3560539 DOI: 10.5812/ircmj.3507] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2011] [Revised: 07/23/2012] [Accepted: 07/25/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND Chronic vestibular dysfunction is a frustrating problem in the elderly and can have a tremendous impact on their life, but only a few studies are available. Vestibular rehabilitation therapy (VRT) is an important therapeutic option for the neuro-otologist in treating patients with significant balance deficits. OBJECTIVES The purpose of this study was to assess the effect of vestibular rehabilitation on dizziness in elderly patients with chronic vestibular dysfunction. MATERIALS AND METHODS A total of 33 patients older than 60 years with chronic vestibular dysfunction were studied. Clinical and objective vestibular tests including videonystagmography (VNG) and dizziness handicap inventory (DHI) were carried out at their first visit, 2 weeks, and 8 weeks post-VRT. The VRT exercises were performed according to Cawthorne and Cooksey protocols. RESULTS Oculomotor assessments were within normal limits in all patients. Nineteen patients (57.57%) showed abnormal canal paralysis on caloric testing which at follow-up sessions; CP values were decreased remarkably after VRT exercises. We found a significant improvement between pre-VRT and post-VRT total DHI scores (P < 0.001). This improvement was most prominent in functional subscore. CONCLUSIONS Our study demonstrated that VRT is an effective therapeutic method for elderly patients with chronic vestibular dysfunction.
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Affiliation(s)
- Arash Bayat
- Department of Audiology, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding author: Arash Bayat, Department of Audiology, Tehran University of Medical Sciences, Tehran, Iran. Tel.: +98-9183615157, Fax: +98-216670051, E-mail:
| | - Akram Pourbakht
- Department of Audiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Nader Saki
- Department of Otolaryngology, Ahwaz Jundishapour University of Medical Sciences, Ahwaz, Iran
| | - Zuraida Zainun
- School of Health Sciences, Universiti Sains Malaysia (USM), Malaysia
| | | | - Golshan Mirmomeni
- Department of Audiology, Tehran University of Medical Sciences, Tehran, Iran
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