Search

Objective: To evaluate how self-report and posturographic measures could be affected in patients with cervicogenic dizziness undergoing sustained natural apophyseal glides. Design: Randomised controlled single-blind study. Setting: Tertiary rehabilitation centre. Subjects: Patients affected by cervicogenic dizziness, diagnosed by applying accepted criteria. Forty-one patients (19 male, 22 female: mean age 44.3 ± 14.8 years) receiving treatment, and 39 patients (18 male, 21 female: mean age 43.8 ± 13.9 years) receiving placebo were included in the study. Interventions: The treatment group underwent sustained natural apophyseal glides, while the placebo was constituted by a detuned laser. Both groups received their interventions six times over 4 weeks. Main measures: Outcomes were tested by means of self-report measures such as perceived dizziness, neck disability, anxiety and depression. Also, cervical range of motion and posturography testing with power spectra frequency were analysed. Results: When compared to placebo, treated patients demonstrated a significant decrease in perceived dizziness (post-treatment total Dizziness Handicap Inventory score 20.5 ± 5.3 as compared to 26.2 ± 6 baseline), neck disability and pain (Neck Disability Index and Neck Pain Index post-treatment scores 12.5 ± 4.3 and 45.6 ± 15.1, respectively, as compared to baseline scores of 15.1 ± 4.8 and 62.5 ± 14.3), as well as significant improvement in cervical range of motion and some posturographic parameters. Conclusion: Sustained natural apophyseal glides may represent a useful intervention in reaching short-term beneficial effects in patients with cervicogenic dizziness, with respect to self-perceived symptoms, proprioceptive integration and cervical range of motion improvement. [ABSTRACT FROM AUTHOR]

To evaluate posturography measurements, and their association with other clinical tests used for cervicogenic dizziness diagnosis, in a cohort of subjects suffering from cervicogenic dizziness, compared with healthy subjects. Ninety-three cervicogenic dizziness patients and 98 age- and gender-matched healthy subjects underwent video-Head impulse test, posturography testing, evaluation of cervical spine movements by means of cervical range of motion goniometer and self-report and performance measures, including Dizziness Handicap Inventory, Neck Disability Index, Neck Pain Intensity, Tampa Scale for Kinesiophobia and Hospital Anxiety and Depression Scale. Cervicogenic dizziness patients demonstrated significant increases in classical posturography parameters (i.e., surface and length) and in power spectra values within middle and high-frequency interval depicting balance control alterations especially due to proprioceptive integration changes. Furthermore, decreases in degrees of cervical range of motion and increases of self-report and performance measures – highlighting significant complaints of subjective feeling of dizziness – were found in these patients when compared with healthy subjects. Multiple correlations were found between posturography testing and cervical range of motion and Dizziness Handicap Inventory as well as between different self-report and performance measures in cervicogenic dizziness patients. The implementation of posturography – including power spectra analysis - coupled with appropriate exclusion of other disorders, may represent a useful tool in improving cervicogenic dizziness assessment in terms of cost, time consumption and correlation with other measurements. Uncertainties in diagnostic assessment of cervicogenic dizziness reflect doubts regarding the causes underpinning the symptoms of imbalance, unsteadiness, and disorientation. Posturography measurement is a low-cost, time-sparing technique and its implementations have proven to be useful in detecting significant alterations in body sway during perturbating situations. Implementation of power spectra analysis on posturography testing may represent a useful tool in improving cervicogenic dizziness assessment also in terms of rehabilitative treatment follow-up. [ABSTRACT FROM AUTHOR]

The aim of this study was to outline an age-dependent range of posturography measures obtained from healthy children. One hundred and fifty healthy 4-18-year-old children underwent video Head Impulse Test and static posturography testing. Surface, length and power spectra values were compared between each group of pupils and 32 healthy adults. As well as a significant (p < 0.025) increase in surface and length, when compared to healthy adults, increased values within the low/middle frequency domain and within the high frequency domain were also observed in 4-13 and 4-7-year-old children, respectively. In conclusion, although the nature of postural control development remains largely undetermined, this study represents a first attempt to outline an age-dependent normal range of the relative contribution of inputs in typically developing children. [ABSTRACT FROM AUTHOR]

Objective: To investigate the long-term effects of adding virtual reality–based home exercises to vestibular rehabilitation in people with unilateral vestibular hypofunction. Design: Follow-up otoneurological examination in two randomized groups following a previous one-month trial. Setting: Tertiary rehabilitation center. Subjects: A total of 47 patients with unilateral vestibular hypofunction, one group (n = 24) undergoing conventional vestibular rehabilitation and the other one (n = 23) implementing, in addition, head-mounted gaming home exercises, 20 minutes per day for one month. Interventions: One year after completing rehabilitation, patients underwent testing with static posturography, video head impulse test, self-report questionnaires, and a performance measure. Main measures: Vestibulo-ocular reflex gain, posturographic parameters such as length, surface, and fast Fourier transform power spectra, self-report, and gait performance measure scores. Results: Vestibulo-ocular reflex gain was significantly better with respect to pretreatment in both groups. The mixed-method group showed significantly higher gain scores: mean (standard deviation (SD)) at 12 months was 0.71 (0.04), versus 0.64 (0.03) for the vestibular rehabilitation–only group (P < 0.001). Accordingly, some classical posturography scores such as surface with eyes open and length with eyes closed and low-frequency power spectra were significantly different between groups, with the virtual reality group showing improvement (P < 0.001). Self-report measures were significantly better in both groups compared to pretreatment, with significant improvement in the mixed-method group as compared to conventional rehabilitation alone: Dizziness Handicap Inventory mean total score was 24.34 (2.8) versus 35.73 (5.88) with a P-value <0.001. Conclusion: Results suggest that head-mounted gaming home exercises are a viable, effective, additional measure to improve long-term vestibular rehabilitation outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Considering recent advances in central cognitive- and age-related processing interfering with balance and sensory reweighting in uncompensated vestibular disorders, purpose of this study is to highlight the vestibular rehabilitation (VR) outcomes in a population of older adults and age-matched mild cognitive impairment (MCI) patients, both affected by unilateral vestibular hypofunction (UVH) and undergoing VR.Methods: Vestibulo-ocular reflex (VOR), postural sway examination (respectively, performed by video head impulse test and static posturography) and dizziness-related and quality-of-life scores were collected in 12 UVH MCI individuals ≥ 55 years and 12 matched UVH older adults with age-appropriate cognitive function—cognitively evaluated by means of Mini-Mental State Examination (MMSE) and Alzheimer’s Disease Assessment Scale—before and after a VR protocol.Results: A significant post-treatment reduction in surface, length and power spectra (PS) values within low-frequency domain and an improvement in performance measures were recorded in both groups. Moreover, the VR protocol highlighted—when comparing pre-/post-treatment differences (Δ)—a significant (i) increase in Δ VOR gain; (ii) decrease in Δ surface and length and (iii) increase in Δ PS within low-frequency domain in older adults when compared to MCI patients. Positive correlations were found between MMSE and Δ Dynamic Gait Index, Δ surface and Δ PS within low-frequency domain when treating patients as ‘a continuum’ along the cognitive decline.Conclusions: Present pilot findings suggest that the cognitive domain insight in older adults scheduled for VR protocols may positively impact on disability consequences. [ABSTRACT FROM AUTHOR]