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BACKGROUND: Unilateral vestibular deficits are associated with postural instability and loss of quality of life. Common treatments frequently fail to achieve satisfactory outcomes. OBJECTIVE: To assess the durability of changes in participant-reported disability and objective posturography after computerized vestibular retraining. METHODS: This was a single-group study. Individuals with persistent symptoms of an objectively determined unilateral vestibular deficit completed questionnaires and posturography assessments before and after twelve sessions of computerized retraining, and 4–6 months and 10–12 months after treatment. RESULTS: 13 participants completed the post-treatment assessments; 9 completed the follow up. Mean improvements in perceived disability at 4–6 months after retraining were: DHI 14.3 points (95% confidence interval 4.0 to 24.5), ABC scale 14.9 points (4.3 to 25.6), FES-I 11.6 points (–3.2 to 26.5). The SOT composite score increased by 11.4 points (95% CI 1.9 to 20.9; p = 0.0175) immediately after treatment, 8.9 points (–2.9 to 20.7; p = 0.1528) at 4–6 months, and 10.6 points (2.2 to 19.0; p = 0.0162) after 10–12 months. At the 10–12 month time point, the areas of the functional stability region increased significantly for both endpoint excursion (p = 0.0086) and maximum excursion (p = 0.0025). CONCLUSION: Computerized vestibular retraining was associated with improved participant reported disability and objective measures of postural stability. [ABSTRACT FROM AUTHOR]

Investigated adult English speakers' production of subject and object relative clause sentences using a picture/symbol-based augmentative and alternative communication (ACC) system with speech output. Most participants avoided the potential ambiguity that resulted from the absence of grammatical markers. Results indicate the combined effects of underlying syntactic knowledge and pragmatic variables on the ACC constituent order patterns observed. (Author/VWL)

Copyright of Canadian Journal of Speech-Language Pathology & Audiology is the property of Speech-Language & Audiology Canada and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Speech-Language Pathology & Audiology is the property of Speech-Language & Audiology Canada and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In order for WAI to become an effective diagnostic tool for use in clinical settings, normative data needs to be established. This presentation has investigated whether WAI values differ significantly in a normal hearing young adult population based on gender, ethnicity and instrument used to make measurements. Eighty normal hearing young adults (age 18-34) were recruited to undergo WAI testing with four different devices, Otostat Mimosa Acoustics, Titan Interacoustics, Reflwin Interacoustics and Mimosa Acoustics HearID. Out of the eighty participants, twenty participants were recruited from each of the male, female, Caucasian and Chinese groups. Across all groups and conditions, power absorbance (PA) values (the most commonly used WAI measurement) was decreased with decreases in frequency before the absorbance maximum (the frequency at which absorbance is closer to one) and decreased with increases in frequency after the absorbance maximum. PA values was lower in the low frequencies for the Chinese group in comparison with the Caucasian group and lower in the high frequencies for the Caucasian group as compared to the Chinese group. Body Mass Index (BMI) and ear canal volume was used as co-variant to explain these differences. PA values at peak pressure was statistically different from PA values at ambient pressure which may have an impact on diagnosis of stiffening pathology such as otosclerosis. While there were statistical differences between different instrumentation, the differences observed were smaller than differences that observed between PA values in normal group and PA in different middle ear pathologies. [ABSTRACT FROM AUTHOR]

As Wideband Tympanometry gains popularity, it is essential to understand the impact of different middle ear pathologies on Absorbance patterns. The purpose of this talk is to cover the general principles of reflectance techniques and examine absorbance patterns in various middle ear pathologies. Absorbance results in cases of otitis media with effusion, negative middle ear pressure, otosclerosis, ossicular discontinuity, rheumatoid arthritis, and ear drum perforation will be compared to age-appropriate normative data. Where applicable, absorbance patterns obtained at ambient pressure as well as pressurized mode (Wideband Tympanometry) will be reviewed. Learning Objectives * Explain Wideband Acoustic Immittance (WAI) and its similarities and differences to conventional tymanometry. * Analyze WAI patterns in normal and different middle ear pathologies. * Differentiate WAI patterns between different age groups and different middle ear pathologies. * Define absorbance, reflectance, and transmittance. * Examine WAI outcomes in normal and different middle ear pathologies. * Understand the pros and cons of WAI in assessment of middle ear function. [ABSTRACT FROM AUTHOR]

Objective: Balance deficits are common and debilitating. Standard treatments have limitations in addressing symptoms and restoring dynamic balance function. This study compares a rehabilitative computerized dynamic posturography (CDP) protocol, computerized vestibular retraining therapy (CVRT), with a home exercise program (HEP) for patients with objectively confirmed unilateral vestibular deficits (UVDs)., Study Design: Single-center, randomized, interventional trial, with 1-sided crossover., Setting: A tertiary neurotology clinic., Methods: Patients with UVDs and Dizziness Handicap Inventory (DHI) score >30 were randomized to receive either CVRT or HEP. After completion of treatment, the HEP group was crossed over to CVRT. Outcome measures were the sensory organization test (SOT) and 3 participants reported dizziness disability measures: the DHI, Activity-Specific Balance Confidence Scale (ABC) scale, and Falls Efficacy Score-International (FES-I)., Results: We enrolled 37 patients: 18 participants completed CVRT and 12 completed HEP, 11 of whom completed the crossover. Seven participants withdrew. The CVRT group demonstrated a greater improvement in SOT composite score than the HEP group (P = .04). Both groups demonstrated improvement in participant-reported measures but there were no differences between groups (DHI: P = .2604; ABC: P = .3627; FES-I: P = .96). Following crossover to CVRT after HEP, SOT composite (P = .002), DHI (P = .03), and ABC (P = .006) improved compared to HEP alone., Conclusion: CVRT and HEP were both associated with improved participant-reported disability outcomes. CVRT was associated with greater improvement in objective balance than HEP. Adding CVRT after HEP was superior to HEP alone. Multimodal CDP-based interventions, such as CVRT, should be considered as an adjunct to vestibular physiotherapy for patients with UVD., (© 2024 American Academy of Otolaryngology–Head and Neck Surgery Foundation.)

Importance: Individuals with persistent unilateral vestibular deficits experience loss of quality of life and increased risk of falling, and they have few well-supported options for effective treatment., Objectives: To evaluate whether vestibular retraining using computerized dynamic posturography is associated with reduced participant-reported disability for patients with an objectively assessed unilateral peripheral vestibular deficit and to assess the feasibility of conducting a randomized clinical trial of vestibular retraining using computerized dynamic posturography., Design, Setting, and Participants: This single-group cohort study was conducted from April 29 to July 23, 2021, in a tertiary neurotology clinic among 13 individuals with a stable unilateral vestibular deficit present for more than 6 months, confirmed with videonystagmography and vestibular evoked myogenic potential testing. Statistical analysis was performed from July 7, 2021, to January 25, 2022., Interventions: Twelve twice-weekly sessions of posturography-assisted vestibular retraining with prescribed weight shifting tasks guided by an interactive display., Main Outcomes and Measures: Change in scores on the Dizziness Handicap Inventory (DHI), the Activities-Specific Balance Confidence (ABC) Scale, and the Falls Efficacy Scale-International (FES-I), which participants completed before and after retraining to measure their perception of their disability. They also completed posturography measurements. Secondary outcomes included tolerability of the intervention and rate of completion of the full protocol., Results: A total of 13 participants (8 men [62%]; median age, 51 years [range, 18-67 years]) were enrolled. All 13 participants completed the intervention and all follow-up. After treatment, the median changes in scores were -16 points (95% CI, -20 to 2) for the DHI, -9 (95% CI, -14 to 1) for the FES-I, and 11.9 (95% CI, 0-17.3) for the ABC Scale. Eight participants (62%) improved by greater than the minimum clinically important difference (MCID) for the DHI, whereas 4 (31%) exceeded the MCID for the ABC Scale, and 3 (23%) exceeded the MCID for the FES-I. Participants with moderate to severe disability at baseline (n = 7) had a larger magnitude of improvement in DHI scores than those with mild disability (n = 6) (-18 [95% CI, -78 to 2] vs -1 [95% CI, -8 to 16]). Six of the 7 patients (86%) with moderate to severe disability improved by greater than the MCID for DHI, wherease 4 of 7 patients (57%) improved by greater than the MCID for the ABC Scale, and 3 of 7 patients (43%) improved by greater than the MCID for the FES-I., Conclusions and Relevance: This cohort study suggests that computerized, dynamic posturography-assisted retraining was associated with clinically meaningful improvements in participant-reported disability among those with stable unilateral vestibular deficit and moderate to severe disability. Further studies should compare posturography-assisted vestibular retraining with conventional physical therapy rehabilitation techniques., Trial Registration: ClinicalTrials.gov Identifier: NCT04875013.

Objective: To ascertain if wideband acoustic immitance (WAI) measurements are useful in assessing crimping status following stapedotomy., Design: WAI measurements were obtained using the Mimosa Acoustics HearID system. Wideband chirp sound stimuli and a set of tone stimuli for nine frequencies between 0.2 and 6 kHz were used at 60 dB SPL. Five sets of measurements were performed on each temporal bone: mobile stapes, stapes fixation and stapedotomy followed by insertion of a tightly crimped, a loosely crimped and an uncrimped prosthesis., Study Sample: Eight fresh-frozen temporal bones were harvested from human cadaveric donors., Results: At lower frequencies, up to 1 kHz, stapes fixation decreased absorbance. Compared to the baseline absorbance, absorbance with stapes fixation dropped by 6 to 17% in absolute terms from the baseline value (p = 0.027). Absorbance was not affected in higher frequencies (p = 0.725). Stapedotomy changed the absorbance curve significantly compared to the normal condition with an increase of absolute absorbance values by 6 to 36% around 0.25-1 kHz (p-value <0.01). The crimping conditions did not differ from one another (p = 0.555)., Conclusion: WAI is not useful in distinguishing between tightly crimped, loosely crimped and uncrimped stapes prostheses following stapedotomy.