Relationship between clinical measures of hearing and clinical measures of vestibular function.

Purpose: Patients often have basic audiometry (BA) but not objective diagnostic tests of the vestibular system (VNG) when complaining of symptoms of a vestibular disorder. The relationship of BA results to VNG results is unknown. This study sought to determine if BA scores are related to impaired VNG scores.

Screening People on Standing Balance with Romberg Testing and Walking Balance with Tandem Walking.

The goal of this protocol is to inform readers about the exact procedures to use to perform two screening tests for vestibular disorders: tandem walking (TW) with eyes closed, also known as heel-toe walking, and the Clinical Test of Sensory Integration and Balance (CTSIB), which is also known as the modified Romberg. The study describes the steps for performing each test and each of the three CTSIB subtests so that the reader will be able to replicate the test conditions for use in the clinic, in the clinical laboratory, or in any other situation needing valid and reliable screening for balance skill which might be affected by changes in vestibular system function. The procedures detailed here can be easily administered and take less than 1 min per trial.

A Retrospective Study of the Relationship Between Hypertension and Vestibular Disorders in Middle-Aged Women With and Without HIV.

Background: Patients often conflate the problem of lightheadedness from hypertension (HTN) and vertigo from a vestibular impairment, describing both problems as dizziness. The goal of the study was to learn if there is a relationship between measures of vestibular function and blood pressure.

Methods: This retrospective study consisted of women who participated in a longitudinal study of the human immunodeficiency virus (HIV) and a control cohort of age-matched women without HIV.

Relationship Between Obstructive Sleep Apnea and Balance on Computerized Dynamic Posturography.

Background: Obstructive sleep apnea (OSA) leads to chronic sleep deprivation. The relationship between OSA and balance is poorly understood.

Aim/objective: This study aimed to determine if OSA adversely affects standing balance.

Extended effects of a wearable sensory prosthesis on gait, balance function and falls after 26 weeks of use in persons with peripheral neuropathy and high fall risk-The walk2Wellness trial.

Background: We recently reported that individuals with impaired plantar sensation and high fall risk due to sensory peripheral neuropathy (PN) improved gait and balance function following 10 weeks of use of Walkasins, a wearable lower limb sensory prosthesis that provides directional specific mechanical tactile stimuli related to plantar pressure measurements during standing and walking (RxFunction Inc., Eden Prairie, MN, United States). Here, we report 26-week outcomes and compare pre- and in-study fall rates.

Changes in Measures of Vestibular and Balance Function and Hippocampus Volume in Alzheimer's Disease and Mild Cognitive Impairment.

Objective: To test the hypotheses that people with Alzheimer's disease and mild cognitive impairment have increased frequency of vestibular impairments and decreased hippocampal volume compared with healthy age-matched controls.

Study Design: Retrospective, with some historical controls.

Setting: Out-patient, tertiary care center.

Screening for balance in children and adults in a community science education setting: Normative data, influence of age, sex, and body mass index, and feasibility.

Background: Screening standing and walking balance is useful for people suspected of having vestibular disorders, a variety of neurologic and musculoskeletal disorders, and for screening astronauts returning after exposure to microgravity. Visitors to a community science education center children and adults, aged 4 to 85, were tested on tandem walking with eyes closed and the modified Romberg test on compliant foam. They were then asked about their experience participating in research, many people for the first time.

Rapid design and implementation of a virtual pain management programme due to COVID-19: a quality improvement initiative.

Background: The COVID-19 pandemic interrupted the delivery of face-to-face pain services including pain management programmes in the United Kingdom with considerable negative impact on patients with chronic musculoskeletal pain. We aimed to develop and implement a remotely delivered pain management programme (PMP) using video-conferencing technology that contains all the core components of a full programme: the 'virtual PMP' (vPMP). By reporting on the process of this development, we endeavour to help address the paucity of literature on the development of remote pain management programmes.

Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Updated Clinical Practice Guideline From the Academy of Neurologic Physical Therapy of the American Physical Therapy Association.

Background: Uncompensated vestibular hypofunction can result in symptoms of dizziness, imbalance, and/or oscillopsia, gaze and gait instability, and impaired navigation and spatial orientation; thus, may negatively impact an individual's quality of life, ability to perform activities of daily living, drive, and work. It is estimated that one-third of adults in the United States have vestibular dysfunction and the incidence increases with age. There is strong evidence supporting vestibular physical therapy for reducing symptoms, improving gaze and postural stability, and improving function in individuals with vestibular hypofunction.

Subjective versus objective tests of dizziness and vestibular function in epidemiologic screening research.

Background: Many epidemiologic studies of vestibular disorders are based on responses to questionnaires which have not been tested against objective tests of the vestibular system.

Objective: The goal was to determine if the dizziness and balance questions used in the National Health Interview Survey (NHIS) are valid and predict performance on objective tests of the vestibular system (VNG).

Methods: Data from 367 participants recruited from the community, aged 21.

Vestibular Impairments on Objective Diagnostic Tests in HIV+ Women and Control Men and Women.

Objective: To describe the value of two vestibular test batteries across ages in healthy men and women for detecting vestibular disorders and to compare the occurrence of vestibular disorders in the healthy adult population and women with human immunodeficiency virus (HIV) disease.

Study Design: Two groups were tested on the battery of objective diagnostic tests of the vestibular system.

Setting: Two tertiary care centers.

Usefulness of Exam Questions and Vital Signs for Predicting the Outcome of Objective Vestibular Tests.

Objectives/hypothesis: To determine the value of standard clinic screening questions and vital signs in predicting abnormal vestibular function, indicated by standard objective diagnostic tests.

Study Design: Retrospective records review.

Methods: We reviewed electronic medical records of 150 patients seen by the neurotologists or the physician assistant they supervised, in an out-patient tertiary care clinic, between June 2018 and March 2020, and subsequently referred for the complete objective vestibular test battery (VB).

A clinical review of the use of Botulinum Toxin type A in managing central neuropathic pain in patients with spinal cord injury.

Context: Botulinum Toxin type A (BTX-A) has historically been used as a treatment to reduce spasticity. However, its potential to treat neuropathic pain is increasingly being recognized in the literature. This clinical review examines the evidence regarding the use of BTX-A in directly treating neuropathic pain in the spinal cord injured population.

The Effects of a Wearable Sensory Prosthesis on Gait and Balance Function After 10 Weeks of Use in Persons With Peripheral Neuropathy and High Fall Risk - The walk2Wellness Trial.

Background: Sensory peripheral neuropathy (PN) is associated with gait, balance problems and high fall risk. The walk2Wellness trial investigates effects of long-term, home-based daily use of a wearable sensory prosthesis on gait function, balance, quality of life and fall rates in PN patients. The device (Walkasins, RxFunction Inc.

Prediction of Functional Limitations in Balance after Tests of Tandem Walking and Standing Balance in Older Adults.

Objective: Older adults who may not complain of balance problems may nevertheless be developing subtle balance problems that may affect future functioning. This study sought to determine whether subtle problems could be predicted by standard balance testing.

Methods: At the geriatric medicine clinic at an academic tertiary-care center, geriatricians referred 27 people who were ambulatory without gait aids and had no apparent neurologic or musculoskeletal impairments affecting their balance or gait performance.

Differences in Responses on the Modified Clinical Test of Sensory Interaction and Balance on Medium Firm and Medium Density Foam in Healthy Controls and Patients with Vestibular Disorders.

Purpose: To determine whether foam density affects modified Romberg balance test performance.

Materials And Methods: Controls and patients with vestibular disorders performed Romberg tests on medium and medium firm foam, with their eyes closed and the head still and moving in yaw and pitch. The trial duration and number of head movements were measured.

Vestibular and oculomotor abnormalities among HIV-infected and HIV-uninfected men and women: A pilot study.

Objective: To determine if middle-aged and aging men and women with HIV disease (HIV+) should be screened for vestibular and oculomotor dysfunction.

Methods: Age- and sociodemographically matched HIV+ and HIV- men and women were tested on vestibular evoked myogenic potential (VEMP), bi-thermic caloric testing, Dix-Hallpike maneuvers and saccades.

Results: HIV+ men had more caloric weakness than HIV- men.

Nurturing the Prepared Mind: Research During Level II Fieldwork.

Importance: Level II fieldwork is one of the last opportunities for students to learn from clinicians modeling how to gather practice-based data for research before independent practice.

Objective: To identify options for incorporating active research opportunities in the Level II fieldwork experience and the barriers that preclude these opportunities.

Design: Approximately 575 electronic surveys (QuestionPro), consisting of 31 questions, distributed to fieldwork sites.

Balance and sound conditions in adults with bilateral cochlear implants.

Purpose: Determine if 1) balance is impaired in patients with bilateral cochlear implants compared to healthy controls; 2) the presence of sound, non-speech or speech, affects standing balance.

Materials And Methods: Four patients with bilateral cochlear implants were tested on three balance conditions on Romberg tests on medium density compliant foam with eyes closed, with head stationary or moving in yaw or pitch, under 5 sound conditions: no sound, ambient background noise, pink noise, foreign language, English language.

Results: Dependent measure were duration of standing and kinematics.

Assessing misperception of rotation in benign paroxysmal positional vertigo with static and dynamic visual images.

Background: Perception of self-motion is difficult for patients to describe. In addition, the relationship between perceived rotation and eye movements is poorly understood, because most studies of patients have investigated only static orientation.

Objective: First, to determine whether patients with benign paroxysmal positional vertigo (BPPV) can use visual images to report perceived rotation elicited by the Dix-Hallpike maneuver.

Screening for Vestibular Disorders Using the Modified Clinical Test of Sensory Interaction and Balance and Tandem Walking With Eyes Closed.

Objectives: Determine accurate cut-points and optimal combinations of screening tests of balance to detect patients with vestibular disorders.

Study Design: Case-control study.

Setting: Out-patient tertiary care.

A review on screening tests for vestibular disorders.

Although many studies have reported on tests of the vestibular system a valid and reliable, evidence-based screening battery for easy clinical use remains elusive. Many screening tests attempt to assess the vestibulo-ocular reflex. Therefore, head shaking, the Dix-Hallpike maneuver, the supine roll test, and head impulse tests are discussed.

Visual dependence and spatial orientation in benign paroxysmal positional vertigo.

People with benign paroxysmal positional vertigo (BPPV) probably have otoconial particles displaced from the utricle into the posterior semicircular canal. This unilateral change in the inertial load distributions of the labyrinth may result in visual dependence and may affect balance control. The goal of this study was to explore the interaction between visual dependence and balance control.