The vertical computerized rotational head impulse test.

The computerized rotational head impulse test (crHIT) uses a computer-controlled rotational chair to deliver whole-body rotational impulses to assess the semicircular canals. The crHIT has only been described for horizontal head plane rotations. The purpose of this study was to describe the crHIT for vertical head plane rotations.

Balance strategies for recovery from perturbed overground walking.

Bipedal locomotion is naturally unstable and requires active control. Walking is believed to be primarily stabilized through the selection of foot placements; however, other strategies are available, including regulation of ankle inversion/eversion, ankle push-off, and angular momentum through trunk postural adjustments. The roles of these strategies in maintaining overall stability are often masked by the dominant foot placement strategy.

Head and vestibular kinematics during vertical semicircular canal impulses.

Background: The video head impulse test (vHIT) is a common assessment of semicircular canal function during high-speed impulses. Reliability of the vHIT for assessing vertical semicircular canals is uncertain. Vertical head impulses require a complex head movement, making it difficult to isolate a single semicircular canal and interpret resulting eye rotations.

The Psychometric Properties of the 9-Item Vestibular Activities Avoidance Instrument.

Objective: The purpose of this study was to establish the psychometric properties of the 9-Item Vestibular Activities Avoidance Instrument (VAAI-9), a patient-reported outcome measure developed to identify fear avoidance beliefs in persons with vestibular disorders.

Methods: This prospective cohort study included 100 participants 18 years and older seeking care at a balance disorders clinic for dizziness. Participants completed the VAAI-9, the Dizziness Handicap Inventory (DHI), and other patient-reported outcomes at the initial visit and the 3-month follow-up.

Rating of perceived difficulty scale for measuring intensity of standing balance exercises in individuals with vestibular disorders.

Background: A method for prescribing the difficulty or intensity of standing balance exercises has been validated in a healthy population, but requires additional validation in individuals with vestibular disorders.

Objective: This study validated the use of ratings of perceived difficulty for estimation of balance exercise intensity in individuals with vestibular disorders.

Methods: Eight participants with a confirmed diagnosis of a vestibular disorder and 16 healthy participants performed two sets of 16 randomized static standing exercises across varying levels of difficulty.

Acute unilateral vestibulopathy/vestibular neuritis: Diagnostic criteria.

This paper describes the diagnostic criteria for Acute Unilateral Vestibulopathy (AUVP), a synonym for vestibular neuritis, as defined by the Committee for the Classification of Vestibular Disorders of the Bárány Society. AUVP manifests as an acute vestibular syndrome due to an acute unilateral loss of peripheral vestibular function without evidence for acute central or acute audiological symptoms or signs. This implies that the diagnosis of AUVP is based on the patient history, bedside examination, and, if necessary, laboratory evaluation.

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.

Vestibular migraine: Diagnostic criteria1.

This paper presents diagnostic criteria for vestibular migraine, jointly formulated by the Committee for Classification of Vestibular Disorders of the Bárány Society and the Migraine Classification Subcommittee of the International Headache Society (IHS). It contains a literature update while the original criteria from 2012 were left unchanged. The classification defines vestibular migraine and probable vestibular migraine.

Utility of a Postural Stability/Perceptual Inhibition Dual Task for Identifying Concussion in Adolescents.

Context: Research in the area of dual-task paradigms to assess sport-related concussion (SRC) status is growing, but additional assessment of this paradigm in adolescents is warranted.

Design: This case-control study compared 49 adolescent athletes aged 12-20 years with diagnosed SRC to 49 age- and sex-matched controls on visual-spatial discrimination and perceptual inhibition (PIT) reaction time tasks performed while balancing on floor/foam pad conditions.

Methods: The SRC group completed measures at a single time point between 1 and 10 days postinjury.

Fear Avoidance Beliefs Are Associated With Perceived Disability in Persons With Vestibular Disorders.

Objective: The purpose of this study was to determine the association between fear-avoidance beliefs and disability in 3 months in people with vestibular disorders while accounting for demographic and clinical characteristics.

Methods: This prospective cohort study included people aged 18 to 100 years who reported dizziness. Participants were recruited from a balance disorders clinic and outpatient physical therapy clinics.

Motion sickness diagnostic criteria: Consensus Document of the Classification Committee of the Bárány Society.

We present diagnostic criteria for motion sickness, visually induced motion sickness (VIMS), motion sickness disorder (MSD), and VIMS disorder (VIMSD) to be included in the International Classification of Vestibular Disorders. Motion sickness and VIMS are normal physiological responses that can be elicited in almost all people, but susceptibility and severity can be high enough for the response to be considered a disorder in some cases. This report provides guidelines for evaluating signs and symptoms caused by physical motion or visual motion and for diagnosing an individual as having a response that is severe enough to constitute a disorder.

Exploratory Factor Analysis of the Vestibular Activities Avoidance Instrument.

Importance: Fear avoidance is a behavioral response to dizziness that can lead to chronic symptoms and maladaptation of the vestibular system, but there is no valid and reliable clinical measure of fear avoidance for persons with dizziness. Although the Vestibular Activities Avoidance Instrument (VAAI) was developed to identify fear avoidance beliefs in persons with dizziness, it was considered too long for clinical use.

Objective: To continue development of the VAAI for clinical use by reducing its length and by assessing the internal consistency and construct validity through associations with measures of disability, quality of life, and psychological well-being.

Changes in Cortical Activation During Dual-Task Walking in Individuals With and Without Visual Vertigo.

Background And Purpose: Persons with vestibular disorders are known to have slower gait speed with greater imbalance and veering during dual-task walking than healthy individuals, but the cerebral mechanisms are unknown. The purpose of this study was to determine whether individuals with visual vertigo (VV) have different cerebral activation during dual-task walking compared with control subjects.

Methods: Fourteen individuals with VV and 14 healthy controls (CON) were included (mean 39 years old, 85% women).

Gray Matter Regions Associated With Functional Mobility in Community-Dwelling Older Adults.

Background/objectives: Neuroimaging indicators of reduced brain health in the form of lower gray matter volume (GMV), lower fractional anisotropy (FA), and higher white matter hyperintensity volume (WMHV) have been related to global mobility measures, such as gait speed, in older adults. The purpose was to identify associations between brain regions and specific mobility functions to provide a greater understanding of the contribution of the central nervous system to independent living.

Design: Cross-sectional study.

Vestibular Rehabilitation and Factors That Can Affect Outcome.

This review will discuss the developmental, environmental, medical, psychological, visual, and other sensory-related factors that affect recovery after vestibular dysfunction. A general overview of the evidence for vestibular rehabilitation for patients with peripheral and central vestibular disorders is provided. Recent findings suggest that age, physical activity, certain congenital disorders, length of symptoms, musculoskeletal, visual and neuromuscular comorbidities, cognition, sleep, and medications are all factors that influence the effectiveness and outcome of vestibular rehabilitation.

Vestibulo-Ocular Reflex Function in Adolescents With Sport-Related Concussion: Preliminary Results.

Background: Oculomotor impairments, dizziness, and imbalance are common after sports-related concussion (SRC) in adolescents and suggest a relationship between SRC and vestibular system dysfunction. However, it is not clear whether the source of these problems is attributable to the peripheral or central vestibular system.

Hypothesis: The video Head Impulse Test (vHIT), which assesses peripheral vestibular function, will show differences in gain between adolescents with and without SRC.

Reliability and Validity of Ratings of Perceived Difficulty During Performance of Static Standing Balance Exercises.

Background: Standardized instruments for measuring the intensity of balance exercises in clinical environments are lacking.

Objective: The objective of this study was to develop a method for quantifying the perceived intensity of standing balance exercises.

Design: A test-retest study design was used, with repeated evaluations within the same visit and between visits 1 week later.

Using Accelerometers to Record Postural Sway in Adolescents With Concussion: A Cross-Sectional Study.

Objective: To investigate the magnitude of postural sway induced by different balance tasks in adolescents with concussion and to examine the associations of postural sway with concussion symptoms.

Design: Cross-sectional study.

Patients Or Other Participants: Fifty-six adolescents (20 girls, 36 boys) between 13 and 17 years of age who sustained a concussion within the past 44 days and were still symptomatic.

The Gaze Stabilization Test Following Concussion.

Background: Concussion can cause vestibular dysfunction and oculomotor abnormalities which can lead to dizziness and protracted recovery time. There are few clinically useful, functional measures of the vestibulo-ocular reflex (VOR) post-concussion.

Purpose: The purpose of this study was to examine the gaze stabilization test (GST) in those referred for vestibular physical therapy following concussion, to determine the association between GST and other measures of recovery following concussion, and to examine the effect of demographic variables on GST performance.

Perceptual Inhibition Associated with Sensory Integration for Balance in Older Adults.

Aims: Inhibition associated with perception has been implicated in sensory integration processes for balance when sensory conflict occurs. The current study examines the associations of three measures of inhibition (perceptual inhibition, motor inhibition, and Stroop interference) with standing balance under sensory conflict conditions in younger and older adults.

Methods: Perceptual inhibition, motor inhibition, and Stroop interference were measured in younger and older subjects.

Inhibition and decision-processing speed are associated with performance on dynamic posturography in older adults.

Changes in cognition due to age have been associated with falls and reduced standing postural control. Sensory integration is one component of postural control that may be influenced by certain aspects of cognitive functioning. This study investigated associations between measures of cognitive function and sensory integration capabilities for healthy young and older adults.

Changes in cerebral activation in individuals with and without visual vertigo during optic flow: A functional near-infrared spectroscopy study.

Background And Purpose: Individuals with visual vertigo (VV) describe symptoms of dizziness, disorientation, and/or impaired balance in environments with conflicting visual and vestibular information or complex visual stimuli. Physical therapists often prescribe habituation exercises using optic flow to treat these symptoms, but it is not known how individuals with VV process the visual stimuli. The primary purpose of this study was to use functional near-infrared spectroscopy (fNIRS) to determine if individuals with VV have different cerebral activation during optic flow compared with control subjects.

Reliability of Postural Sway Measures of Standing Balance Tasks.

The reliability of balance exercises performance in experimental and clinical studies has typically been confined to a small set of exercises. In order to advance the field of assessing balance exercise intensity, establishing the reliability of performance during a more diverse array of exercises should be undertaken. The purpose of this study was to investigate the test-retest reliability of postural sway produced during performance of 24 different balance tasks, and to evaluate the reliability of different measures of postural sway.