Activity and Participation Are Associated With Future Falls, Hospitalizations, and Emergency Visits in Community-Dwelling Older Adults.

Objective: Activity and participation are important for older adults as they are associated with well-being and quality of life. Falls, emergency department (ED) visits, and hospitalizations are adverse health outcomes that impact older adults. Limited research has investigated whether measurement of activity and participation are related to adverse health events in community dwelling older adults.

Neighborhood Walkability Is Associated With Global Positioning System-Derived Community Mobility of Older Adults.

Background: Neighborhood walkability may encourage greater out-of-home travel (ie, community mobility) to support independent functioning in later life. We examined associations between a novel walkability audit index and Global Positioning System (GPS)-derived community mobility in community-dwelling older adults. We compared associations with the validated Environmental Protection Agency (EPA) National Walkability Index and further examined moderation by clinical walking speed.

Fear avoidance beliefs, anxiety, and depression in healthy individuals and persons with vestibular disorders across cultures.

Background/introduction: In persons with vestibular disorders, disturbed vestibular input and accompanying dizziness can be associated with anxiety or depression. To avoid dizziness, persons with vestibular disorders can develop mal-adaptive fear avoidance behaviors which can negatively influence daily life functioning. The aims of this study were to (1) document different psychological factors in patients with vestibular disorders and healthy adults across cultures and (2) to assess the convergent validity of the 9-item Vestibular Activities Avoidance Instrument (VAAI), which quantifies fear avoidance beliefs.

Global Positioning System Indicators of Community Mobility and Future Health Outcomes Among Older Adults.

Background: We examined the relationship between global positioning system (GPS) indicators of community mobility and incident hospitalizations, emergency department (ED) visits, and falls over 1-year in community-dwelling older adults.

Methods: We performed a secondary analysis of a randomized trial investigating a physical therapy intervention to improve mobility in older adults. One hundred and forty-eight participants (mean age: 76.

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.

Association of Gait Quality With Daily-Life Mobility: An Actigraphy and Global Positioning System Based Analysis in Older Adults.

Objective: Walking is a key component of daily-life mobility. We examined associations between laboratory-measured gait quality and daily-life mobility through Actigraphy and Global Positioning System (GPS). We also assessed the relationship between two modalities of daily-life mobility i.

Utility of VestAid to Detect Eye-Gaze Accuracy in a Participant Exposed to Directed Energy.

Introduction: The VestAid is a tablet-based application that provides feedback about a patient's eye/head movements during exercise after concussion. The goal of this case series was to determine if VestAid could be used to detect eye-gaze accuracy in a participant exposed to directed energy (DE).

Materials And Methods: The VestAid results of a participant with DE were compared to an age- and gender-matched healthy control, a participant post-concussion, and a participant with vestibular neuritis.

Categorizing individuals based on the severity of Visual Vertigo Analogue Scale symptoms.

Background: The Visual Vertigo Analogue Scale (VVAS) assesses visual vertigo. Instead of the original scoring methods (positive VVAS > 1), we propose categorizing patients as having No (0), Mild (0.1-40), Moderate (40.

Facilitators and barriers to real-life mobility in community-dwelling older adults: a narrative review of accelerometry- and global positioning system-based studies.

Real-life mobility, also called "enacted" mobility, characterizes an individual's activity and participation in the community. Real-life mobility may be facilitated or hindered by a variety of factors, such as physical abilities, cognitive function, psychosocial aspects, and external environment characteristics. Advances in technology have allowed for objective quantification of real-life mobility using wearable sensors, specifically, accelerometry and global positioning systems (GPSs).

The reliability of the Dutch version of the vestibular activities avoidance instrument in persons with and without dizziness.

Background: Avoidance of activities that trigger dizziness in persons with vestibular disorders may inhibit dynamic vestibular compensation mechanisms.

Objective: To determine the reliability of the Vestibular Activities Avoidance Instrument (VAAI) 81 and 9 item tool and to compare the VAAI scores in Dutch-speaking healthy adults and in patients with vestibular disorders.

Methods: A prospective cohort study was conducted including 151 healthy participants and 106 participants with dizziness.

The Association of Mobility Determinants and Life Space Among Older Adults.

Background: It is important to understand the factors associated with life-space mobility so that mobility disability can be prevented/treated. The purpose of this study was to identify the association between mobility determinants and life space among older adults.

Methods: This study was a cross-sectional analysis of 249 community-dwelling older adults (mean age = 77.

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.

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.

Reliability and Concurrent Validity of Life Space Assessment in Individuals With Vestibular Disorders.

Background And Purpose: The Life Space Assessment (LSA) is a self-report measure that allows clinicians to determine how often someone moves around in his or her environment with or without assistance. Presently, there are no reliable and valid measures that capture all 3 aspects of mobility (ie, mobility frequency, distance, and assistance needed) for individuals with vestibular disorders. The purpose of this study was to describe life space and to determine the reliability and concurrent validity of the LSA as a tool to measure mobility and function in individuals with balance and vestibular disorders.

Predictors of Physical Therapy Referral Among Persons With Peripheral Vestibular Disorders in the United States.

Objective: To determine the rate of physical therapy (PT) referral and patient and physician characteristics associated with PT referral for benign paroxysmal positional vertigo (BPPV) and other peripheral vestibular disorders (PVD) in ambulatory care clinics in the United States.

Design: Cross-sectional analysis of the National Ambulatory Medical Care Survey 2004-2015 SETTING: Ambulatory care clinics in the United States.

Participants: We identified 5.

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).

Management of Benign Paroxysmal Positional Vertigo in an Adult With Severe Osteogenesis Imperfecta.

The purpose of this case report was to describe the evaluation and management of atypical benign paroxysmal positional vertigo (BPPV) in an adult with severe osteogenesis imperfecta. A 29-year-old male was referred to a physical therapist with extensive experience in vestibular rehabilitation who provided horizontal canal BPPV treatment with a canalith repositioning maneuver over two treatment sessions. The individual's symptoms had reduced by 65% and his nystagmus during the roll test was reduced.

Assessment of Health Care Utilization for Dizziness in Ambulatory Care Settings in the United States.

Objective: Describe patient and physician characteristics, and physician recommendations for ambulatory care visits for dizziness in the US.

Study Design: Cross-sectional analysis of visits for dizziness from the National Ambulatory Medical Care Survey (2013-2015).

Setting: Ambulatory care clinics in the US.

Vestibular Physical Therapy in Individuals With Cognitive Impairment: A Theoretical Framework.

Falls are a major health care concern in individuals with Alzheimer disease (AD) and their caregivers. Vestibular impairment is a known risk factor for falls, and individuals with AD have been shown to have an increased prevalence of vestibular loss compared with age-matched controls. Vestibular physical therapy (VPT) is effective in improving balance and reducing fall risk in cognitively-intact persons with vestibular impairment.

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.

Vestibular rehabilitation: advances in peripheral and central vestibular disorders.

Purpose Of Review: Rehabilitation for persons with vertigo and balance disorders is becoming commonplace and the literature is expanding rapidly. The present review highlights recent findings of both peripheral and central vestibular disorders and provides insight into evidence related to new rehabilitative interventions. Risk factors will be reviewed to create a better understanding of patient and clinical characteristics that may effect recovery among persons with vestibular disorders.

Assessment of Physician Adherence to Guidelines for the Diagnosis and Treatment of Benign Paroxysmal Positional Vertigo in Ambulatory Care Settings.

This cohort study uses data from the National Ambulatory Medical Care Survey to evaluate the prevalence of patient visits to ambulatory care clinics for benign paroxysmal positional vertigo and whether physicians’ diagnostic and treatment recommendations adhered to clinical practice guidelines over time.

A Case Study of High-Velocity, Persistent Geotropic Nystagmus: Is This BPPV?

Background And Purpose: Deciphering the cause for a persistent, direction-changing geotropic nystagmus can be difficult. Migraine and light cupula are two possible causes, though can be confused with benign paroxysmal positional vertigo (BPPV) affecting the horizontal semicircular canal. In migraine, the persistent geotropic nystagmus tends to be slow; in light cupula, the nystagmus has been illustrated to beat in the direction opposite that of prone positioning.

Transitioning to a narrow path: the impact of fear of falling in older adults.

Background: Everyday ambulation requires navigation of variable terrain, transitions from wide to narrow pathways, and avoiding obstacles. While the effect of age on the transition to a narrow path has been examined briefly, little is known about the impact of fear of falling on gait during the transition to a narrow path. The purpose was to examine the effect of age and fear of falling on gait during transition to a narrow path.