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RESUMO Objetivo avaliar se a posturografia, exame que avalia a habilidade de manter o equilíbrio em condições sensoriais conflitantes, pode identificar risco de queda em idosos com tontura. Métodos comparar os resultados posturográficos de idosos com e sem história de quedas, pareados por gênero, idade e diagnóstico etiológico da tontura. Resultados dezoito idosos com quedas – 4 com único episódio e 14 com história de 2 ou mais quedas no último ano - foram comparados com 18 idosos sem quedas, pareados por gênero, idade e diagnóstico etiológico. Pacientes com quedas apresentaram resultados piores para as análises de dependência visual (p=0,04, p=0,01, p=0,03). Pacientes com quedas recorrentes (2 ou mais episódios) apresentaram piores resultados em diversas condições sensoriais: somatossensorial, vestibular, dependências visuais e índice de equilíbrio composto. Conclusão a posturografia mostrou-se útil na identificação de idosos com quedas, principalmente em indivíduos com quadros recorrentes.

Introduction: Postural instability is one the most common disabling features in vestibular disorders. Objective: This study aimed to analyze the limit of stability and the influence of manipulation of visual, somatosensorial and visual–vestibular information on postural control in older adults with vestibular disorder, with and without a history of falls. Methods: Cross-sectional study. Participants – 76 elderly patients with vestibular disorder (G1, without falls; G2, with falls) and 41 healthy elderly subjects (control group; CG). Using posturography, analyzed were limit of stability area, body center of pressure, and velocity of oscillation in the standing position in 10 conditions, including open/closed eyes, unstable surface with eyes closed, saccadic and optokinetic stimuli, and visual–vestibular interaction. Results: Limit of stability area in CG was better compared with G1-2, and center of pressure values were worse in G1 than in CG. Center of pressure area in all conditions and velocity of oscillation in the following conditions: open/closed eyes, optokinetic stimulation, and visual–vestibular interaction showed worse values in G2 than in CG. Center of pressure area in the following conditions: open/closed eyes, saccadic and optokinetic stimuli, visual–vestibular interaction, and unstable surface with eyes closed showed worse values in G2 than in G1. Conclusion: Older adults with vestibular disorder presented reduced limit of stability and increased postural sway in the following conditions: conflict between visual and somatosensory information and visual–vestibular interaction. Deterioration in postural control was significantly associated with history of falls. Resumo: Introdução: Instabilidade postural é uma das características incapacitantes mais comuns nos distúrbios vestibulares. Objetivo: Analisar o limite de estabilidade e a influência da manipulação de informações visuais, somatossensoriais e visuais-vestibulares no controle postural em idosos com disfunção vestibular, com e sem histórico de quedas. Método: Estudo transversal. Participantes: 76 idosos com distúrbios vestibulares (G1, sem quedas; G2, com quedas) e 41 idosos saudáveis (grupo controle; GC). Com o uso da posturografia, foram analisadas a área do limite de estabilidade, centro de pressão e velocidade de oscilação na posição ereta em 10 condições, incluindo olhos abertos/fechados, superfície instável com olhos fechados, estímulos sacádicos e optocinéticos e interação visual-vestibular. Resultados: A área de limite de estabilidade no GC foi melhor comparada com o G1-2 e os valores do centro de pressão foram piores no G1 do que no GC. A área do centro de pressão em todas as condições e a velocidade de oscilação nas seguintes condições: olhos abertos/fechados, estímulo optocinético e interação visual-vestibular mostraram valores piores no G2 do que no GC. A área do centro de pressão nas seguintes condições: olhos abertos/fechados, estímulos sacádicos e optocinéticos, interação visual-vestibular e superfície instável com olhos fechados apresentou valores piores no G2 do que no G1. Conclusão: Idosos com disfunção vestibular apresentaram redução de limite de estabilidade e aumento da oscilação postural nas seguintes condições: conflito entre informação visual e somatossensorial e interação visual-vestibular. A deterioração no controle postural foi significantemente associada ao histórico de quedas.

Introdução: A patologia vestibular na população pediátrica é um tema bastante controverso, mas que tem ganho cada vez mais destaque. A prevalência reportada nesta população varia entre 0,7% e 15%. No entanto, este valor pode estar subestimado, uma vez que a sua forma de expressão na população pediátrica é muito diferente da dos adultos, podendo ir desde a vertigem rotatória até queixas de alterações da visão, cefaleias, atraso motor ou dificuldades na aprendizagem. Embora na literatura a otite média com efusão seja considerada a principal causa de disfunção vestibular nesta faixa etária, existem outras que devem ser consideradas. O objetivo deste estudo foi descrever as características clínicas da população pediátrica encaminhada para avaliação em consulta de Otorrinolaringologia num hospital terciário, por suspeita de disfunção vestibular, desde o ano de 2013 até 2017; Também se pretendeu comparar os resultados e realizar uma revisão da literatura acerca das etiologias mais frequentes, características diagnósticas e abordagem terapêutica. Material e Métodos: Foram analisados de forma retrospetiva os processos clínicos dos doentes observados na consulta de subespecialidade de Vertigem de Otorrinolaringologia com idades entre 0 e 18 anos. Foram excluídos os doentes com diagnóstico de otite média com efusão. Resultados: Cumpriam os critérios de inclusão 37 doentes, dos quais 59% eram do sexo feminino, sendo a idade média da primeira consulta de 10,9 anos. O motivo mais frequente de referenciação foi a vertigem rotatória. As náuseas e cefaleias foram também sintomas frequentemente descritos. Todos os doentes foram submetidos a audiometria tonal; a videonistagmografia foi realizada em 41% dos casos; exames de imagem foram realizados em 59% dos doentes. No que respeita às etiologias do quadro, as mais frequentes foram a enxaqueca vestibular e a vertigem paroxística benigna da infância (ambas em 27% dos casos), seguida da neuronite vestibular (em 22% dos casos). Discussão: Embora os resultados sejam, em parte, sobreponíveis à literatura, comparativamente a outros centros de referência a diversidade de motivos de referenciação e de patologias é menor, o que pode apontar para o subdiagnóstico da disfunção vestibular nesta faixa etária. Conclusão: A disfunção vestibular em idade pediátrica pode ter uma multiplicidade de etiologias, pelo que pediatras, neurologistas, fisiatras, médicos de família e otorrinolaringologistas devem estar alerta para as diversas formas de apresentação desta entidade. Deverão ser criados protocolos de referenciação e avaliação adequados para esta população.

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RESUMO Objetivo descrever, por meio de revisão da literatura, alterações auditivas e/ou vestibulares relacionadas ao uso em curto ou em longo prazo da mefloquina. Estratégia de pesquisa trata-se de uma revisão integrativa, realizada nas seguintes bases de dados: PubMed, Web of Science, SciELO, LILACS, Scopus, ScienceDirect, Cochrane Library, Embase, OpenGrey, DissOnline e OAlster. Critérios de seleção foram incluídos estudos com participantes a partir de 18 anos de idade, que fizeram uso de mefloquina e que foram submetidos à avaliação auditiva e/ou questionário referente à função auditiva e vestibular. Foram excluídas revisões de literatura, capítulos de livros e estudos que utilizaram a mefloquina combinada a outros medicamentos. Resultados foram identificados 1.267 estudos nas bases de dados utilizadas, sendo selecionados 28 artigos para leitura completa. Destes, 12 foram incluídos na revisão, de acordo com os critérios de elegibilidade. Quatro artigos apontaram a presença de alterações vestibulares e auditivas, 2 indicaram apenas alterações auditivas e 6 apenas desordens vestibulares. No que se refere às manifestações auditivas, zumbido e perda auditiva foram os sintomas mais frequentes. Vertigem/tontura e desequilíbrio corresponderam às alterações vestibulares comumente apresentadas. Conclusão manifestações auditivas e vestibulares foram referidas em curto e longo prazo, após o tratamento com a droga. A descontinuação de seu uso possibilitou a reversão das manifestações, porém, em alguns casos, foi observada a permanência das afecções. Considera-se importante a realização de acompanhamento audiológico e vestibular durante a ingestão da mefloquina, visto o seu perfil de toxicidade e possíveis manifestações colaterais de caráter auditivo e vestibular.

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Introduction: vestibular disorders can be associated with changes such as vertigo, imbalances, dizziness and labyrinthitis. Vestibular rehabilitation has been described as an effective treatment for patients with vertigo due to vestibular disorders. Objectives: systematically review studies on the effects of vestibular rehabilitation on postural balance in the elderly with vestibular disorders. Methods: systematic review, outlined by PRISMA, carried out on the bases: PUBMED, EBSCO, LILACS, MEDLINE, VHL Portal, and SciELO. Search conducted between August and October 2020, using the keywords: "Rehabilitation", "Vestibular Diseases", "Postural Balance" and Aged. Included: randomized controlled trials that have evaluated the effects of vestibular rehabilitation in elderly people with postural instability. Such studies should be available in full. There were no restrictions on the language and time of publication of the studies. Methodological quality was assessed using the PEDro scale. Results: searches identified 162 articles, however, after analysis 2 were included. The studies were published between 2016 and 2018. The sample had a total of 188 individuals of both sexes, more than 75% women, who had vestibular disorders. Based on the studies, the interventions lasted from 5 to 50 minutes, from 1 to 2 times a day, from 2 weeks to 2 months. The findings indicate that VR improves balance and reduces the number of falls. The studies showed high methodological quality. Conclusions: individuals who underwent vestibular rehabilitation, had progress in the postural balance of the elderly, consequently reducing the risk of falls. research proposed for this population. [ABSTRACT FROM AUTHOR]

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Copyright of Fisioterapia Brasil is the property of Atlantica Editora 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.)

ABSTRACT INTRODUCTION: Some patients with severe impairment of body balance do not obtain adequate improvement from vestibular rehabilitation (VR). OBJECTIVE: To evaluate the effectiveness of Vertiguard(tm) biofeedback equipment as a sensory substitution (SS) of the vestibular system in patients who did not obtain sufficient improvement from VR. METHODS: This was a randomized prospective clinical study. Thirteen patients without satisfactory response to conventional VR were randomized into a study group (SG), which received the vibrotactile stimulus from Vertiguard(tm) for ten days, and a control group (CG), which used equipment without the stimulus. For pre- and post-treatment assessment, the Sensory Organization Test (SOT) protocol of the Computerized Dynamic Posturography (CDP) and two scales of balance self-perception, Activities-specific Balance Confidence (ABC) and Dizziness Handicap Inventory (DHI), were used. RESULTS: After treatment, only the SG showed statistically significant improvement in C5 (p = 0.007) and C6 (p = 0.01). On the ABC scale, there was a significant difference in the SG (p= 0.04). The DHI showed a significant difference in CG and SG with regard to the physical aspect, and only in the SG for the functional aspect (p = 0.04). CONCLUSION: The present findings show that sensory substitution using the vibrotactile stimulus of the Vertiguard(tm) system helped with the integration of neural networks involved in maintaining posture, improving the strategies used in the recovery of body balance.

Resumo: OBJETIVO: aferir a prevalência de vestibulopatia e seus fatores associadosem idosos institucionalizados por meio do exame clínico de cabeceira. MÉTODOS: trata-se de um estudo transversal realizado nas 12 Instituições de longa permanência para idosos de Natal-Brasil, regulamentadas pela Vigilância Sanitária. Foram eleitos os idosos com bom nível cognitivo e capazes de deambular, totalizando 115 indivíduos. Os idosos foram questionados sobre a presença de tontura no último ano, e quando a resposta era positiva, eram submetidos a questionário e exame físico específico para diagnóstico de vestibulopatia, segundo o protocolo de Johnson e Lalwani (2004). Para a análise estatística, utilizou-se o teste do Qui-quadrado ou exato de Fisher para um nível de significância de 5% e cálculo da razão de prevalência. RESULTADOS: a prevalência de vestibulopatia foi de 10,56%e foram associados a osteoartrose e o etilismo. CONCLUSÃO: a vestibulopatia apresenta baixa prevalência nos idosos institucionalizados de Natal-Brasil.

INTRODUCTION: Children with sensorineural hearing loss can present with instabilities in postural control, possibly as a consequence of hypoactivity of their vestibular system due to internal ear injury.OBJECTIVE: To assess postural control stability in students with normal hearing (i.e., listeners) and with sensorineural hearing loss, and to compare data between groups, considering gender and age.METHODS: This cross-sectional study evaluated the postural control of 96 students, 48 listeners and 48 with sensorineural hearing loss, aged between 7 and 18 years, of both genders, through the Balance Error Scoring Systems scale. This tool assesses postural control in two sensory conditions: stable surface and unstable surface. For statistical data analysis between groups, the Wilcoxon test for paired samples was used.RESULTS: Students with hearing loss showed more instability in postural control than those with normal hearing, with significant differences between groups (stable surface, unstable surface) (p < 0.001).CONCLUSIONS: Students with sensorineural hearing loss showed greater instability in the postural control compared to normal hearing students of the same gender and age.

Introduction: With aging, the sensory systems suffer an accumulation of degenerative, infectious and/or traumatic processes that may hinder the body balance maintenance. Objective: To assess the influence of sensory information on static body balance of elderly individuals with vestibular disorders. Methods: Cross-sectional study of elderly individuals with vestibular disorders. The Clinical Test of Sensory Interaction and Balance and posturography integrated with virtual reality (Balance Rehabilitation UnitTM) were used. Posturography parameters analyzed included center of pressure and velocity of body sway. Results: 123 individuals with mean age of 73.11 were assessed. Worst performance was observed in the Clinical Test of Sensory Interaction and Balance condition of visual dome-unstable surface. Differences between conditions were: firm surface-open eyes/firm surface-closed eyes, unstable surface-open eyes/unstable surface-closed eyes (p < 0.001), and unstable surface-closed eyes/unstable surface-visual dome. Considering center of pressure and velocity of body sway, significant differences were observed between the following conditions: firm surface-open eyes/firm surface-closed eyes: firm surface-saccadic stimulus/firm surfacevertical optokinetic stimulus; firm surface-optokinetic stimuli/firm surface-visual-vestibular interaction; and firm surface-visual-vestibular interaction/unstable surface. Worse performances were observed in conditions firm surface-closed eyes, firm surface-vertical optokinetic stimulus, F-visual-vestibular interaction, and unstable surface-closed eyes. There was a difference in the center of pressure between firm surface-closed eyes/firm surface-saccadic stimulus, with a worse performance in the condition of firm surface-closed eyes, and of velocity of body sway, between firm surface-saccadic stimulus/firm surface-horizontal optokinetic stimulus (p < 0.001). Conclusion: Static body balance in elderly individuals with vestibular disorders is worse when the sensory conditions are more challenging, i.e. stable and unstable surfaces, visual stimuli, such as optokinetic and visual-vestibular interaction, and with the eyes closed.

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INTRODUCTION: Patients with vestibular hypofunction, a typical finding in peripheral vestibular disorders, show body balance alterations. OBJECTIVE: To evaluate the postural control of patients with vertigo and unilateral vestibular hypofunction. METHOD: This is a clinical cross-sectional study. Twenty-five patients with vertigo and unilateral vestibular hypofunction and a homogeneous control group consisting of 32 healthy individuals were submitted to a neurotological evaluation including the Tetrax Interactive Balance System posturography in eight different sensory conditions. RESULTS: For different positions, vertiginous patients with unilateral vestibular hypofunction showed significantly higher values of general stability index, weight distribution index, right/left and tool/heel synchronizations, Fourier transformation index and fall index than controls. CONCLUSION: Increased values in the indices of weight distribution, right/left and tool/heel synchronizations, Fourier transformation and fall risk characterize the impairment of postural control in patients with vertigo and unilateral vestibular hypofunction.

Introduction: Vertigo is one of the most important known neurological symptoms, and is able to limit the subject's functions and impact his quality of life. There are many alternative treatments for this kind of dysfunction, for example, the techniques of Traditional Chinese Medicine. This study aims to conduct a literature review on these techniques, verifying their effectiveness in solving vertigo occurrences. Methodology: This is a literature review study that aimed to analyze articles published between 2005 and 2015, found in major scientific databases (Virtual Health Library, Physiotherapy Evidence Database, Bireme, Medline, Capes, SciELO and Google Scholar). Results: Were found eleven articles about techniques of traditional Chinese medicine in the treatment of vertigo. Of these, nine publications were selected according to this study's inclusion and exclusion criteria. Conclusion: The techniques used by traditional Chinese medicine can contribute to the improvement of vertigo and associated symptoms; however, further research in the area is still needed. [ABSTRACT FROM AUTHOR]

This article discusses the influence of the intensity and chronicity of vestibular complaints on the quality of life of individuals with vestibular dysfunction. The study was conducted with 100 participants, the majority of whom were women, with a median age of 42 years. Scales were used to assess the intensity of dizziness and its impact on quality of life. The results showed that individuals with higher intensity and chronicity of dizziness had higher scores on the Dizziness Handicap Inventory, indicating a more pronounced impact on quality of life. [Extracted from the article]

This article summarizes a study presented at the VII Brazilian Congress of Neurofunctional Physiotherapy on vestibular migraine and its impact on quality of life. Vestibular migraine is characterized by intense and prolonged dizziness, imbalance, and sensitivity to visual, auditory, and/or olfactory stimuli. The objective of the study was to evaluate the impact of dizziness on the quality of life of individuals with isolated vestibular migraine and those associated with peripheral vestibular disorders compared to other vestibular disorders. The results showed that individuals with vestibular migraine associated with peripheral vestibular disorders have a greater impact on quality of life compared to those with isolated vestibular migraine and other vestibular disorders. [Extracted from the article]

A Vestibular Disorders Activities of Daily Living Scale (VADL) avalia o impacto da tontura e desequilíbrio corporal nas atividades cotidianas de indivíduos vestibulopatas. A escala contempla 28 atividades divididas em três dimensões (funcional, locomoção e instrumental). OBJETIVO: Traduzir, adaptar transculturamente e verificar a confiabilidade da VADL para o português do Brasil. MÉTODO: Pesquisa metodológica de tradução de questionário. Foram recrutados 80 idosos (> 65 anos) com tontura crônica de origem vestibular, dos quais 40 participaram do pré-teste e 40 da análise de confiabilidade. A confiabilidade foi testada pelo Coeficiente de Correlação de Concordância (CCC) e a consistência interna pelo Alfa de Cronbach (α). RESULTADOS: No pré-teste, houve 15% de incompreensão em duas atividades da versão brasileira da VADL, sendo necessária adaptação desses itens. A VADL-Brasil apresentou valor semelhante de confiabilidade intra e inter-examinadores para o escore total com concordância substancial (CCC = 0,79). A consistência interna apresentou valor excelente para o escore total (α = 0,92), bom para as dimensões funcional (α = 0,89) e locomoção (α = 0,86), e fraco para a instrumental (α = 0,56). CONCLUSÃO: A versão brasileira da VADL mostrou-se adequada, com boa confiabilidade e consistência interna, sendo, assim, uma alternativa para avaliar a capacidade funcional de vestibulopatas.The Vestibular Disorders Activities of Daily Living Scale (VADL) assesses the impact of dizziness and body imbalance on the everyday activities of patients with vestibulopathy. The scale encompasses 28 activities divided into three sub-scales (functional, ambulation and instrumental). OBJECTIVE: To translate and cross-culturally adapt the VADL to the Brazilian Portuguese language and verify its reliability. METHOD: Questionnaire translation methodological research. Eighty elderly subjects (age > 65 years) with chronic dizziness arising from vestibular disorders were enrolled, of which 40 participated in the pre-testing stage and 40 in reliability analysis. Concordance Correlation Coefficient (CCC) analysis was used to assess reliability. Internal consistency was estimated using Cronbach's alpha (α). RESULTS: Pre-test analysis revealed 15% of incomprehension on two activities; these items had to be adapted. The VADL-Brazil had similar levels of test-retest and inter-rater reliability for total score and presented substantial agreement (CCC = 0.79). Internal consistency was excellent for total score (α = 0.92), good for the functional (α = 0.89) and locomotion (α = 0.86) sub-scales, and poor for the instrumental subscale (α = 0.56). CONCLUSION: The Brazilian version of the VADL was proven adequate, with good levels of reliability and internal consistency. It might be thus considered as an alternative to assess the functional capacity of vestibulopathy patients.

A Vertigem Posicional Paroxística Benigna (VPPB) apresenta grande prevalência na população geriátrica, desencadeando alterações no equilíbrio corporal. OBJETIVO: Comparar os resultados obtidos na posturografia estática em idosos antes e após as manobras de reposição otolítica e após um intervalo de 12 meses do tratamento inicial. Tipo de estudo: longitudinal, descritivo, analítico. MÉTODO: Pacientes de ambos os gêneros, com diagnóstico clínico de VPPB, foram submetidos à posturografia estática por meio da Balance Rehabilitation Unit em 10 condições sensoriais em três momentos: pré e pós-MRO e após 12 meses do tratamento. RESULTADOS: Foram avaliados 23 idosos com média etária de 68,74 anos. A posturografia revelou que o limite de estabilidade não apresentou diferença significante quando comparado nos três momentos de avaliação (p = 0,405). O centro de pressão (CoP) apresentou alteração significativa na condição 2 (superfície firme e olhos fechados), pois o CoP no momento pós manobra de reposicionamento diferiu significativamente dos momentos pré e pós 12 meses do tratamento (p = 0,003). Os valores da velocidade de oscilação corporal (VOC) demonstraram diferença significante em seis condições sensoriais nos três momentos avaliados. CONCLUSÃO: A posturografia estática após 12 meses do tratamento para VPPB apresentou as alterações do equilíbrio corporal semelhantes ao momento pré-tratamento.Benign Paroxysmal Positional Vertigo is highly prevalent in the elderly population, triggering major changes in body balance. OBJECTIVE: To compare the results obtained from static posturography in the elderly before and after otoliths repositioning maneuvers and 12 months after treatment onset. Design: longitudinal, descriptive and analytical study. METHOD: Elderly patients with clinical diagnosis of BPPV submitted to Balance Rehabilitation Unit static posturography in 10 sensory conditions at three time intervals: before and after the repositioning maneuver and12 months after the treatment RESULTS: We studied 23 subjects with a mean age of 68.74 years. Posturography revealed that the stability limit was not significantly different when the three time intervals were compared (p = 0.405). The center of pressure (CoP) showed a significant change in condition 2 (stable surface and closed eyes), because after the repositioning maneuver, the CoP significantly differed vis-à-vis the results before and 12 months after the treatment (p = 0.003). The values of body velocity sway (BVS) were significantly different in six sensory conditions in these three time intervals. CONCLUSION: 12 months after the treatment for BPPV, the static posturography showed balance abnormalities similar to those found before treatment.

Idosos com disfunção vestibular crônica podem apresentar alteração do equilíbrio corporal e disfunção cognitiva. OBJETIVO: Avaliar a relação entre o processamento cognitivo e o equilíbrio corporal de idosos com vestibulopatia periférica crônica. Forma de Estudo: Transversal. MATERIAL E MÉTODO: O estudo incluiu 76 pacientes (> 60 anos), com disfunção vestibular periférica crônica, com queixa de tontura há mais de três meses. Os testes utilizados para investigar o equilíbrio corporal foram: Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Timed Up and Go Test (TUGT) e Timed Up Go Test modificado (TUGTm) e para a avaliação cognitiva utilizou-se Mini Exame do Estado Mental (MEEM), Teste do Relógio (TR) e Teste de Fluência Verbal (FV). RESULTADOS: A média etária dos pacientes foi de 69,03 anos (DP=6,21 anos), sendo a maioria feminina (82,9%). Observou-se correlação negativa significante entre o MEEM e TUGT (ρ=-0,312; p=0,01), MEEM e TUGTm (ρ=-0,306; p=0,01), FV e TUGT (ρ=-0,346; p=0,01) e FV e TUGTm (ρ=-0,536; p=0,01); e correlação positiva significante entre TR e BBS (ρ=0,343; p=0,01), TR e DGI (ρ=0,298; p=0,01), FV e BBS (ρ=0,299; p=0,01), e FV e DGI (ρ=0,306; p=0,01). CONCLUSÃO: Idosos com vestibulopatia periférica crônica com pior desempenho no equilíbrio corporal funcional apresentam prejuízo nas habilidades cognitivas.Abnormal body balance and cognitive dysfunction may develop in elderly patients with chronic vestibular dysfunction. AIM: To evaluate the relationship between cognitive processing and body balance in elderly patients with chronic peripheral vestibular disease. Type of Study: Cross-sectional. METHODS: Seventy-six patients (> 60 years) with chronic peripheral vestibular dysfunction and dizziness for more than three months were enrolled. The tests for investigating body balance were: the Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Timed Up and Go Test (TUGT) Timed Up and Go Test modified (TUGTm); the Mini Mental State Examination (MMSE), Test Clock (RT,) and Verbal Fluency Test (VF) were applied for assessing cognition. RESULTS: The mean age was 69.03 years (SD=6.21 years); most were female (82.9%). There was a significant negative correlation between the MMSE and the TUGT (ρ=-0.312; p=0.01), MMSE and TUGTm (ρ=-0.306; p=0.01), FV and TUGT (ρ=-0.346; p=0.01), and FV and TUGTm (ρ=-0.536; p=0.01); there was a significant positive correlation between the TR and BBS (ρ=0.343; p=0.01), TR and DGI (ρ=0.298; p=0.01), FV and BBS (ρ=0.299; p=0.01), and FV and DGI (ρ=0.306; p=0.01). CONCLUSION: Elderly patients with chronic peripheral vestibular disease and worse performance in body balance tests have functional impairment in cognitive skills.

OBJETIVO: Avaliar o equilíbrio corporal e quantificar possíveis alterações na posturografia estática do Balance Rehabilitation Unit (BRU TM) em pacientes com disfunção vestibular. MÉTODOS: Estudo retrospectivo, com prontuários de 100 pacientes com topodiagnóstico de disfunção vestibular periférica ou central e 100 indivíduos hígidos compondo o Grupo Controle, de ambos os gêneros, entre 7 a 86 anos. Para a posturografia foi utilizado o equipamento Balance Rehabilitation Unit (BRU TM), da Medicaa®. Foram analisados os parâmetros limite de estabilidade, área de elipse e velocidade de oscilação em dez condições sensoriais. RESULTADOS: A média dos valores do limite de estabilidade, da área de elipse e da velocidade de oscilação do Grupo Experimental foi significativa em relação ao Grupo Controle em todas as condições. A média dos parâmetros do gênero feminino do Grupo Experimental foi significativa em relação ao do Grupo Controle em todas as condições avaliadas. Os pacientes com disfunção vestibular central obtiveram maiores valores que os pacientes com disfunção vestibular periférica nas variáveis área de elipse e velocidade de oscilação, porém menor valor da área do limite de estabilidade. CONCLUSÃO: A posturografia com estímulos de realidade virtual foi um método de avaliação eficaz para detectar alterações relacionadas às variáveis limite de estabilidade, área de elipse e velocidade de oscilação, uma vez que o Grupo Controle obteve melhor desempenho, tanto entre os grupos quanto entre os gêneros. Entre as disfunções vestibulares, os indivíduos com acometimento periférico obtiveram melhor desempenho do que os indivíduos com disfunção vestibular central em todas as variáveis analisadas na posturografia.PURPOSE: To assess body balance and to quantify possible alterations over the static posturography of the Balance Rehabilitation Unit (BRU TM) in patients with vestibular dysfunction. METHODS: Retrospective study, with files of 100 patients with topographic diagnosis of peripheral or central vestibular dysfunction and 100 healthy individuals that composed the control group, of both genders, with ages varying between 7 and 86 years. For the posturography, the Balance Rehabilitation Unit (BRU TM), of Medicaa® was used. The following parameters were analyzed: stability limits, elliptical area, and speed of oscillation in ten sensory conditions. RESULTS: Mean values ​​of the stability limit, the elliptical area and the speed of oscillation in the experimental group was significant when compared to the control group in all conditions. The mean parameters of the female experimental group were significant when compared to the control group in all conditions. Patients with central vestibular dysfunction obtained higher values than patients with peripheral vestibular dysfunction in the variables elliptical area and speed of oscillation, however with lower value of the area of the stability limit. CONCLUSION: Posturography with virtual reality stimuli was an effective assessment method for detecting alterations related to the variables stability limits, elliptical area, and speed of oscillation, since the control group performed better, both between groups and between genders. Among the vestibular dysfunctions, individuals with peripheral condition performed better than those with central vestibular dysfunction in all the variables analyzed on posturography.

As doenças vestibulares são frequentes na população idosa, resultando, principalmente, em tontura e desequilíbrio corporal, sintomas que podem prejudicar as atividades de vida diária. OBJETIVO: Estudar a correlação entre equilíbrio corporal e a capacidade funcional e a comparação entre risco de queda, ocorrência de queda e a capacidade funcional de idosos com disfunções vestibulares crônicas. MATERIAL E MÉTODO: Forma de estudo transversal, clínico e experimental com 50 idosos, de 60 a 86 anos, com vestibulopatias periféricas crônicas. Estes idosos foram submetidos à avaliação do equilíbrio por meio do Dynamic Gait Index (DGI) e à avaliação da capacidade funcional, por meio da Medida de Independência Funcional (MIF). Os dados obtidos foram submetidos ao teste de correlação de Spearman e aos de comparação de Mann-Whitney e Kruskal-Wallis, sendo considerado α=5% (0,05). RESULTADOS: Verificou-se correlação positiva entre o escore total do DGI e todas as pontuações da MIF, especialmente a MIF total (r=0,447; pVestibular disorders are common among the elderly, mainly resulting in dizziness and imbalance - symptoms which can impact daily routine activities. AIM: To study the correlation between body balance and functional capacity and a comparison of risk of falls, actual falls and the functional capacity of the elderly with chronic vestibular dysfunctions. MATERIALS AND METHODS: A cross-sectional, clinical and experimental study with 50 senior citizens - 60 to 86 years, with chronic peripheral vestibular dysfunction. These participants underwent body balance assessment by the Dynamic Gait Index (DGI) and functional capacity assessment by the Functional Independence Measure (FIM). The data was tested using the Spearman correlation and comparison tests, Mann-Whitney and Kruskal- Wallis, being α=5% (0.05). RESULTS: There was a significant correlation between the total DGI score and all FIM scores, especially the total score (r=0.447; p

Knowledge of the anatomy and physiology of the semicircular canals and their central pathways is essential for the diagnosis of vestibular pathology. This 3 dimensional (3D) scheme of the Semicircular Canals (SSCC) is a teaching tool and a useful reference guide for rapid consultation. MATERIAL AND METHODS: A multicolored cardboard model is accompanied by a user manual which provides a thorough description of the tool for the most common vestibular diseases. RESULTS: Although results cannot be quantitatively assessed, the model has been well received at several Latin American scientific conferences. The model is often understood with verbal instruction only; nevertheless, a printed user manual is included. CONCLUSIONS: This 3 dimensional (3D) model of the Semicircular Canals (SSCC) is a practical, low cost tool for use in private and academic settings.A identificação de determinadas afecções vestibulares exige conhecimento prévio sobre anatomia e fisiologia dos canais semicirculares (CSC) e de suas conexões centrais, que apresentam complexidade anatômica tridimensional e funcional. OBJETIVO: Propor um modelo anatômico e funcional dos CSC, em 3 dimensões (3D), para servir como uma ferramenta didática e um guia útil de consulta rápida. MATERIAL E MÉTODOS: O modelo é projetado em cartão, com impressão em cores diferentes, acompanhados de um texto explicativo de 22 folhas, que detalha sua descrição topográfica, descritiva e sua utilização com base em exemplos das doenças vestibulares mais frequentes. RESULTADOS: Embora os resultados não possam ser avaliados numericamente, este modelo já foi compreendido por diversos especialistas e tem sido bastante utilizado por eles. Além disso, o produto deste trabalho já foi apresentado em diferentes eventos científicos latino-americanos com excelente aceitação. CONCLUSÃO: Trata-se de ferramenta útil e de baixo custo para o ensino, a prática clínica diária em otoneurologia.

A vertigem produz impactos significativos na qualidade de vida (QV). É necessário mensurar os efeitos das terapêuticas antivertiginosas na QV. OBJETIVO: Investigar o efeito da manobra de reposicionamento na qualidade de vida de pacientes com vertigem posicional paroxística benigna (VPPB). MATERIAL E MÉTODOS: Estudo retrospectivo, através da revisão dos prontuários de 21 pacientes com VPPB atendidos no serviço de Reabilitação Vestibular (RV) de uma clínica escola de Belo Horizonte atendidos em 2007-2008. Foram analisados os escores físicos, funcionais e emocionais, pré e pós-terapia de RV com realização de manobras de reposicionamento de Epley, por meio do questionário Dizziness Handicap Inventory (DHI), específico para avaliação da interferência da tontura na QV. RESULTADOS: O intervalo mediano entre as avaliações foi de 21 dias. O número médio de manobras foi 2,3±1,1. A aplicação do DHI mostrou um significante impacto da VPPB na QV dos pacientes em todas as dimensões da vida diária, com os seguintes escores médios pré e pós-terapia: físico (17,5/3,7), funcional (17,3/3,9), emocional (13,2/3,2) e total (48,1/10,9), respectivamente (pQuality of life (QoL) is significantly impaired by vertigo. The effect of specific treatments on QoL deserves investigation. AIM: To assess the effect of repositioning maneuvers on the QoL of benign paroxysmal positioning vertigo (BPPV) patients. MATERIALS AND METHODS: A retrospective study design consiting of reviews of charts of BPPV patients in a vestibular rehabilitation unit at a teaching institution in Belo Horizonte, MG, Brazil, from 2007 to 2008. Pre- and post-therapy (Epley's repositioning maneuver) scores on the physical, functional and emotional dimensions of the Dizziness Handicap Inventory (DHI) were analyzed. RESULTS: Twenty-one patients were included, eighteen (86%) were females; the average age was 53.2 years. Ten patients presented bilateral BPPV; in eleven it was unilateral. The mean interval between assessments (pre- and post-treatment) was 21 days. The average number of required maneuvers was 2.3 (±1.1). Pre-treatment DHI results showed a significant impact of BPPV on quality of life. Initial scores for physical (17.5), functional (17.3), emotional (13.2) dimensions decreased with therapy: respectively 3.7, 3.9, and 3.2 (p

Tontura é muito frequente em idosos. OBJETIVOS: Avaliar a qualidade de vida (QV) em idosos vestibulopatas e relacioná-la com o gênero e a faixa etária. MATERIAL E MÉTODO: Estudo prospectivo que incluiu série de 120 casos de idosos com tontura que foram avaliados por meio das versões brasileiras dos questionários Whoqol-bref e Dizziness Handicap Inventory (DHI). Os resultados obtidos foram submetidos à Análise Fatorial (AF) e aos testes de Mann Whitney, Kruskal Wallis e correlação de Spearman. RESULTADOS: O domínio físico avaliado pelo DHI, e o físico e o ambiental do Whoqol-bref foram os mais comprometidos. A AF resultou em 3 fatores no DHI e 5 no Whoqol-bref: Houve moderada correlação (-0,596) entre o escore total de ambos os instrumentos. Os homens apresentaram melhor QV nos fatores "percepção ambiental e introspectividade" e "percepção da saúde" do Whoqol-bref. As idosas obtiveram melhor QV no fator "percepção da funcionalidade" do Whoqol-bref. Não houve diferenças significantes entre os fatores dos dois instrumentos por faixa etária. CONCLUSÕES: Idosos vestibulopatas apresentam QV prejudicada. As idosas vestibulopatas apresentam pior QV em relação aos fatores "percepção ambiental e introspectividade" e "percepção da saúde" e melhor QV em relação ao fator "percepção da funcionalidade" que os homens.Dizziness is frequent in elderly people. AIMS: To evaluate the Quality of Life (QoL) in elderly subjects with dizziness, relate it with gender and age. MATERIAL AND METHOD: A prospective study comprising 120 elderly patients with dizziness evaluated with Brazilian versions of the Whoqol-bref and the dizziness handicap inventory (DHI). The factor analysis (FA), the Mann Whitney and Kruskal Wallis tests, and the Spearman correlation were applied to study the results. RESULTS: The most compromised domains were the DHI physical domain and the Whoqol-bref physical and environment domains. FA resulted in 3 factors in the DHI and 5 factors in the Whoqol-bref. There was a moderate correlation (-0.596) in the total scores of both instruments. Males had a better QoL in the "environment perception and introspectivity" and "health perception" factors of the Whoqol-bref test. Females had a better QoL in the "functionality perception" factor of the Whoqol-bref test. There were no significant age differences. CONCLUSIONS: Elderly patients with dizziness have a worse QoL. Elderly females with dizziness have worse QoL scores in "environment perception and introspectivity" and "health perception" and better QoL in the "functionality perception" factor compared to elderly males.

OBJECTIVE: To compare the academic performance of university students with or without neurotological symptoms. METHOD: 100 students enrolled in the Biomedical Sciences Graduate School - Medical Modality of UNIFESP-EPM in 2007 and answered a neurotological screening questionnaire. RESULTS: The symptoms presented once, sometimes, many times or always, in a decreasing order of prevalence, were headache (74.0%), difficulty with concentration (57.0%), lack of memory (45.0%), physical indisposition, nausea /dizziness when in moving vehicle (37.0%), fainting (27.0%), nausea (26.0%), sensation of fullness in the ear (26.0%), hypersensitivity to sounds (26.0%), tinnitus (22.0%), vertigo and other kinds of dizziness (21.0%), imbalance when walking (21.0%), difficulty in hearing (21.0%), imminent sensation of fainting (11.0%) and vomiting (8.0%), alone or in different associations; convulsion was not mentioned. The final academic performance score ranged from 5.1 to 10.0. CONCLUSION: University students with or without neurotological symptoms have manifested similar academic performance.OBJETIVO: Comparar o rendimento escolar de universitários com e sem sintomas otoneurológicos. MÉTODO: Cem alunos matriculados e ativos no Curso de Graduação em Ciências Biomédicas - Modalidade Médica da UNIFESP-EPM em 2007 responderam um questionário de triagem otoneurológica. RESULTADOS: Os sintomas presentes uma vez, algumas vezes, muitas vezes ou sempre, em ordem decrescente de prevalência, foram: dor de cabeça (74,0%), dificuldade de concentração (57,0%), dificuldade de memória (45,0%), mal-estar/enjôo/tontura em veículos em movimento (37,0%), desmaio (27,0%), enjôo (26,0%), sensação de ouvido tapado (26,0%), hipersensibilidade a sons (26,0%), zumbido (22,0%), vertigem ou outros tipos de tontura (21,0%), desequilíbrio ao andar (21,0%), dificuldade para ouvir (21,0%), sensação de desmaio iminente (11,0%) e vômito (8,0%), isoladamente ou em diferentes combinações; convulsão não foi referida. As notas da avaliação final dos alunos foram variáveis entre 5,1 e 10,0. CONCLUSÃO: Estudantes universitários com ou sem sintomas otoneurológicos apresentaram rendimento escolar semelhante.

Benign paroxysmal positional vertigo (BPPV) is one of the most common vestibular disorders. AIM: To study the recurrence and persistence of BPPV in patients treated with canalith repositioning maneuvers (CRM) during the period of one year. STUDY DESIGN: longitudinal contemporary cohort series. MATERIALS AND METHODS: One hundred patients with BPPV were followed up during 12 months after a treatment with CRM. Patients were classified according to disease evolution. Aquatic physiotherapy for vestibular rehabilitation (APVR) protocol was applied in cases of persistent BPPV. RESULTS: After CRM, 96% of the patients were free from BPPV's typical nystagmus and dizziness. During the follow up period of 1 year, 26 patients returned with typical BPPV nystagmus and vertigo. Nystagmus and vertigo were persistent in 4% of the patients. Persistent BPPV presented improvement when submitted to APVR. Conclusion: During the period of one year, BPPV was not recurrent in 70% of the patients, recurrent in 26% and persistent in 4%.A vertigem posicional paroxística benigna (VPPB) é das vestibulopatias mais comuns. OBJETIVO: Verificar a recorrência e a persistência da VPPB no período de um ano em pacientes que foram tratados com manobras de reposicionamento de estatocônios (MRE). FORMA DE ESTUDO: coorte contemporânea longitudinal. MATERIAL E MÉTODO: Cem pacientes com VPPB foram acompanhados durante 12 meses após o tratamento com MRE. Os pacientes foram classificados de acordo com a evolução da doença no período de um ano. O protocolo de fisioterapia aquática para reabilitação vestibular (FARV) foi aplicado nos pacientes com VPPB persistente. RESULTADOS: Após as MRE, 96% dos pacientes aboliram o nistagmo e a vertigem de posicionamento. Destes pacientes, 26 apresentaram recorrência da VPPB, no período de um ano. Em 4% dos pacientes, a VPPB foi persistente. Os pacientes com VPPB persistente apresentaram melhora clínica após a realização da FARV. CONCLUSÃO: No período de um ano, a VPPB foi não recorrente em 70% dos pacientes, recorrente em 26% e persistente em 4%.

OBJETIVO: Verificar a efetividade dos exercícios de reabilitação vestibular na melhora do zumbido e da tontura por meio de avaliação pré e pós-aplicação do questionário Dizziness Handicap Inventory (DHI) e Tinnitus Handicap Inventory (THI), ambos adaptados à população brasileira. MÉTODOS: Avaliaram-se seis pacientes (dois do sexo masculino e quatro do sexo feminino), na faixa etária de 43 a 70 anos. Os pacientes foram submetidos aos seguintes procedimentos: anamnese, inspeção otológica, avaliação vestibular por meio da vectoeletronistagmografia e aplicação dos questionários pré e pós-reabilitação vestibular, utilizando-se o protocolo de Cawthorne e Cooksey. RESULTADOS: a) com relação às queixas mais referidas, observou-se desequilíbrio à marcha (83,3%), dor de cabeça (66,6%) e depressão (66,6%); b) no exame vestibular todos os pacientes apresentaram alteração na prova calórica, sendo a maior freqüência das síndromes vestibulares periféricas irritativas (83,3%); c) constataram-se no exame vestibular dois casos de síndrome vestibular periférica irritativa, dois casos de síndrome vestibular periférica irritativa unilateral; um caso de síndrome vestibular periférica irritativa bilateral e um caso de síndrome vestibular periférica deficitária unilateral; d) na aplicação do DHI, observou-se melhora nos aspectos: funcional e emocional, mantendo-se inalterado o aspecto físico; e) na aplicação do THI, observou-se melhora em todos os aspectos avaliados. CONCLUSÃO: O protocolo utilizado de reabilitação vestibular promoveu diminuição do zumbido e da tontura, melhorando a qualidade de vida dos pacientes.PURPOSE: To verify the effectiveness of vestibular rehabilitation exercises in the improvement of tinnitus and dizziness through an evaluation carried out before and after the administration of the Dizziness Handicap Inventory (DHI) and the Tinnitus Handicap Inventory (DHI) questionnaires, both adapted to the Brazilian population. METHODS: Six patients (two male and four female), with ages ranging from 43 to 70 years, were evaluated. The patients were submitted to the following procedures: anamnesis, otoscopy, vestibular evaluation through vectoelectronystagmography, and administration of the questionnaires, before and after vestibular rehabilitation, using the Cawthorne and Cooksey protocol. RESULTS: a) regarding the most related complaints, imbalance when walking (83,3%), headache (66,6%) and depression (66,6%), were observed; b) in the vestibular exam all the patients showed alterations in the caloric test, and the most frequent syndrome was the irritative peripheral vestibular (83,3%); c) two cases of irritative peripheral vestibular syndrome, two cases of irritative peripheral unilateral vestibular syndrome, one case of irritative peripheral bilateral vestibular syndrome and one case of peripheral deficient unilateral vestibular syndrome were verified in the vestibular exam; d) in the administration of the DHI, an improvement in the functional and emotional aspects were observed, with the physical aspect remaining unchanged; e) in the administration of the THI, an improvement was observed in all the aspects evaluated. CONCLUSION: The protocol of vestibular rehabilitation used in the study, promoted a decrease in tinnitus and dizziness, hence improving the quality of life of the patients.

OBJETIVO: Estudar os sintomas vestibulares em crianças com queixas de dificuldades escolares. MÉTODOS: Foram estudadas 88 crianças entre sete e 12 anos, que freqüentavam escolas públicas da cidade de Piracicaba no período de 2004 a 2006. Os procedimentos utilizados foram: a anamnese; exame otorrinolaringológico; exame audiológico e questionário dirigido utilizado como instrumento de coleta de dados. RESULTADOS: Das crianças avaliadas 51% não relataram dificuldades escolares e 49% referiram ter dificuldades escolares. A queixa referida mais comum foi a de vertigem (22,7%), e os sintomas referidos mais comuns no ambiente escolar foram de ansiedade (95,5%) e cefaléia (53,4%), as dificuldades escolares mais citadas foram a de ler (56,8%) e a de copiar (43,2%). CONCLUSÕES: A queixa de tontura e as dificuldades em ler e copiar apresentaram relação estatisticamente significante nas crianças com queixas de dificuldades escolares.PURPOSE: To study vestibular symptoms in children with complaints of school difficulties. METHODS: Eighty-eight children between seven and 12 years old were studied. The subjects attended public schools from Piracicaba - SP (Brazil) during the period from 2004 to 2006. The procedures included: anamnesis, otorhinolaryngological examination, audiological examination, and a directed questionnaire used as an instrument for data gathering. RESULTS: From the evaluated children, 51% had no complaints of school difficulties, and 49% reported school difficulties. The most common complaint reported was vertigo (22.7%), and the most common symptoms reported in school environment were anxiety (95.5%) and chronic headache (53.4%). The most cited school difficulties were reading (56.8%) and copying (43.2%). CONCLUSIONS: Vertigo complaints and reading and copying difficulties presented a statistically significant relation in children with complaints of school difficulties.

Population aging brings problems of public health, such as chronic degenerative diseases. The aim of this study was to describe Otoneurological findings in a pacient with Olivopontocerebellar Atrophy. The case report is about a 60 years old, female gender, with olivopontocerebellar degeneration. Audiometry results denoted normal thresholds, type "A" tympanometry with ipsilateral acoustic reflexes present bilaterally and contralateral acoustic reflexes bilaterally missing, transient evoked otoacoustic emissions and distortion product otoacoustic emissions were present bilaterally. Positioning nystagmus research at Dix Hallpike maneuver denoted absent nystagmus. Vecto-electronystagmography demonstrated deficient central vestibular syndrome on the right. Brainstem evoked auditory response, revealed absolute latencies increased in III and V waves, and interpeak latencies I-III and I-V increased in both ears. Otoneurological evaluation by vecto-electronystagmography and brainstem evoked auditory response, demonstrated to be very sensitive to justify the presence of significant clinical signs and symptoms of the disease, may be useful both to aid in the diagnosis and prognosis of these lesions. [ABSTRACT FROM AUTHOR]

Population aging brings problems of public health, such as chronic degenerative diseases. The aim of this study was to describe Otoneurological findings in a pacient with Olivopontocerebellar Atrophy. The case report is about a 60 years old, female gender, with olivopontocerebellar degeneration. Audiometry results denoted normal thresholds, type "A" tympanometry with ipsilateral acoustic reflexes present bilaterally and contralateral acoustic reflexes bilaterally missing, transient evoked otoacoustic emissions and distortion product otoacoustic emissions were present bilaterally. Positioning nystagmus research at Dix Hallpike maneuver denoted absent nystagmus. Vecto-electronystagmography demonstrated deficient central vestibular syndrome on the right. Brainstem evoked auditory response, revealed absolute latencies increased in III and V waves, and interpeak latencies I-III and I-V increased in both ears. Otoneurological evaluation by vecto-electronystagmography and brainstem evoked auditory response, demonstrated to be very sensitive to justify the presence of significant clinical signs and symptoms of the disease, may be useful both to aid in the diagnosis and prognosis of these lesions. [ABSTRACT FROM AUTHOR]

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Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva 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.)

Purpose: To assess body balance and to quantify possible alterations over the static posturography of the Balance Rehabilitation Unit (BRU™) in patients with vestibular dysfunction. Methods: Retrospective study, with files of 100 patients with topographic diagnosis of peripheral or central vestibular dysfunction and 100 healthy individuals that composed the control group, of both genders, with ages varying between 7 and 86 years. For the posturography, the Balance Rehabilitation Unit (BRU™), of Medicaa® was used. The following parameters were analyzed: stability limits, elliptical area, and speed of oscillation in ten sensory conditions. Results: Mean values of the stability limit, the elliptical area and the speed of oscillation in the experimental group was significant when compared to the control group in all conditions. The mean parameters of the female experimental group were significant when compared to the control group in all conditions. Patients with central vestibular dysfunction obtained higher values than patients with peripheral vestibular dysfunction in the variables elliptical area and speed of oscillation, however with lower value of the area of the stability limit. Conclusion: Posturography with virtual reality stimuli was an effective assessment method for detecting alterations related to the variables stability limits, elliptical area, and speed of oscillation, since the control group performed better, both between groups and between genders. Among the vestibular dysfunctions, individuals with peripheral condition performed better than those with central vestibular dysfunction in all the variables analyzed on posturography. [ABSTRACT FROM AUTHOR]

Objective: To summarize the results of clinical trials on vestibular rehabilitation (VR) in middle-aged and elderly people with vestibular disorders. Methods: A search for relevant trials was performed in the databases LILACS, EMBASE, MEDLINE, SciELO, Cochrane, ISI Web of Knowledge and virtual libraries of theses and dissertations. Randomized controlled trials published in the last 10 years and written in English, Portuguese or Spanish were included. The methodological quality of the studies was assessed by the PEDro scale. Results from the included studies were analyzed through a critical review of content. Results: Nine studies were included in the review. Four studies reported on participants aged over 40 years (middle-aged and elderly) and five studies consisted exclusively of elderly subjects (over 60 years). Findings of vestibular dysfunction were diverse and the most common complaints were body imbalance or postural instability (3 studies), and vertigo or dizziness (3 studies). The Visual Analogue Scale (VAS) was the most commonly used instrument to assess subjective perception of symptoms of vestibular dysfunction (4 studies). According to the PEDro scale, four studies were considered to be of good quality. The most common experimental intervention was the Cawthorne & Cooksey protocol (4 studies). For most outcome measures, the studies comparing VR with another type of intervention showed no differences between the groups after the therapy. Conclusions: The studies included in this review provide evidence for the positive effects of VR in elderly and middle-aged adults with vestibular disturbances. [ABSTRACT FROM AUTHOR]

Objectives: To investigate head and shoulder alignment among patients with unilateral vestibular hypofunction (UVH), using computerized biophotogrammetry (CB) and to correlate these measurements with gender, age, duration of clinical evolution, self-perception of intensity of dizziness and occurrences of falls. Methods: This was a cross-sectional study. Thirty individuals with UVH and 30 with normal vestibular function and without complaints of dizziness underwent CB in the anterior, right and left and posterior views, in an upright standing position. Alcimage™ 2.0 was used to evaluate three angles in order to verify the anterior deviation and inclination of the head, and the alignment of the shoulders. The groups were paired according to age, gender and height. The statistical analysis consisted of the Mann-Whitney test, Kruskal-Wallis test followed by the Dunn test, and the Spearman Correlation Coefficient. Results: The patients with UVH had greater forward (55.44±16.33) and lateral (2.03±1.37) head deviation angles than did the normal individuals (34.34±4.60 and 1.34±1.05 respectively), with a statistically significant difference (p<0.001). The increment of forward and lateral deviation in the UVH group was 38.05% and 33.78% respectively. Forward head was associated with the duration of clinical symptoms of the vestibular disease (p=0.003), age (p=0.006), intensity of dizziness (p<0.001) and occurrence of falls (p=0.002). Conclusions: Patients with UVH had greater forward and lateral head deviations. Forward head deviation increased with age, duration of clinical symptoms and greater self-perception of the intensity of dizziness. Forward head deviation was also greater among patients who reported having had falls. [ABSTRACT FROM AUTHOR]