scholarly journals Walking stability in patients with benign paroxysmal positional vertigo: an objective assessment using wearable accelerometers and machine learning

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Yuqian Zhang ◽  
He Wang ◽  
Yifei Yao ◽  
Jianren Liu ◽  
Xuhong Sun ◽  
...  
Keyword(s):  
Machine Learning ◽  
Benign Paroxysmal Positional Vertigo ◽  
Support Vector ◽  
Clinical Settings ◽  
Healthy Controls ◽  
Lower Trunk ◽  
Positional Vertigo ◽  
Wearable Accelerometers ◽  
Gait Disturbances ◽  
Paroxysmal Positional Vertigo

Abstract Background Benign paroxysmal positional vertigo (BPPV) is one of the most common peripheral vestibular disorders leading to balance difficulties and increased fall risks. This study aims to investigate the walking stability of BPPV patients in clinical settings and propose a machine-learning-based classification method for determining the severity of gait disturbances of BPPV. Methods Twenty-seven BPPV outpatients and twenty-seven healthy subjects completed level walking trials at self-preferred speed in clinical settings while wearing two accelerometers on the head and lower trunk, respectively. Temporo-spatial variables and six walking stability related variables [root mean square (RMS), harmonic ratio (HR), gait variability, step/stride regularity, and gait symmetry] derived from the acceleration signals were analyzed. A support vector machine model (SVM) based on the gait variables of BPPV patients were developed to differentiate patients from healthy controls and classify the handicapping effects of dizziness imposed by BPPV. Results The results showed that BPPV patients employed a conservative gait and significantly reduced walking stability compared to the healthy controls. Significant different mediolateral HR at the lower trunk and anteroposterior step regularity at the head were found in BPPV patients among mild, moderate, and severe DHI (dizziness handicap inventory) subgroups. SVM classification achieved promising accuracies with area under the curve (AUC) of 0.78, 0.83, 0.85 and 0.96 respectively for differentiating patients from healthy controls and classifying the three stages of DHI subgroups. Study results suggest that the proposed gait analysis that is based on the coupling of wearable accelerometers and machine learning provides an objective approach for assessing gait disturbances and handicapping effects of dizziness imposed by BPPV.

Walking Stability in Patients With Benign Paroxysmal Positional Vertigo: An Objective Assessment Using Wearable Accelerometers and Machine Learning

2020 ◽  
Author(s):  
Yuqian Zhang ◽  
He Wang ◽  
Yifei Yao ◽  
Jianren Liu ◽  
Xuhong Sun ◽  
...  
Keyword(s):  
Machine Learning ◽  
Benign Paroxysmal Positional Vertigo ◽  
Support Vector ◽  
Clinical Settings ◽  
Gait Symmetry ◽  
Lower Trunk ◽  
Positional Vertigo ◽  
Wearable Accelerometers ◽  
Gait Disturbances ◽  
Paroxysmal Positional Vertigo

Abstract Background: Benign paroxysmal positional vertigo (BPPV) is one of the most common peripheral vestibular disorders leading to balance difficulties and increased fall risks. This study aims to investigate the walking stability of BPPV patients in clinical settings and propose a machine-learning-based classification method for determining the severity of gait disturbances of BPPV. Methods: Twenty-seven BPPV outpatients and twenty-seven healthy subjects completed level walking trials at self-preferred speed in clinical settings while wearing one accelerometer on the head and one on the lower trunk. Temporo-spatial variables and six walking stability related variables (root mean square (RMS), harmonic ratio (HR), gait variability, step/stride regularity, and gait symmetry) derived from the acceleration signals were analyzed. A support vector machine model (SVM) based on the gait variables of BPPV patients were developed to classify the BPPV severity of gait disturbances. Results: The results showed that BPPV patients employed a conservative gait and significantly reduced walking stability compared to the healthy controls. Significant different mediolateral HR at the lower trunk and anteroposterior step regularity at the head were found in BPPV patients among mild, moderate, and severe DHI (dizziness handicap inventory) subgroups. SVM classification achieved promising accuracies with area under the curve (AUC) = 0.87, 0.80, and 0.95 respectively for classifying the three stages of DHI subgroups. Conclusions: Results suggested that the proposed gait analysis that is based on the coupling of wearable accelerometers and machine learning provides an objective approach for assessing gait disturbances and handicapping effects of dizziness imposed by BBPV.Trial registration: The trial was registered in the Chinese Clinical Trial Registry (http://www.chictr.org.cn) on March 29, 2018. Registration number: ChiCTR1800015432 (http://www.chictr.org.cn/showproj.aspx?proj=25587).

Canalith repositioning procedure improves gait and static balance in people with posterior semicircular canal benign paroxysmal positional vertigo

2020 ◽  
Vol 30 (5) ◽  
pp. 335-343
Author(s):  
Yafit Cohen-Shwartz ◽  
Yael Nechemya ◽  
Alon Kalron
Keyword(s):  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Signs And Symptoms ◽  
Healthy Controls ◽  
Posterior Semicircular Canal ◽  
Positional Vertigo ◽  
Balance Tests ◽  
Canalith Repositioning Procedure ◽  
The Impact ◽  
Paroxysmal Positional Vertigo

BACKGROUND: Investigations measuring gait tests have rarely been studied in the benign paroxysmal positional vertigo (BPPV) population. OBJECTIVE: Examine instrumented mobility metrics in people with posterior semicircular canal BPPV. We examined the impact of a canalith repositioning procedure (CRP), prior to and after treatment on instrumented mobility measures, comparing the scores to those of healthy controls. METHODS: At baseline, the subject performed a series of instrumented gait and balance tests and then, the CRP was performed. At re-evaluation (1-week later), identical gait and balance tests were assessed. In addition, the Hallpike-Dix test identified patients who had improved or had not improved in their BPPV signs and symptoms. RESULTS: Thirty-two people with BPPV (25 women) and 15 healthy subjects participated in the study. At baseline (pre-CRP), people with BPPV demonstrated an increased vestibular ratio, and walked more slowly compared with the healthy controls. The CRP resolved the vertigo in 90.6% of the BPPV subjects. Compared with the pre-CRP scores, the BPPV subjects demonstrated a decreased vestibular ratio and faster walking at the post-CRP evaluation. Out of the five parameters that were significantly different from the healthy values pre-CRP, only one remained different post-CRP. CONCLUSIONS: Besides vertigo and balance difficulties, people with BPPV demonstrate walking modifications. Furthermore, the CRP has a high success rate in improving not only vertigo but also in restoring gait and balance in persons with BPPV.

Clinical Implications of the Center of Balance for a Veteran with Traumatic Brain Injury

2015 ◽  
pp. 280-289
Keyword(s):  
Traumatic Brain Injury ◽  
Case Report ◽  
Brain Injury ◽  
Benign Paroxysmal Positional Vertigo ◽  
Medical Center ◽  
Treatment Plan ◽  
Successful Outcome ◽  
Model Case ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

Background: It is known that traumatic brain injury (TBI), even of the mild variety, can cause diffuse multisystem neurological damage. Coordination of sensory input from the visual, vestibular and somatosensory pathways is important to obtain proper balance and stabilization in the visual environment. This coordination of systems is potentially disrupted in TBI leading to visual symptoms and complaints of dizziness and imbalance. The Center of Balance (COB) at the Northport Veterans Affairs Medical Center (VAMC) is an interprofessional clinic specifically designed for patients with such complaints. An evaluation entails examination by an optometrist, audiologist and physical therapist and is concluded with a comprehensive rehabilitative treatment plan. The clinical construct will be described and a case report will be presented to demonstrate this unique model. Case Report: A combat veteran with a history of a gunshot wound to the skull, blunt force head trauma and exposure to multiple explosions presented with complaints of difficulty reading and recent onset dizziness. After thorough evaluation in the COB, the patient was diagnosed with and treated for severe oculomotor dysfunction and benign paroxysmal positional vertigo. Conclusion: Vision therapy was able to provide a successful outcome via improvement of oculomotor efficiency and control. Physical therapy intervention was able to address the benign paroxysmal positional vertigo. The specific evaluation and management as pertains to the aforementioned diagnoses, as well as the importance of an interprofessional rehabilitative approach, will be outlined.

scholarly journals Benign Paroxysmal Positional Vertigo Treated with Maneuvers to Change Head Position.

1995 ◽  
Vol 88 (7) ◽  
pp. 857-862
Author(s):  
Takayoshi ITAYA ◽  
Hiroya KITANO ◽  
Yoshiro YAZAWA ◽  
Akira KODAMA ◽  
Ichiro KOMADA ◽  
...  
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Head Position ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo
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