Virtual reality in vestibular rehabilitation: a pilot study

2019 ◽  
Vol 26 (7) ◽  
pp. 1-13 ◽  
Author(s):  
Otávio Corrêa Miziara ◽  
Vanessa Rossato de Oliveira ◽  
Andréa Licre Pessina Gasparini ◽  
Beatriz Coelho Souza ◽  
Angela Santos ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Benign Paroxysmal Positional Vertigo ◽  
Berg Balance Scale ◽  
T Test ◽  
Dizziness Handicap Inventory ◽  
Balance Confidence ◽  
Balance Scale ◽  
Positional Vertigo ◽  
Confidence Scale ◽  
Paroxysmal Positional Vertigo

Background/AimsWe evaluated the efficacy of using virtual reality with specific games for vestibular rehabilitation to treat patients with benign paroxysmal positional vertigo.MethodsThe Activity-Specific Balance Confidence Scale (ABC Scale), Dizziness Handicap Inventory, Tinnitus Handicap Inventory, Berg Balance Scale, Balancim, Romberg and Dix-Hallpike tests were used to evaluate 10 participants (5 males and 5 females; mean age 38.5 ± 14.7 years) with benign paroxysmal positional vertigo, who played 3 specific games of Nintendo Wii console (Snowboard Slalom, Tightrope Walk, Rhythm Parade) for 10 minutes twice a week for 4 weeks.ResultsThe intervention resulted in significant increases in Activity-Specific Balance Confidence Scale score (d de Cohen >0.50), decreases in Dizziness Handicap Inventory (P<0.05 in t test for all dimensions and total score) and Tinnitus Handicap Inventory (P<0.05 in Wilcoxon test for all dimensions and total score), and improvement in balance shown on Romberg test, Berg Balance Scale (P<0.05 in t test for all dimensions and total score) and Balancim (d de Cohen >0.80).ConclusionsVirtual reality with the selected games seemed to be effective on benign paroxysmal positional vertigo treatment, improving scores of tests and scales used in the assessment.

A Case Report: Balance Training with Virtual Reality in Patients with Bilateral Peripheral Vestibulopathy

2017 ◽  
pp. 24-28
Author(s):  
Esra Dogru Huzmeli
Keyword(s):  
Virtual Reality ◽  
Balance Training ◽  
Berg Balance Scale ◽  
Bilateral Vestibulopathy ◽  
Balance Confidence ◽  
Before And After ◽  
Peripheral Vestibulopathy ◽  
The Subject ◽  
Balance Rehabilitation ◽  
Confidence Scale

The use of computerised imaging technologies in vestibular rehabilitation is a new concept. We aimed to examine the effects of virtual reality in a bilateral vestibulopathy patient. The subject was a 22-year old male patient. The bilateral semi-circular channels of patient were ossified, which showed advanced stage sensorineural hearing loss. Balance was analysed with Berg balance Scale (BBS), state of balanced feeling with visual analogue scale (VAS), and daily living activities with the activitiesspecific balance confidence scale (ABC). The scales were applied before and after treatment. The patient’s balance was treated with virtual reality for 18 sessions, after which the patient was feeling his balance better. The patient’s VAS score before rehabilitation was 5 and later it was 7. The ABC scores changed from 60 to 90. The BBS score was 51 before rehabilitation and later it was 56. Balance rehabilitation was successful in bilateral vestibulopathy. Keywords: Bilateral vestibulopathy, virtual reality, balance, vertigo.

scholarly journals Community Delivery of a Comprehensive Fall-Prevention Program in People with Multiple Sclerosis

2016 ◽  
Vol 18 (1) ◽  
pp. 42-48 ◽  
Author(s):  
Cinda L. Hugos ◽  
Debra Frankel ◽  
Sara A. Tompkins ◽  
Michelle Cameron
Keyword(s):  
Multiple Sclerosis ◽  
Fall Prevention ◽  
Berg Balance Scale ◽  
Timed Up And Go ◽  
Balance Confidence ◽  
Balance Scale ◽  
Scale Scores ◽  
The Impact ◽  
Confidence Scale

Background: People with multiple sclerosis (MS) fall frequently. In 2011, the National Multiple Sclerosis Society launched a multifactorial fall-prevention group exercise and education program, Free From Falls (FFF), to prevent falls in MS. The objective of this study was to assess the impact of participation in the FFF program on balance, mobility, and falls in people with MS. Methods: This was a retrospective evaluation of assessments from community delivery of FFF. Changes in Activities-specific Balance Confidence scale scores, Berg Balance Scale scores, 8-foot Timed Up and Go performance, and falls were assessed. Results: A total of 134 participants completed the measures at the first and last FFF sessions, and 109 completed a 6-month follow-up assessment. Group mean scores on the Activities-specific Balance Confidence scale (F1,66 = 17.14, P &lt; .05, η2 = 0.21), Berg Balance Scale (F1,68 = 23.39, P &lt; .05, η2 = 0.26), and 8-foot Timed Up and Go (F1,79 = 4.83, P &lt; .05, η2 = 0.06) all improved significantly from the first to the last session. At the 6-month follow-up, fewer falls were reported (χ2 [4, N = 239] = 10.56, P &lt; .05, Phi = 0.21). Conclusions: These observational data suggest that the FFF group education and exercise program improves balance confidence, balance performance, and functional mobility and reduces falls in people with MS.

scholarly journals Physical Therapy for Benign Positional Vertigo of Posterior Canal: The Role of Alternated Epley and Semont Maneuvers

2021 ◽  
pp. 014556132098018
Author(s):  
Andrea Lovato ◽  
Gino Marioni ◽  
Daniele Monzani ◽  
Giacomo Rossettini ◽  
Elisabetta Genovese ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Benign Paroxysmal Positional Vertigo ◽  
Positional Nystagmus ◽  
Dizziness Handicap Inventory ◽  
Posterior Semicircular Canal ◽  
Positional Vertigo ◽  
Significant Difference ◽  
Paroxysmal Positional Vertigo

Objective: To investigate if alternated Epley (EP) and Semont (ST) maneuvers could be more effective than repetition of the same in benign paroxysmal positional vertigo of posterior semicircular canal (pBPPV). Design: We retrospectively reviewed the outcome of pBPPV patients treated with a second maneuver for the persistence of positional nystagmus. Study Sample: Forty-seven patients underwent 2 STs, 64 with 2 EPs, and 71 EPs followed by ST. Videonystagmography and Dizziness Handicap Inventory (DHI) questionnaire were performed. Results: Absence of positional nystagmus was achieved after 2 maneuvers in 136 patients with pBPPV: 65.9% in the ST group, 70.3% in the EP group, and 84.5% in the EP-ST group. Alternated EP and ST were significantly more effective than repeated ST ( P = .03), while we found no significant difference when compared with repeated EP ( P = .07). At 1-month follow-up, 12 patients showed persistent positional nystagmus without difference between groups. After 1 month, the 46 patients with negative outcome had significantly higher DHI values ( P = .01) than other 136 patients with pBPPV. Conclusions: Alternated EP and ST seemed more effective than repeating the same maneuver in treating pBPPV, and this should be confirmed in prospective clinical studies. Resolution of nystagmus after maneuvers was fundamental to reduce handicap deriving from dizziness as reported in DHI.

scholarly journals A sürgősségi osztályon szédüléses panaszokkal megjelent betegek életminőségének vizsgálata

2021 ◽  
Vol 162 (30) ◽  
pp. 1216-1221
Author(s):  
Stefani Maihoub ◽  
András Molnár ◽  
András Csikós ◽  
Péter Kanizsai ◽  
László Tamás ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Emergency Department ◽  
Benign Paroxysmal Positional Vertigo ◽  
Interdisciplinary Cooperation ◽  
Dizziness Handicap Inventory ◽  
Significant Statistical Difference ◽  
Positional Vertigo ◽  
Central Lesions ◽  
Paroxysmal Positional Vertigo

Összefoglaló. Bevezetés: A szédülés gyakori panasz, amellyel a betegek felkeresik a sürgősségi osztályt. Emellett fontos tünet, hiszen kihívást jelent mind a diagnosztika, mind a terápia szempontjából, és nagy hatással lehet a betegek életminőségére. Célkitűzés: Kutatásunk célja annak vizsgálata, hogy mennyire befolyásolta a szédülés a betegek életminőségét a sürgősségi osztály elhagyását követően. Módszer: A vizsgálat időtartama alatt 879, szédülést panaszoló beteg jelent meg a Semmelweis Egyetem sürgősségi osztályán. Részükre kérdőív került kiküldésre, amely tartalmazta a ’Dizziness Handicap Inventory’ (DHI-) kérdőívet is. Megkeresésünkre 308 beteg (110 férfi, 198 nő; átlagéletkor: 61,8 ± 12,31 SD) válaszolt, az általuk visszaküldött kérdőíveket részletesen elemeztük. Eredmények: A leggyakoribb diagnózisok közé a benignus paroxysmalis positionalis vertigo, a centrális egyensúlyrendszeri eltérések és a szédülékenység tartoztak. Az elemzés alapján különbség volt látható a fizikális, a funkcionális és az emocionális pontszámok között. Kiemelendő, hogy a legmagasabb értékeket a fizikális csoportban regisztráltuk. A részletes otoneurológiai kivizsgáláson átesett betegek DHI-értékeit összevetettük azokéival, akik nem jártak ilyen vizsgálaton, a két csoport értékei között azonban nem volt szignifikáns különbség (p = 0,97). Emellett a DHI-érték emelkedése volt látható a végleges diagnózisig eltelt idő függvényében. Következtetés: A végleges diagnózisig eltelt idő, illetve a megfelelő kivizsgálás hiánya jelentős hatással van a szédülő betegek életminőségére. Lényeges a kivizsgálás, a mielőbbi diagnózis és a részletes egyensúlyrendszeri vizsgálat szerepe, ugyanakkor az utóbbi indokolt esetben kell, hogy történjen. Orv Hetil. 2021; 162(30): 1216–1221. Summary. Introduction: Dizziness and vertigo are among the most common complaints in the emergency department. This may require interdisciplinary cooperation due to their complex presentation in the department and the effects on the patients’ quality of life. Objective: Our study aimed to assess the effect of an acute vertigo episode on the quality of life after patients’ discharge from the emergency department. Method: 879 patients examined at the Semmelweis University emergency department with vertigo and dizziness were included in the study. A questionnaire, including the Dizziness Handicap Inventory (DHI), was addressed to this population. We received 308 answered questionnaires back (110 males, 198 females; mean age 61.8 years ± 12.31 SD), which were further analyzed. Results: The most frequent diagnoses were benign paroxysmal positional vertigo, central lesions and dizziness. According to the analysis of the DHI questionnaire, a difference between physical, functional and emotional scores was shown, whereas the highest scores were registered in the physical group. The DHI questionnaire scores of patients undergoing a neurotological examination and those who did not were further compared, whereas no significant statistical difference was indicated (p = 0.97). In addition, an increase in DHI scores was seen depending on the time elapse for the definitive diagnosis. Conclusion: The absence of adequate examination and a late diagnosis of the dizziness cause have a significant impact on the quality of life of patients. Therefore, substantial investigation, early diagnosis, and detailed vestibular examination are essential, but the latter should take place in justified cases. Orv Hetil. 2021; 162(30): 1216–1221.

scholarly journals Postural Restriction in Benign Paroxysmal Positional Vertigo: A Randomized Clinical Trial

2020 ◽  
Author(s):  
Yuvatiya Plodpai ◽  
Pattarawadee Prayuenyong
Keyword(s):  
Clinical Trial ◽  
Recurrence Rate ◽  
Head Movement ◽  
Benign Paroxysmal Positional Vertigo ◽  
P Value ◽  
Dizziness Handicap Inventory ◽  
Positional Vertigo ◽  
Group A ◽  
Group B ◽  
Paroxysmal Positional Vertigo

Objective: We compared the efficacy between addition of post-maneuver postural restriction, and that of the modified Epley’s maneuver alone.Material and Methods: One hundred eighty patients with posterior canal benign paroxysmal positional vertigo were divided into two groups, using a block of four randomization. Group A were instructed to avoid head movement for 48 hours after the modified Epley’s maneuver. Group B were treated with the modified Epley’s maneuver alone. DixHallpike test and dizziness handicap inventory (DHI) scores were assessed at 1 and 2 weeks, and followed up for 48 weeks to assess recurrent symptoms.Results: There were no significant differences between the two groups in terms of changes from a positive to a negative Dix-Hallpike test; while the DHI score and recurrence rate were significantly lower in group A (p-value 0.042).Conclusion: Postural restriction after the modified Epley’s maneuver can improve the DHI score, and reduce the recurrence rate of vertigo, compared with the modified Epley’s maneuver alone.

Comparing the effects of hydrotherapy and land-based therapy on balance in patients with Parkinson’s disease: a randomized controlled pilot study

2014 ◽  
Vol 28 (12) ◽  
pp. 1210-1217 ◽  
Author(s):  
Daniele Volpe ◽  
Maria Giulia Giantin ◽  
Roberto Maestri ◽  
Giuseppe Frazzitta
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Outcome Measures ◽  
Rating Scale ◽  
Controlled Trial ◽  
Berg Balance Scale ◽  
Secondary Outcome ◽  
Balance Confidence ◽  
Balance Scale ◽  
Confidence Scale

Objective: Our aim was to evaluate the feasibility of a hydrotherapy treatment in patients with Parkinson’s disease and the effectiveness of this treatment on balance parameters in comparison to a traditional land-based physical therapy. Design: A randomized single-blind controlled trial. Setting: Outpatients. Subjects: Thirty-four patients with Parkinson’s disease in Hoehn-Yahr stage 2.5–3. Intervention: Group 1 hydrotherapy treatment, group 2 land-based rehabilitation treatment. The two groups underwent the same rehabilitation period (60 minutes of treatment, five days a week for two months). Main measures: The primary outcome measures were the centre of the pressure sway area recorded with open and closed eyes, using a stabilometric platform. Secondary outcome measures were Unified Parkinson’s Disease Rating Scale II and III, Timed Up and Go Test, Berg Balance Scale, Activities-specific Balance Confidence Scale, Falls Efficacy Scale, Falls diary and Parkinson’s Disease Questionnaire-39. Results: Hydrotherapy treatment proved to be feasible and safe. Patients in both groups had a significant improvement in all outcome variables. There was a better improvement in patients who underwent hydrotherapy than in patients treated with land-based therapy in the centre of pressure sway area closed eyes (mean SD change: 45.4 SD64.9 vs. 6.9 SD45.3, p = 0.05), Berg Balance Scale (51.2 SD3.1 vs. 6.0 SD3.1, p = 0.005), Activities-specific Balance Confidence Scale (16.8 SD10.6 vs. 4.1 SD5.4, p = 0.0001), Falls Efficacy Scale (−5.9 SD4.8 vs. −1.9 SD1.4, p = 0.003), Parkinson’s Disease Quetionnaire-39 (−18.4 SD12.9 vs. −8.0 SD7.0, p = 0.006) and falls diary (−2.4 SD2.2 vs. −0.4 SD0.5, p = 0.001). Conclusion: Our study suggests that hydrotherapy may constitute a possible treatment for balance dysfunction in Parkinsonian patients with moderate stage of disease.

Analysis of Residual Symptoms after Treatment in Benign Paroxysmal Positional Vertigo Using Questionnaire

2009 ◽  
Vol 141 (2) ◽  
pp. 232-236 ◽  
Author(s):  
No Hee Lee ◽  
Hee Jun Kwon ◽  
Jae Ho Ban
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Control Group ◽  
Dizziness Handicap Inventory ◽  
Residual Symptoms ◽  
Positional Vertigo ◽  
Canalith Repositioning Procedure ◽  
And Control ◽  
Subsequent Comparison ◽  
Paroxysmal Positional Vertigo

OBJECTIVES: Canalith repositioning procedure (CRP) provides rapid and long-lasting relief of symptoms in most patients with benign paroxysmal positional vertigo. However, some patients express nonspecific symptoms such as anxiety or discomfort after treatment, even after the disappearance of nystagmus and vertigo. The purpose of this study was to assess the residual symptoms after CRP in patients with benign paroxysmal positional vertigo using the Dizziness Handicap Inventory (DHI) in a questionnaire format. STUDY DESIGN AND SETTING: Controlled, prospective study. SUBJECTS AND METHODS: CRP was performed in 135 patients until nystagmus and vertigo disappeared. Patients were asked to complete the questionnaire before and 5 to 7 days after treatment. A control group of 135 normal volunteers was selected and cross-matched according to the age and sex of the patient group. The data were compared for the pre-CRP, post-CRP, and control groups. RESULTS: There was a significant improvement in the DHI scores when comparing the pre- and post-CRP groups ( P = 0.000), although six items showed incomplete improvement. Subsequent comparison of DHI scores between the control group and the post-CRP group still showed a difference in some items so that the improvement was incomplete. CONCLUSION: Even after successful CRPs, Dizziness Handicap Inventory scores indicated that residual subjective symptoms may remain. Thus, additional follow-up and management are important for these patients.

scholarly journals Correlation between Residual Dizziness and Modified Clinical Test of Sensory Integration and Balance in Patients with Benign Paroxysmal Positional Vertigo

2021 ◽  
Vol 20 (3) ◽  
pp. 93-100
Author(s):  
Jung-Yup Lee ◽  
In-Buhm Lee ◽  
Min-Beom Kim
Keyword(s):  
Sensory Integration ◽  
Benign Paroxysmal Positional Vertigo ◽  
Semicircular Canals ◽  
Clinical Test ◽  
Analog Scale ◽  
Dizziness Handicap Inventory ◽  
Positional Vertigo ◽  
Postural Imbalance ◽  
Canalith Repositioning Procedure ◽  
Paroxysmal Positional Vertigo

Objectives: This study was performed to investigate the correlation between subjective residual dizziness and objective postural imbalance after successful canalith repositioning procedure (CRP) in benign paroxysmal positional vertigo (BPPV) by using questionnaires and modified Clinical Test of Sensory Integration and Balance (mCTSIB). Methods: A total of 31 patients with BPPV were included prospectively in the study. All included patients were successfully treated after initial CRP and their symptoms and nystagmus disappeared. Two weeks after CRP, all patients were asked to fill out the questionnaire including both Dizziness Handicap Inventory (DHI) and visual analog scale (VAS). We also conducted mCTSIB 2 weeks after CRP. We divided patients into two groups according to VAS: RD (residual dizziness) group, VAS＞0; non-RD group, VAS=0. We compared age, number of CRP, rates associated with three semicircular canals, DHI score and mCTSIB results between two groups. In addition, we analyzed the correlation between DHI score and mCTSIB results. Results: There were no significant differences in age, number of CRP, and rates associated with three semicircular canals between the two groups. RD group showed significantly higher DHI score and abnormal mCTSIB results than the non-RD group (<i>p</i>＜0.05). DHI score and the number of abnormal mCTSIB showed a statistically significant correlation. Conclusions: We demonstrated the correlation between DHI score and mCTSIB after successful CRP for BPPV. It also represents that subjective residual dizziness is correlated with objective postural imbalance even after successful CRP. Therefore, mCTSIB would be a useful test to evaluate both residual dizziness and postural imbalance after CRP in BPPV.

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