scholarly journals Migraine With Aura Is Related to Delayed Motor Control Reaction and Imbalance Following External Perturbations

2021 ◽  
Vol 12 ◽  
Author(s):  
Gabriela F. Carvalho ◽  
Kerstin Luedtke ◽  
Carina F. Pinheiro ◽  
Renato Moraes ◽  
Tenysson W. Lemos ◽  
...  
Keyword(s):  
Motor Control ◽  
Chronic Migraine ◽  
Fear Of Falling ◽  
Self Report ◽  
Dynamic Posturography ◽  
Everyday Activities ◽  
Postural Responses ◽  
Adaptation Test ◽  
Balance Deficits ◽  
Vestibular Symptoms

Background: It is evidenced that migraineurs present balance deficits. However, the balance recovery following unexpected ground perturbations, which reflect conditions of everyday activities, has not been investigated in this population.Aim: We aimed to assess the reactive postural responses among patients with migraine with and without aura, chronic migraine, and controls. We further aimed to assess the factors associated with greater self-report of falls.Methods: Ninety patients diagnosed by headache specialists were equally classified into three migraine subgroups according to the presence of aura and chronic migraine. Thirty controls were also recruited. All participants underwent the motor control test (MCT) and adaptation test (ADT) protocols of dynamic posturography tests (EquiTest®, NeuroCom, USA). Clinical and headache features and information on falls in the previous year, fear of falling, and vestibular symptoms were also assessed.Results: Patients with aura presented a greater sway area in most of the MCT conditions than the other three groups (p = 0.001). The aura group also presented delayed latency responses after perturbations compared with controls and patients without aura (p < 0.03). In the ADT, a greater sway area was observed in patients with aura than in groups without aura, chronic migraine, and controls (p < 0.0001). The MCT and ADT sway area, the frequency of aura, and the fear of falling explained 46% of the falls in the previous 12 months.Conclusion: Patients with aura exhibited greater delay and sway area after unexpected ground perturbations than controls and other migraine subgroups, which are related to the reported number of falls.

Does the Management of Visual and Audible Motion Information during an Immersive Virtual Reality Timed Up and Go Test Impact Locomotor Performance in the Elderly?

Gerontology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Frédéric Muhla ◽  
Karine Duclos ◽  
Fabien Clanché ◽  
Philippe Meyer ◽  
Séverine Maïaux ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Motor Control ◽  
Optical Flow ◽  
Fear Of Falling ◽  
The Elderly ◽  
Public Health Issue ◽  
Immersive Virtual Reality ◽  
Timed Up And Go ◽  
Friedman's Test ◽  
Risk Of Falls

<b><i>Background/Aims:</i></b> Falling among the elderly is a major public health issue, especially with the advancing age of the baby boomers. The fall risk assessment tests for many lack a context that would bring them closer to everyday life. Thus, immersive virtual reality, which makes it possible to simulate everyday situations, could make it possible to strengthen the quality of the assessment of the risk of falls. However, it is necessary to understand how the use of a virtual reality device influences the motor control of elderly participants. If vestibular physiotherapists use VR to virtualize their tools, what impact would a visual simulation of movement have on motor control in a locomotor task, if this simulation were plausible? <b><i>Methods:</i></b> Sixty-two elders (70.8 ± 6.7 years old) completed a Timed Up and Go task under 3 conditions: real, virtual reality, and virtual reality with visual and sound movement information. The virtual reality task takes place in a train either stationary at a station or in uniform linear motion. The time and number of steps were recorded using video, and comparisons between conditions were made using Friedman’s test. <b><i>Results:</i></b> The results show a significant increase in the time and number of steps in “virtual reality” condition compared to the “real” condition. They do not show significant differences between the 2 virtual conditions. <b><i>Conclusion:</i></b> The use of a running virtual train to provide plausible movement is particularly distinguished from vestibular physiotherapy applications with first a fixed visual support partially obscuring the optical flow. This visual aid coupled with the attention dedicated to the task inhibits the effect of the moving environment on locomotion. However, the visual optical flow will potentially have an effect in people with fear of falling. Virtual reality shows great potential for the simulation of realistic environments for the assessment of the risk of falls and opens up avenues for the development of tests.

scholarly journals Managing Challenges in an Aging Vestibular System: Rehabilitation Strategies Normalize Balance Function in a Cohort of Patients Up to 99 Years

2019 ◽  
Vol 98 (1) ◽  
pp. 37-43
Author(s):  
Daniel A. Deems ◽  
Rhonda O. Deems ◽  
Bert W. O’Malley
Keyword(s):  
Fall Risk ◽  
Older Patients ◽  
The United States ◽  
Falls Prevention ◽  
Balance Function ◽  
Average Life Expectancy ◽  
Allied Health Professionals ◽  
Dynamic Posturography ◽  
Major Health Problem ◽  
Balance Deficits

Imbalance is a major health problem affecting 90 million Americans and is the primary risk factor in falls, which consume $50 billion annually in medical costs (US). A person is often unaware of their balance challenge and its potential impact on fall risk and subsequent injury. Even when balance deficits and fall risk are realized, older patients may not pursue intervention for their disorder due to a fatalistic view of their advanced age. In this retrospective study, a cohort of older patients who had completed a course of vestibular rehabilitation therapy was studied for extent of recovery using computerized dynamic posturography (CDP) as the outcomes measure. The study group was comprised of sequential outpatients from a community-based balance treatment facility for whom pre- and posttherapy CDPs were available for analyses (N = 76). Patients had been referred for imbalance, vertigo, unsteadiness, and falls—age range 66 to 99 years (mean 80.5 years). Balance function, measured by composite sensory organization test (SOT) CDP scores, improved on average 35% ( P < .0001). Average posttherapy SOT score was 72.8, equivalent to the oldest SOT normative scores available (70 to 79 year age bracket; SOT Norm = 72.9). A subset 10 years above this eldest norm, mean age 89.4 years (N = 25, range 85 to 99 years), was then analyzed. Results revealed an improvement in balance function of 42.1% ( P < .0001), with average posttherapy SOT score of 74.2. Data confirm that vestibular therapy programs can significantly recover, if not normalize imbalance even to age 99. Given that the eldest participants were well above average life expectancy in the United States (78.9 years), this study could be used by allied health professionals to encourage older patients to engage in balance and falls prevention programs.

Presence of vestibular symptoms and related disability in migraine with and without aura and chronic migraine

Cephalalgia ◽  
2018 ◽  
Vol 39 (1) ◽  
pp. 29-37 ◽  
Author(s):  
Gabriela F Carvalho ◽  
Flávia Heck Vianna-Bell ◽  
Lidiane L Florencio ◽  
Carina F Pinheiro ◽  
Fabiola Dach ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Migraine With Aura ◽  
Migraine Without Aura ◽  
Cross Sectional Study ◽  
Control Group ◽  
Dizziness Handicap Inventory ◽  
Cross Sectional ◽  
Severe Handicap ◽  
Migraine Frequency ◽  
Vestibular Symptoms

Objective To assess the presence and handicap due to vestibular symptoms in three subgroups of patients with migraine and controls. Methods Women between 18–55 years old were diagnosed by headache specialists and stratified as migraine with aura (n = 60), migraine without aura (n = 60), chronic migraine (n = 60) and controls (n = 60). Information regarding demographics, headache and vestibular symptoms were collected in this cross-sectional study. The self-perceived handicap related to vestibular symptoms was assessed through the Dizziness Handicap Inventory questionnaire. Results A total of 85% of women with migraine with aura and chronic migraine had vestibular symptoms contrasted to 70% of the migraine without aura group ( p < 0.05), and 12% of the control group reported symptoms ( p < 0.0001). Patients with migraine exhibited greater Dizziness Handicap Inventory scores than controls ( p < 0.001); and migraine with aura and chronic migraine groups reached greater scores than migraine without aura ( p < 0.01). Presence of migraine is associated with a greater risk of vestibular symptoms (migraine without aura: 5.20, migraine with aura: 6.60, chronic migraine:6.20, p < 0.0003) and with a greater risk of moderate-to-severe handicap (migraine without aura: 20.0, migraine with aura: 40.0, chronic migraine: 40.0, p < 0.0003). The presence of aura and greater migraine frequency adds to the risk of any handicap (migraine with aura: 1.9, chronic migraine: 1.7, p < 0.04) and to the risk of moderate-to-severe handicap (migraine with aura: 2.0, chronic migraine: 2.0, p < 0.0003). Migraine aura, intensity and frequency predict 36% of the dizziness handicap. Conclusion The prevalence of vestibular symptoms is increased in migraine during and between headache attacks, particularly in migraine with aura and chronic migraine along with an increased handicap due to those symptoms. Vestibular symptoms among subgroups of migraine should be considered when evaluating the functional impact of migraine.

scholarly journals A New Postural Stability-Indicator to Predict the Level of Fear of Falling In Parkinson’s Disease Patients

2020 ◽  
Author(s):  
Ehsan Pourghayoomi ◽  
Saeed Behzadipour ◽  
Mehdi Ramezani ◽  
Mohammad Taghi Joghataei ◽  
Gholamali shahidi
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Postural Stability ◽  
Human Error ◽  
Fear Of Falling ◽  
Center Of Pressure ◽  
Threshold Level ◽  
Berg Balance Scale ◽  
Self Report ◽  
Timed Up And Go

Abstract Background Fear of falling (FoF) is defined as a lasting concern about falling that causes a person to limit or even stop the daily activities that he/she is capable of. 70% of Parkinson’s disease (PD) patients report activity limitations due to FoF. Timely identification of FoF is critical to prevent its additional adverse effects on the quality of life. Self-report questionnaires are commonly used to evaluate the FoF, which may be prone to human error. Objectives In this study, we attempted to identify a new postural stability-indicator to objectively predict the intensity of FoF and its related behavior(s) in PD patients. Methods Thirty-eight PD patients participated in the study (mean age, 61.2 years), among whom 10 (26.32%) were identified with low FoF and the rest (73.68%) with high FoF, based on Falls Efficacy Scale-International (FES-I). We used a limit of stability task calibrated to each individual and investigated the postural strategies to predict the intensity of FoF. New parameters (FTRi’s; functional time ratio) were extracted based on the center of pressure presence pattern in different rectangular areas (i = 1, 2, and 3). The task was performed on two heights to investigate FoF related behavior(s). Results FTR 1/2 (the ratio between FTR1 and FTR2) was strongly correlated with the FES-I (r = − 0.63, P < 0.001), Pull Test (r = − 0.65, P < 0.001), Timed Up and Go test (r = − 0.57, P < 0.001), and Berg Balance Scale (r = 0.62, P < 0.001). The model of FTR1/2 was identified as a best-fitting model to predicting the intensity of FoF in PD participants (sensitivity = 96.43%, specificity = 80%), using a threshold level of ≤ 2.83. Conclusions Using the proposed assessment technique we can accurately predict the intensity of FoF in PD patients. Also, The FTR1/2 index can be potentially considered as a mechanical biomarker to sense the FoF-related postural instability in PD patients.

scholarly journals What Psychosocial and Physical Characteristics Differentiate Office Workers Who Develop Standing-Induced Low Back Pain? A Cross-Sectional Study

2020 ◽  
Vol 17 (19) ◽  
pp. 7104
Author(s):  
Beatriz Rodríguez-Romero ◽  
Michelle D Smith ◽  
Alejandro Quintela-del-Rio ◽  
Venerina Johnston
Keyword(s):  
Low Back Pain ◽  
Motor Control ◽  
Back Pain ◽  
Self Report ◽  
Office Workers ◽  
Muscle Endurance ◽  
Low Back ◽  
Cross Sectional ◽  
Hip Abduction ◽  
History Of

This study examines demographic, physical and psychosocial factors associated with an increase in low back pain (LBP) during a one-hour standing task. A cross-sectional survey with 40 office workers was conducted. The primary outcome was pain severity during a one-hour standing task recorded every 15 min using a 100 mm Visual Analogue Scale (VAS). Participants were defined as pain developers (PD), if they reported a change in pain of ≥10 mm from baseline, or non-pain developers (NPD). Physical outcomes included participant-rated and examiner-rated trunk and hip motor control and endurance. Self-report history of LBP, physical activity, psychosocial job characteristics, general health and pain catastrophising were collected. Fourteen participants were PD. Hip abduction, abdominal and spinal muscle endurance was lower for PD (p ≤ 0.05). PD had greater self-reported difficulty performing active hip abduction and active straight leg raise tests (p ≤ 0.04). Those reporting a lifetime, 12 month or 7-day history of LBP (p < 0.05) and lower self-reported physical function (p = 0.01) were more likely to develop LBP during the standing task. In conclusion, a history of LBP, reduced trunk and hip muscle endurance and deficits in lumbopelvic/hip motor control may be important to consider in office workers experiencing standing-induced LBP.

Vestibular function in migraine-related dizziness: A pilot study

2005 ◽  
Vol 15 (5-6) ◽  
pp. 327-332
Author(s):  
Joseph M. Furman ◽  
Patrick J. Sparto ◽  
Michael Soso ◽  
Dawn Marcus
Keyword(s):  
Semicircular Canal ◽  
Constant Velocity ◽  
Postural Sway ◽  
Vestibular Function ◽  
Group Differences ◽  
Dynamic Posturography ◽  
Ocular Reflex ◽  
Visual Vestibular Interaction ◽  
Vestibular Symptoms ◽  
Vestibular Pathways

Migraine-related dizziness (MRD) refers to a disorder in which vestibular symptoms are an integral part of migraine symptomatology. The purpose of this study was to better define the pathophysiology of MRD, which is incompletely understood and to generate hypotheses regarding MRD by assessing the semicircular canal-ocular reflex, the otolith-ocular reflex, visual-vestibular interaction, vestibulo-spinal function, and visually induced postural sway. Subjects included five subjects with MRD, five subjects with migraine without dizziness, and five headache-free controls. Subjects with migraine were tested interictally. Results indicated that the mean gain of the semicircular canal-ocular reflex during both sinusoidal and constant velocity rotation was reduced in subjects with MRD. No changes were noted in the dynamics of the semicircular canal-ocular reflex. The otolith-ocular reflex, assessed with constant velocity OVAR, indicated that subjects with MRD showed a larger modulation component. No group differences were found in the bias component during constant velocity OVAR, nor in semicircular canal-otolith interaction or visual-vestibular interaction. Computerized dynamic posturography indicated that subjects with MRD demonstrated a surface-dependent pattern. Postural sway during optic flow indicated that subjects with MRD swayed more than the other subjects. We hypothesize that competing processes of serotonergic excitation and inhibition alter central vestibular pathways differently for semicircular canal vs. otolithic responses and for vestibulo-ocular vs. vestibulo-spinal pathways.

scholarly journals Effects of Soccer Training on Body Balance in Young Female Athletes Assessed Using Computerized Dynamic Posturography

2020 ◽  
Vol 10 (3) ◽  
pp. 1003 ◽  
Author(s):  
Grażyna Olchowik ◽  
Agata Czwalik
Keyword(s):  
Motor Control ◽  
Postural Stability ◽  
Female Athletes ◽  
Lower Limbs ◽  
Control Group ◽  
Control Test ◽  
Dynamic Posturography ◽  
Balance System ◽  
Computerized Dynamic Posturography ◽  
Soccer Training

The aim of this study was to determine the effect of regular soccer training on the balance system for young women. Computerized dynamic posturography of female footballers (n = 25) and control group (n = 50) was assessed during three tests: Sensory Organization Test, Motor Control Test, and Adaptation Test. Statistically significant differences between the groups was found in Composite Equilibrium Score with higher values, indicating better postural stability, for footballers. Regular trainees also showed better usefulness of vestibular system while maintaining balance. Weight symmetry of the lower limbs during Motor Control Test also showed statistically significant differences between the groups. This study shows that female footballers have better postural stability than their inactive peers and that regular workouts may improve the balance system.

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