ABSTRACT
Resumen Introducción: La posturografía es un método de exploración complementario para valorar el grado de desplazamiento del centro de gravedad (COP); no debe usarse de forma aislada al evaluar equilibrio, pero se acepta para seguimiento de la respuesta a tratamiento. Es de baja disponibilidad, por su alto costo comercial. Como alternativa se documenta la plataforma Wii Balance Board (WBB) de Nintendo para registro posturográfico. Objetivo: Describir valores de normalidad en parámetros posturográficos en población chilena sin patología vestibular, usando un registro simple y accesible. Material y Método: Estudio transversal de valores referenciales en herramienta para evaluación del equilibrio. Se registraron valores posturográficos con versión adaptada del Sensory Organization Test (SOT) a adultos sanos. Mediciones con software WBB Sway Program mediante WBB. Se midieron índices somatosensorial, visual y vestibular, y patrones de control postural en ejes anteroposterior y mediolateral durante SOT-adaptado. Resultados: Se obtuvieron valores de velocidad de desplazamiento del COP, área del COP y desviaciones estándar correspondientes para 4 situaciones del SOT-adaptado de 35 sujetos entre 18-65 años, 21 mujeres, 14 hombres. Discusión: WBB permitió evaluar estos parámetros en población sana, como aproximación a determinar rangos de referencia. Esta herramienta de uso rápido y accesible constituye una alternativa útil para determinar patrones de control postural en sujetos sanos. Presentamos valores a utilizar como rango referencial en nuestra población; se sugiere utilizar estos valores como objetivo terapéutico en rehabilitación vestibular en pacientes evaluados en conjunto con otros parámetros clínico-sintomáticos.
Abstract Introduction: Posturography is a complementary method for evaluating the center of pressure (COP) displacement; it should not be used in isolation when assessing balance, but it is accepted for follow-up of the treatment response. Due to its high commercial cost and low availability, we documented the Nintendo Wii Balance Board (WBB) as an alternative for posturography. Aim: To describe the normal range of posturography parameters in the Chilean population without vestibular pathology, using a simple and accessible registry method. Material and Method: Cross-sectional study of referential values in a balance assessment tool. Posturography values were registered using an adapted version of the Sensory Organization Test (SOT) on healthy adults. Measurements with WBB Sway Program software through WBB. With adapted-SOT, somatosensory, visual and vestibular indices, as well as anterior/posterior and mediolateral axes postural control patterns, were measured. Results: Values of displacement velocity of the COP, COP area and corresponding standard deviations were obtained for 4 SOT-adapted situations from 35 subjects between 18-65 years, 21 women, 14 men. Discussion: As an approach to determine referential range values, WBB allowed to evaluate these parameters in healthy population. To determine healthy subjects postural control patterns this quick and accessible tool is a useful alternative. We present referential range values to use in our population; it is suggested to use these values as therapeutic objectives in vestibular rehabilitation in patients evaluated along with other clinical-symptomatic parameters.
ABSTRACT
Abstract Introduction: Attention deficit hyperactivity disorder is a common impairing neuropsychiatric disorder with onset in early childhood. Almost half of the children with attention deficit hyperactivity disorder also experience a variety of motor-related dysfunctions ranging from fine/gross motor control problems to difficulties in maintaining balance. Objectives: The main purpose of this study was to investigate the effects of distractors two different auditory distractors namely, relaxing music and white noise on upright balance performance in children with attention deficit hyperactivity disorder. Methods: We compared upright balance performance and the involvement of different sensory systems in the presence of auditory distractors between school-aged children with attention deficit hyperactivity disorder (n = 26) and typically developing controls (n = 20). Neurocom SMART Balance Master Dynamic Posturography device was used for the sensory organization test. Sensory organization test was repeated three times for each participant in three different test environments. Results: The balance scores in the silence environment were lower in the attention deficit hyperactivity disorder group but the differences were not statistically significant. In addition to lower balance scores the visual and vestibular ratios were also lower. Auditory distractors affected the general balance performance positively for both groups. More challenging conditions, using an unstable platform with distorted somatosensory signals were more affected. Relaxing music was more effective in the control group, and white noise was more effective in the attention deficit hyperactivity disorder group and the positive effects of white noise became more apparent in challenging conditions. Conclusion: To the best of our knowledge, this is the first study evaluating balance performance in children with attention deficit hyperactivity disorder under the effects of auditory distractors. Although more studies are needed, our results indicate that auditory distractors may have enhancing effects on upright balance performance in children with attention deficit hyperactivity disorder.
Resumo Introdução: O transtorno do déficit de atenção e hiperatividade é um distúrbio neuropsiquiátrico comum que causa comprometimentos, com início na primeira infância. Quase metade das crianças com transtorno do déficit de atenção e hiperatividade também experimenta uma variedade de distúrbios relacionados às habilidades motoras, desde problemas de controle de habilidades motoras finas/grossas até dificuldades na manutenção do equilíbrio. Objetivos: O principal objetivo deste estudo foi investigar os efeitos de distrações, especificamente duas distrações auditivas diferentes, música relaxante e ruído branco, sobre o desempenho do equilíbrio vertical em crianças com transtorno de déficit de atenção e hiperatividade. Método: Comparamos o desempenho do equilíbrio vertical e o envolvimento de diferentes sistemas sensoriais na presença de distração auditiva entre crianças em idade escolar com transtorno do déficit de atenção e hiperatividade (n = 26) e controles com desenvolvimento típico (n = 20). O dispositivo Neurocom Smart Balance Master Dynamic Posturography foi utilizado para o teste de organização sensorial. O teste de organização sensorial foi repetido três vezes para cada participante em três ambientes de teste diferentes. Resultados: Os escores de equilíbrio no ambiente em silêncio foram menores no grupo com transtorno do déficit de atenção e hiperatividade, mas as diferenças não foram estatisticamente significativas. Além dos escores de equilíbrio mais baixos, as razões vestibulares e visuais também foram menores. As distrações auditivas afetaram positivamente o desempenho do equilíbrio geral para ambos os grupos. Condições mais desafiadoras, usando uma plataforma instável com sinais somatossensoriais distorcidos, foram mais afetados. Música relaxante foi mais eficaz no grupo de controle, e ruído branco foi mais eficaz no grupo de hiperatividade com déficit de atenção e os efeitos positivos do ruído branco se tornaram mais evidentes em condições desafiadoras. Conclusão: Que seja de nosso conhecimento, este é o primeiro estudo que avalia o desempenho do equilíbrio em crianças com transtorno do déficit de atenção e hiperatividade sob os efeitos de distrações auditivas. Embora mais estudos sejam necessários, os nossos resultados indicam que as distrações auditivas podem ter efeitos de aumento no desempenho do equilíbrio vertical em crianças com transtorno de déficit de atenção e hiperatividade.
Subject(s)
Humans , Male , Female , Child , Attention Deficit Disorder with Hyperactivity/physiopathology , Sensation Disorders/physiopathology , Postural Balance/physiology , Reaction Time , Attention Deficit Disorder with Hyperactivity/complications , Case-Control Studies , Sensation Disorders/complicationsABSTRACT
This study investigated the relationship among the severity of hearing impairment,vestibular function and balance function in patients with idiopathic sudden sensorineural hearing loss (ISSNHL).A total of 35 ISSNHL patients (including 21 patients with vertigo) were enrolled.All of the patients underwent audiometry,sensory organization test (SOT),caloric test,cervical vestibular-evoked myogenic potential (cVEMP) test and ocular vestibular-evoked myogenic potential (oVEMP) test.Significant relationship was found between vertigo and hearing loss grade (P=0.009),and between SOT VEST grade and hearing loss grade (P=0.001).The abnormal rate of oVEMP test was the highest,followed by the abnormal rates of caloric and cVEMP tests,not only in patients with vertigo but also in those without vertigo.The vestibular end organs were more susceptible to damage in patients with vertigo (compared with patients without vertigo).Significant relationship was found between presence of vertigo and SOT VEST grade (P=0.010).We demonstrated that vestibular end organs may be impaired not only in patients with vertigo but also in patients without vertigo.The cochlear and vestibular impairment could be more serious in patients with vertigo than in those without vertigo.Vertigo does not necessarily bear a causal relationship with the impairment of the vestibular end organs.SOT VEST grade could be used to reflect the presence of vertigo state in the ISSNHL patients.Apart from audiometry,the function of peripheral vestibular end organs and balance function should be evaluated to comprehensively understand ISSNHL.Better assessment of the condition will help us in clinical diagnosis,treatment and prognosis evaluation of ISSNHL.
ABSTRACT
BACKGROUND AND OBJECTIVES: The aim of this study was to evaluate the usefulness of computerized dynamic posturography (CDP) in patients with acute vestibular neuritis (AVN) by identifying the recovery period of Sensory Organization Test (SOT) and comparing the result of SOT with those of the vestibulo-ocular reflex (VOR) tests and subjective symptoms. SUBJECTS AND METHOD: A prospective study was conducted on 41 patients who were diagnosed with AVN. The SOT was measured daily until the equilibrium composite score recovered the normal value. A survey, composing of questionnaires on Visual Analogue Scale (VAS), Dizziness Handicap Inventory (DHI), motion sensitive quotient (MSQ) and Activities-Specific Balance Confidence Scale (ABC), was conducted on the patient's initial visit and on the day the normal value of SOT was recovered. Videonystagmography and the caloric test were also performed, and the results were compared with those of the SOT. RESULTS: The mean duration from the onset of vertigo to the recovery of SOT scores was 3.7±2.9 days (median 3.0 days) and that from the onset of vertigo to the disappearance of spontaneous nystagmus was 17.1±27.2 days (median 6.0 days). The scores of 4 questionnaires (VAS, DHI, MSQ, and ABC) were significantly different between the initial day and the day of recovery to the normal value of SOT (p<0.001). However, the velocity of spontaneous nystagmus on the initial visit and the degree of canal paresis from the caloric test showed no significant correlations to recovery duration from the onset of vertigo to the normalization of SOT score. CONCLUSION: The recovery duration of vestibulospinal reflex (VSR) is much shorter than that of VOR in patients with AVN. The recovery of subjective symptoms showed close correlation with the recovery of VSR, but the results of VSR was not correlated with that of VOR. Therefore, CDP could be a very useful test for monitoring the resolution of subjective symptoms in patients with AVN.
Subject(s)
Humans , Caloric Tests , Compensation and Redress , Cytidine Diphosphate , Dizziness , Methods , Paresis , Prospective Studies , Reference Values , Reflex , Reflex, Vestibulo-Ocular , Vertigo , Vestibular NeuronitisABSTRACT
BACKGROUND: The purpose of this study is to evaluate balance functions as one ages using the values of the sensory organization test (SOT) and the motor control test (MCT) of computerized dynamic posturography (CDP) in healthy Korean adults. METHODS: We studied the equilibrium scores of the SOT and weight symmetries, latencies, and adaptation scores of the MCT in 72 healthy Korean adults. Subjects were divided into three age groups, the 30's (young group), 50's (middle-aged group), and 70's (elderly group). RESULTS: In the SOT, the range of mean equilibrium scores was from 69.8 to 94.2 in the 3rd decade group, 62.6 to 93.8 in the 5th decade group, 59.2 to 91.2 in the 7th decade group. In the MCT, during sudden anterior and posterior perturbations, the weight symmetries were 101.1 +/- 7.5 in the 3rd decade group, 103.6 +/- 6.9 in the 5th decade group, and 106.4 +/- 9.4 in the 7th decade group. The mean latencies were 123.6-132.8 msec in the 3rd decade group, 130.5-138.5 msec in the 5th decade group, 132.7-141.8 msec in the 7th decade group. CONCLUSIONS: Almost all measures of balance were significantly worse in the elderly group compared with the young group and some changes of balance were observed in the middle-aged group as well. These significant age-associated declines of balance function suggested the decreased capacity to process sensory inputs in aged persons. This occurs most likely as a result of biomechanical or central processing changes.