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Variantes da manobra de epley no tratamento da vertigem postural paroxística benigna de canal posterior em idosos / Variations on Epley manuever in benign paroxysmal positional vertigo treatment of posterior canal for canalithiasis in elderlyAndré, Ana Paula do Rego 26 October 2007 (has links)
A Vertigem Postural Paroxística Benigna (VPPB) é a mais comum das vestibulopatias periféricas, principalmente em idosos e apresenta como etiologia mais comum nessa população à degeneração da mácula utricular. Caracteriza-se por tontura rotatória e nistagmo posicional à mudança de posição da cabeça ou por determinada posição do corpo e, como conseqüência, pode ocorrer quedas e limitações na qualidade de vida dos mesmos, e torná-los limitados físico e emocionalmente. O presente estudo teve como objetivo comparar a eficácia das variantes da manobra de Epley, para que se possa promover ao paciente, cada vez mais, tratamentos rápidos, eficazes e confortáveis. Participaram do estudo 53 voluntários com hipótese diagnóstica otorrinolaringológica de VPPB de canal semicircular posterior por ductolitíase, com faixa etária entre 60 e 91 anos, com média de 67,19 anos. Quanto ao gênero, 38 (71,7 %) eram do sexo feminino. Os pacientes foram distribuídos de forma aleatória em três grupos, conforme tratamento pré-estabelecido, ou seja, no Grupo A, 23 pacientes foram submetidos à manobra de Epley associada ao uso do colar cervical e orientações pós-manobra, enquanto no Grupo B, 15 pacientes foram submetidos à manobra de Epley sem uso do colar cervical e/ou restrições pós-manobra. Por fim, no Grupo C, 15 pacientes foram submetidos à manobra de Epley associada com o uso de um mini vibrador, aplicado na mastóide durante a manobra, sem uso de colar cervical e/ou restrições pós-manobra. No tratamento da VPPB por meio da reabilitação vestibular o número de manobras de Epley variou de uma a três, sendo que este número não foi diferente entre os Grupos estudados. Aplicou-se o questionário (Dizziness Handicap Inventory - DHI brasileiro) pré e pós RV para quantificar a tontura quanto aos aspectos: físico, emocional, funcional e geral. Sobre estes aspectos observou-se diferença estatisticamente significativa (p<0,0001) entre todos os escores pré e pós RV para os três grupos avaliados, embora não se encontrou diferença significativa dos escores entre os grupos estudos, com exceção da diferença média entre o Grupo A e o Grupo B dentro do tempo pós (p=0,009). Concluímos que os escores dos aspectos avaliados no DHI brasileiro melhoraram após intervenção fonoaudiológica pela RV nos pacientes idosos com VPPB de canal semicircular posterior, o que ocasionou impacto na qualidade de vida dos voluntários idosos estudados. Conclui-se ainda que o tratamento realmente válido para a VPPB neste estudo foi à manobra de Epley, sem restrições associadas. / Benign Paroxysmal Positional Vertigo (BPPV) is the most common peripheral vestibulopathy in adults, especially in aged people and presents the utricle degeneration as the most common etiology in this population. It is characterized by rotating dizziness and positional nystagmus to the cephalic movements or by determined body movements and, as a result, can cause falls and quality of life restrictions, making them physically and emotionally limited. The present study had as objective to compare the efficacy of variations on Epley maneuver, in order to provide the patient increasingly, fast, effective and comfortable treatment. Fifty three volunteers took part of the study with otorrinolaringologic diagnostic hypothesis of BPPV of posterior semicircular canal for cupulolithiasis or canalithiasis, at ages between 60 and 91 years old, average 67,19 years old. Concerning the genre, 38 (71,7%) were women. The patients were distributed randomly in three groups according to the pre-determined treatment, in other words, in group A, 23 patients were submitted to the Epley maneuver associated to the use of cervical collar and post-maneuver instructions, meanwhile, in group B, 15 patients were submitted to the Epley maneuver with no cervical collar and/or post-maneuver restrictions. At last, in group C, 15 patients were submitted to the Epley maneuver associated to the use of a mini-vibrator, applied on the mastoid during the maneuver, with no cervical collar and/or post-maneuver restrictions. In BPPV treatment by vestibular rehabilitation the number of maneuvers varied from one to three, and this number was not different among the studied groups. The questionnaire (Dizziness Handicap Inventory - DHI) was applied previously and afterwards VR to quantify the aspects of dizziness: physical, emotional, functional and general. Concerning these aspects, it was observed a significant statistical difference (p<0,001) among the scores previously and afterwards Vestibular Rehabilitation to the analysed groups (A, B, C). It was concluded that the scores of the analysed aspects in DHI were improved after speech pathological intervention by VR in patients with posterior semicircular canal BPPV, that caused impact in the life quality of the studied volunteers regardless the Epley maneuver variation chosen to this treatment. It is also concluded that the real valid treatment for BPPV was the Epley maneuver, with no restrictions.
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Reliability and validity of electronic measures of balance and gaze control in people with peripheral vestibular hypofunctionWonneck, Elizabeth 13 August 2013 (has links)
The purpose of this study was to assess the reliability and validity of a new computerized method of assessing balance and gaze control under a broad range of physical and visual conditions in people with vestibular hypofunction. Test retest reliability for balance performance as measured by COP excursion was good in all conditions with ICCs ranging from .64 to .90 in the AP and ML directions. Closed loop visual tracking as measured by COD had high reliability on the sponge and treadmill (ICC=.71-.75) as compared to open loop tracking (ICC=.325-.463) which was poor. Convergent validity showed poor correlation between clinical tests and the electronic balance and gaze assessments. Construct validity demonstrated that as physical and visual loads increased, balance performance decreased significantly on the sponge as measured by an increase in COP excursion and visual tracking performance decreased significantly on the treadmill as measured by a decrease in COD.
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Reliability and validity of electronic measures of balance and gaze control in people with peripheral vestibular hypofunctionWonneck, Elizabeth 13 August 2013 (has links)
The purpose of this study was to assess the reliability and validity of a new computerized method of assessing balance and gaze control under a broad range of physical and visual conditions in people with vestibular hypofunction. Test retest reliability for balance performance as measured by COP excursion was good in all conditions with ICCs ranging from .64 to .90 in the AP and ML directions. Closed loop visual tracking as measured by COD had high reliability on the sponge and treadmill (ICC=.71-.75) as compared to open loop tracking (ICC=.325-.463) which was poor. Convergent validity showed poor correlation between clinical tests and the electronic balance and gaze assessments. Construct validity demonstrated that as physical and visual loads increased, balance performance decreased significantly on the sponge as measured by an increase in COP excursion and visual tracking performance decreased significantly on the treadmill as measured by a decrease in COD.
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Variantes da manobra de epley no tratamento da vertigem postural paroxística benigna de canal posterior em idosos / Variations on Epley manuever in benign paroxysmal positional vertigo treatment of posterior canal for canalithiasis in elderlyAna Paula do Rego André 26 October 2007 (has links)
A Vertigem Postural Paroxística Benigna (VPPB) é a mais comum das vestibulopatias periféricas, principalmente em idosos e apresenta como etiologia mais comum nessa população à degeneração da mácula utricular. Caracteriza-se por tontura rotatória e nistagmo posicional à mudança de posição da cabeça ou por determinada posição do corpo e, como conseqüência, pode ocorrer quedas e limitações na qualidade de vida dos mesmos, e torná-los limitados físico e emocionalmente. O presente estudo teve como objetivo comparar a eficácia das variantes da manobra de Epley, para que se possa promover ao paciente, cada vez mais, tratamentos rápidos, eficazes e confortáveis. Participaram do estudo 53 voluntários com hipótese diagnóstica otorrinolaringológica de VPPB de canal semicircular posterior por ductolitíase, com faixa etária entre 60 e 91 anos, com média de 67,19 anos. Quanto ao gênero, 38 (71,7 %) eram do sexo feminino. Os pacientes foram distribuídos de forma aleatória em três grupos, conforme tratamento pré-estabelecido, ou seja, no Grupo A, 23 pacientes foram submetidos à manobra de Epley associada ao uso do colar cervical e orientações pós-manobra, enquanto no Grupo B, 15 pacientes foram submetidos à manobra de Epley sem uso do colar cervical e/ou restrições pós-manobra. Por fim, no Grupo C, 15 pacientes foram submetidos à manobra de Epley associada com o uso de um mini vibrador, aplicado na mastóide durante a manobra, sem uso de colar cervical e/ou restrições pós-manobra. No tratamento da VPPB por meio da reabilitação vestibular o número de manobras de Epley variou de uma a três, sendo que este número não foi diferente entre os Grupos estudados. Aplicou-se o questionário (Dizziness Handicap Inventory - DHI brasileiro) pré e pós RV para quantificar a tontura quanto aos aspectos: físico, emocional, funcional e geral. Sobre estes aspectos observou-se diferença estatisticamente significativa (p<0,0001) entre todos os escores pré e pós RV para os três grupos avaliados, embora não se encontrou diferença significativa dos escores entre os grupos estudos, com exceção da diferença média entre o Grupo A e o Grupo B dentro do tempo pós (p=0,009). Concluímos que os escores dos aspectos avaliados no DHI brasileiro melhoraram após intervenção fonoaudiológica pela RV nos pacientes idosos com VPPB de canal semicircular posterior, o que ocasionou impacto na qualidade de vida dos voluntários idosos estudados. Conclui-se ainda que o tratamento realmente válido para a VPPB neste estudo foi à manobra de Epley, sem restrições associadas. / Benign Paroxysmal Positional Vertigo (BPPV) is the most common peripheral vestibulopathy in adults, especially in aged people and presents the utricle degeneration as the most common etiology in this population. It is characterized by rotating dizziness and positional nystagmus to the cephalic movements or by determined body movements and, as a result, can cause falls and quality of life restrictions, making them physically and emotionally limited. The present study had as objective to compare the efficacy of variations on Epley maneuver, in order to provide the patient increasingly, fast, effective and comfortable treatment. Fifty three volunteers took part of the study with otorrinolaringologic diagnostic hypothesis of BPPV of posterior semicircular canal for cupulolithiasis or canalithiasis, at ages between 60 and 91 years old, average 67,19 years old. Concerning the genre, 38 (71,7%) were women. The patients were distributed randomly in three groups according to the pre-determined treatment, in other words, in group A, 23 patients were submitted to the Epley maneuver associated to the use of cervical collar and post-maneuver instructions, meanwhile, in group B, 15 patients were submitted to the Epley maneuver with no cervical collar and/or post-maneuver restrictions. At last, in group C, 15 patients were submitted to the Epley maneuver associated to the use of a mini-vibrator, applied on the mastoid during the maneuver, with no cervical collar and/or post-maneuver restrictions. In BPPV treatment by vestibular rehabilitation the number of maneuvers varied from one to three, and this number was not different among the studied groups. The questionnaire (Dizziness Handicap Inventory - DHI) was applied previously and afterwards VR to quantify the aspects of dizziness: physical, emotional, functional and general. Concerning these aspects, it was observed a significant statistical difference (p<0,001) among the scores previously and afterwards Vestibular Rehabilitation to the analysed groups (A, B, C). It was concluded that the scores of the analysed aspects in DHI were improved after speech pathological intervention by VR in patients with posterior semicircular canal BPPV, that caused impact in the life quality of the studied volunteers regardless the Epley maneuver variation chosen to this treatment. It is also concluded that the real valid treatment for BPPV was the Epley maneuver, with no restrictions.
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Is there a link between dizziness and vision? A systematic reviewArmstrong, Deborah, Charlesworth, Emily, Alderson, Alison J., Elliott, David 02 June 2016 (has links)
Yes / Purpose: The aim of this study was to systematically review the literature to investigate
the link (if any) between vision and dizziness.
Methods: Medline, CINAHL, AMED, Web of Science and The Cochrane Library
were searched with keywords chosen to find articles which investigated the causes
of dizziness and considered vision as a possible trigger. Citation chaining of all
included papers was performed in addition to the hand searching of all reference
lists. Unpublished literature was identified using www.opengrey.eu. The review
considered studies involving adults which link, measure or attempt to improve
any aspect of vision in relation to dizziness.
Results: Nine thousand six hundred and eighty one possible references were
found, and the abstracts were screened independently by two reviewers to determine
if they should be included in the study. Thirteen papers were found which
investigated whether dizziness was linked to an assessment of vision. Visual
impairment measures were crude and typically self-report, or Snellen visual acuity
with little or no measurement details. Five studies found an independent link
between dizziness and vision, five found a weak association (typically finding a
link when univariate analyses were used, but not when multivariate analyses were
used), and three found no association. Studies finding a strong link were usually
cross-sectional with a large study population whereas those finding a weak association
had relatively small numbers of participants. Studies which did not find an
association used a broad definition of dizziness that included the term light-headedness,
an unreliable Rosenbaum near visual acuity chart or an unusual categorisation
of visual acuity.
Conclusions: This review suggests that dizziness (although likely not ‘light-headedness’)
is linked with poor vision although further studies using more appropriate
measures of vision are recommended. / Deborah Armstrong was funded by a College of Optometrists Research Scholarship and Emily Charlesworth by a College of Optometrists summer studentship.
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Subjective Verticality Is Disrupted by Astigmatic Visual Distortion in Older PeopleElliott, David, Black, A.A., Wood, J.M. 25 April 2020 (has links)
Yes / PURPOSE:
There is little research evidence to explain why older adults have more problems adapting to new spectacles incorporating astigmatic changes than younger adults. We tested the hypothesis that astigmatic lenses oriented obliquely would lead to errors in verticality perception that are greater for older than younger adults.
METHODS:
Participants included 12 young (mean ± SD age 25.1 ± 5.0 years) and 12 older (70.2 ± 6.3 years) adults with normal vision. Verticality perception was assessed using a computer-based subjective visual vertical (SVV) task, under static and dynamic (in the presence of a moving peripheral distractor) conditions and when viewing targets through the near refractive correction (control condition), and two forms of astigmatic lenses oriented in the vertical, horizontal, and oblique meridians.
RESULTS:
The older group demonstrated much greater dynamic SVV errors (e.g., 3.4° for the control condition) than the younger group (1.2°, P = 0.002), larger errors with vertical and horizontal astigmatic lenses (older group 4.1°and 5.2° for toric and magnifier lenses vs. younger group 1.2° and 1.4°, respectively, P < 0.001), and a larger influence of the oblique astigmatic lenses (older group 5.6° vs. younger group 2.1°, P<0.001).
CONCLUSIONS:
Astigmatic lenses produced little or no errors in SVV in young adults, but large static and dynamic SVV errors in older adults. This indicates a greater reliance on visual input with increased age for SVV, and helps explain why oblique astigmatic refractive corrections can cause dizziness in older patients and why they report greater difficulties adapting to new spectacles with astigmatic changes.
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Development and validation of the vision-related dizziness questionnaireArmstrong, Deborah, Alderson, Alison J., Davey, Christopher J., Elliott, David 29 May 2018 (has links)
Yes / Purpose: To develop and validate the first patient-reported outcome measure (PROM)
to quantify vision-related dizziness. Dizziness is a common, multifactorial syndrome that
causes reductions in quality of life and is a major risk factor for falls, but the role of vision
is not well understood.
Methods: Potential domains and items were identified by literature review and discussions
with experts and patients to form a pilot PROM, which was completed by 335
patients with dizziness. Rasch analysis was used to determine the items with good
psychometric properties to include in a final PROM, to check undimensionality, differential
item functioning, and to convert ordinal questionnaire data into continuous interval
data. Validation of the final 25-item instrument was determined by its convergent validity,
patient, and item-separation reliability and unidimensionality using data from 223 patients
plus test–retest repeatability from 79 patients.
results: 120 items were originally identified, then subsequently reduced to 46 to form
a pilot PROM. Rasch analysis was used to reduce the number of items to 25 to produce
the vision-related dizziness or VRD-25. Two subscales of VRD-12-frequency and
VRD-13-severity were shown to be unidimensional, with good psychometric properties.
Convergent validity was shown by moderately good correlations with the Dizziness
Handicap Inventory (r = 0.75) and good test–retest repeatability with intra-class correlation
coefficients of 0.88.
conclusion: VRD-25 is the only PROM developed to date to assess vision-related
dizziness. It has been developed using Rasch analysis and provides a PROM for this
under-researched area and for clinical trials of interventions to reduce vision-related
dizziness. / College of Optometrists (UK) research studentship.
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Hipersensibilidade a inalantes e alimentos nos distúrbios do equilíbrio corporal / Hypersensitivity to inhalants and foods in corporal equilibrium disturbsDomingues, Erika Cisi 10 March 2010 (has links)
Introdução: O saco endolinfático tem sido apontado como o alvo das reações imuno-alérgicas da orelha interna. A prevalência de alergia em pacientes com Doença de Ménière foi estabelecida em torno de 41,6% para inalantes e 26,6% para alimentos, por Derebery em 2000, dados aumentados em relação à prevalência de alergia na população em geral, que, no Brasil, varia de 9% a 30% para inalantes e de 1% a 3% para alimentos. Objetivos: Avaliar a prevalência de reações de hipersensibilidade tipo I a inalantes e alimentos na população do setor de Otoneurologia do Hospital das Clínicas da Faculdade de Medicina de São Paulo e descrever os sintomas vestibulares dos pacientes. Casuística e método: Setenta e cinco pacientes com distúrbios do equilíbrio de origem periférica foram submetidos a questionário de caracterização clínica de sintomas cócleo-vestibulares e teste cutâneo (prick test) para 13 inalantes e 5 alimentos. Resultados: Vinte e cinco (33,3%) pacientes apresentaram prick test positivo a pelo menos um alérgeno inalante e 6 (8%) a pelo menos um alérgeno alimentar. Quatro pacientes apresentaram prick test positivo na ausência de sintomas alérgicos. Prevaleceu a queixa de tontura de caráter rotatório em proporções semelhantes entre os pacientes com prick test positivo e negativo. Conclusão: A prevalência de reações de hipersensibilidade tipo I a inalantes e a alimentos na população avaliada foi maior do que na população em geral. Os sintomas vestibulares não diferiram entre os pacientes da amostra, com prick test positivo ou negativo. No entanto, deve-se obter maior número de amostra para que os dados sejam confiáveis. / Introduction: The endolymphatic sac has been pointed out as the target of immuno-allergic reactions in the inner ear. The prevalence of allergy in patients with Ménières disease was established as approximately 41,6% for inhalants and 26,6% for food by Derebery in 2000, an increase in the data in relation to that of the prevalence of allergy in the general population, which in Brazil varies from 9% to 30% for inhalants and from 1% to 3% for food. Objectives: To evaluate the prevalence of reactions to type I hypersensitivity to inhalants and food in the population of the Otoneurological Section of the Clinics Hospital of the University of São Paulo Medicine School and to describe the vestibular symptoms of the patients. Method: Seventy-five patients with peripheral equilibrium disturbances who had answered a questionnaire of clinical characterization regarding cochlear-vestibular symptoms and undergone prick test for 13 inhalants and 5 types of food. Results: Twenty-five (33,3%) of the patients were positive for the prick test and for at least one allergen inhalant and 6 (8%) for at least one food allergen. Four patients were positive for the prick test in the absence of allergy symptoms. There was a prevalence of the complaint of rotatory dizziness in similar proportions among the patients with positive and negative prick test. Conclusion: The presence of type I hypersensitivity reactions to inhalants and food in the population evaluated was greater than in the general population. The vestibular symptoms did not differ among the patients in the sample, neither with positive or negative prick test results. However, a sample of greater number should be obtained for a higher confidence level of data results.
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Tontura e suas implicações: para além do corpo orgânico / Dizziness and its implications to beyond the organic bodyLardaro, Vanessa Cristina 22 March 2005 (has links)
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Previous issue date: 2005-03-22 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Dizziness is the symptom pointed as the most frequent in medical literature of the diseases of the vestibular system. The treatment of the vestibular alterations may be by drugs, by surgery or functional. This last one, generally, is up to the speech therapist, responsible for the so-called vestibular rehabilitation. While accompanying a vestibular rehabilitation process, the researcher observed the fact that the patient speaks continuously about his/her symptoms which are they and how are they and his/her speech did not constitute an object of attention or hearing by the speech therapist.
So, in order to understand the nature of the relationship between symptom and patient speech the purpose of this study showed up: to analyze the subject s speech with vestibular alterations to identify the symptoms that are present there and to point out the possible relationships of its implication between dizziness and subjectivity. The study justifies itself by allowing circumscribing the dizziness as a manifestation that surpasses the boundaries of what is related to the body. The theoretical and methodological approach used the Discourse Analysis of French line allowed the inclusion of the patient s speech, as part of the clinical material on which the therapist is going to act. It was concluded, that the speeches, which were not signified before, begin, according to this approach to be interpreted by the own subject that, while talking about his/her symptoms not only gives them meanings but also act upon them, putting the meanings on circulation. It is understood that this speech circulation may be operative, contributing to a greater efficacy of the so called vestibular rehabilitation / A tontura é o sintoma retratado, como o mais frequente na literatura médica sobre as doenças do sistema vestibular. O tratamento das alterações vestibulares pode ser medicamentoso, cirúrgico e funcional. Este último cabe, geralmente, ao fonoaudiólogo, responsável pela chamada reabilitação vestibular. Ao acompanhar um processo de reabilitação vestibular, a pesquisadora observou o fato de pacientes falarem continuamente a respeito de seus sintomas - quais são e como são - e seus dizeres não se constituiram em objeto de atenção ou de escuta do fonoaudiólogo. Assim, pelo interesse em entender a respeito da natureza da relação entre o sintoma e a fala do paciente, surgiu o objetivo deste estudo: analisar o discurso de um sujeito com alterações vestibulares para identificar os sintomas que ali se presentificam e apontar as possíveis relações de sua implicação entre tontura e subjetividade. O estudo justifica-se por permitir circunscrever a tontura, como manifestação que ultrapassa os limites do que é relativo ao corpo. A abordagem teórico-metodológica adotada - a Análise de Discurso de linha francesa - permitiu a inclusão dos dizeres do paciente como parte do material clínico sobre o qual o terapeuta irá atuar. Conclui-se que os dizeres antes não significados, passam, nesta abordagem, a ser interpretados pelo próprio sujeito que, ao falar de seu(s) sintoma(s), não só lhe(s) atribui sentidos mas também opera sobre ele(s), colocando os sentidos em circulação. Entende-se que esta circulação de dizeres poderá ser operativa, contribuindo para maior eficácia da chamada reabilitação vestibular
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Avaliação do benefício da intervenção fonoaudiológica em adultos e idosos com tonturaRosa, Luiza Diniz da 12 December 2016 (has links)
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Previous issue date: 2016-12-12 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / INTRODUCTION: Dizziness is a very common symptom and it affects mainly adults and the elderly. It can lead to significant damage, disrupting the patient´s quality of life. Considering the high prevalence of reported dizziness in the population, many studies have been carried out in order to both identify its possible causes and develop speech therapy intervention techniques. OBJECTIVE: To evaluate the benefits of speech therapy intervention in adults and elderly people with dizziness. METHOD: Prospective and longitudinal clinical study conducted on a sample of 20 patients with complaints of dizziness, of both sexes and aged between 48 and 85 years of age (average of 66 years of age). All subjects were referred to vestibular rehabilitation by medical indication and they underwent ten sessions of exercises based and adapted from the Cawthorne (1944) and Cooksey (1946) Protocol. In addition, we applied the Dizziness Handicap Inventory (DHI), the Geriatric Depression Scale (GDS) and the Dizziness Quantification Scale questionnaires in three moments: before the intervention, at the fifth session of speech therapy intervention and after the tenth session. At the end of the ten sessions, all subjects answered a question concerning the improvement of the dizziness symptomatology. We used the questionnaires in the three moments of intervention both for comparison purposes and for the assessment of the effectiveness of the treatment. RESULTS: After the intervention, 17 subjects (85%) showed improvement in the DHI score and 18 (90%) reported improvement in the dizziness symptomatology. In spite of the fact that the three tests had a decrease in average in the three moments, we observed intervention interference only in relation to the DHI. The symptoms of depression, anxiety and insecurity were considered as influence variables in the intervention results. Cronbach’s Alpha showed that the DHI delivers a good consistency level, whereas GDS-5 showed only reasonable significance. CONCLUSION: The speech therapy intervention on dizziness proved to be effective. We observed there was a greater benefit in the 10-session intervention, when compared to the 5-session intervention. The use of questionnaires to assess the result of the interventions is an important instrument in the assessment of the treatment effectiveness. However, self-reference and clinical hearing should be taken into account / INTRODUÇÃO: a tontura é um sintoma muito comum e afeta principalmente adultos e idosos. Pode levar a prejuízos significativos, atrapalhando a qualidade de vida. Considerando a alta prevalência da queixa de tontura na população, muitos estudos têm sido realizados com o objetivo tanto de identificar as possíveis causas, quanto de desenvolver técnicas de intervenção fonoaudiológica. OBJETIVO: avaliar o benefício da intervenção fonoaudiológica em adultos e idosos com tontura. MÉTODO: estudo clínico prospectivo e longitudinal realizado em uma amostra de 20 pacientes com queixa de tontura, de ambos os sexos e com idade entre 48 e 85 anos (média de 66 anos). Todos os sujeitos foram encaminhados para reabilitação vestibular por indicação médica e realizaram dez sessões de exercícios, baseados e adaptados do Protocolo de Cawthorne (1944) e Cooksey (1946). Além disso, foram aplicados os questionários Dizziness Handicap Inventory (DHI), Escala Geriátrica de Depressão (GDS) e Escala de Quantificação da Tontura (QT) em três momentos: antes da intervenção, na 5ª sessão de intervenção fonoaudiológica e após a décima sessão. No término das dez sessões, todos responderam a uma questão referente à melhoria do sintoma de tontura. Os questionários foram utilizados para fins comparativos entre os três momentos da intervenção e para avaliação da efetividade do tratamento. RESULTADOS: após a intervenção, 17 sujeitos (85%) apresentaram melhora no escore do DHI e 18 (90%) relataram melhora do sintoma de tontura. Apesar dos três testes terem tido diminuição das médias nos três momentos, foi observada interferência da intervenção apenas em relação ao DHI. Os sintomas de depressão, ansiedade e insegurança foram considerados como variáveis de influência nos resultados das intervenções. O Alfa de Conbrach mostrou que o DHI apresenta um bom nível de consistência, já a GDS-15 demonstrou significância razoável. CONCLUSÃO: a intervenção fonoaudiológica na tontura mostrou-se efetiva. Foi observado maior benefício quanto a intervenção com 10 sessões, quando comparado a 5 sessões. O uso de questionários para verificar o resultado das intervenções consiste em um importante instrumento de avaliação da efetividade do tratamento. Entretanto, a auto-referência e a escuta clínica devem ser valorizadas
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