A tontura é um sintoma que acomete a população mundial, sendo observada maior prevalência em idosos devido ao processo de deterioração funcional dos sistemas auditivo e vestibular com o envelhecimento e também devido à alta sensibilidade destes sistemas a problemas clínicos situados em outras partes do corpo humano, comumente relacionados à etiologia vascular e metabólica. A Reabilitação Vestibular (RV) tem se mostrado uma importante e efetiva estratégia no tratamento de indivíduos com desordens do equilíbrio corporal, proporcionando uma acentuada melhora na qualidade de vida. O objetivo deste trabalho foi avaliar prospectivamente o efeito da RV como forma de tratamento das labirintopatias de origem vascular e metabólica sobre a qualidade de vida de indivíduos idosos. O estudo foi delineado como um ensaio clínico prospectivo, longitudinal, observacional, com a participação de 40 indivíduos idosos de ambos os gêneros, com faixa etária entre 60 e 84 anos, divididos em 2 grupos conforme o diagnóstico médico, tontura de origem vascular ou metabólica. Os pacientes passaram por anamnese, aconselhamento, avaliação da qualidade de vida (escala de quantificação da tontura e Dizziness Handicap Inventory brasileiro) e a RV propriamente dita que se baseou no protocolo de Cawthorne e Cooksey. A análise estatística dos dados foi feita através do teste t-Student, para comparações de amostras pareadas, usando um teste de hipótese bilateral; os coeficientes de Pearson e de Spearman foram usados no estudo de correlações. Observou-se que o idoso portador de labirintopatia de origem metabólica ou vascular, possui idade média de 70,2 anos, diagnóstico prevalente no grupo metabólico de diabetes mellitus e no grupo vascular de hipertensão arterial sistêmica. Pelas escalas utilizadas podemos observar que os aspectos avaliados por meio do DHI (físico, emocional, funcional e geral) e escala de quantificação de tontura, melhoraram após a intervenção terapêutica pela Reabilitação Vestibular nos idosos portadores de labirintopatias de origem vascular e metabólica. Contudo não se observou diferença significativa nas escalas do DHI e quantificação da tontura pós RV entre os grupos metabólico e vascular. Observou-se ainda, neste estudo, correlação significativa entre a escala de quantificação da tontura com o DHI pré e pós-tratamento. Pelas questões abordadas no DHI houve um incremento na qualidade de vida de todos os idosos em estudo. O período de terapia mediante RV variou de quatro a dez sessões terapêuticas. Assim, levando em consideração os dados epidemiológicos do envelhecimento no Brasil e sabendo que a grande parte dos idosos com afecções otoneurológicas tem origem vascular e metabólica, conclui-se que a RV baseada nos protocolos de Cawthorne e Cooksey pode ser utilizada de modo benéfico nesta população, trazendo inclusive impacto positivo na qualidade de vidas destes indivíduos. / The dizziness is a symptom that attacks the world-wide population, being observed bigger predominance in old due to the process of functional deterioration of the hearing and vestibular systems with the aging and also due to the high sensibility of these systems to clinical problems situated in other parts of the human body, usually related to vascular and metabolic etiology. The Vestibular Rehabilitation (VR) has shown an important and effective strategy in the individuals\' treatment with disorders of the physical balance, providing an accented improvement in the quality of life. The objective of this work was evaluate prospectively the effect of the RV as form of treatment of the labyrinth disease of vascular and metabolic origin in the quality of life of geriatric patients. The study was outlined like a clinical prospective test, longitudinal, observed, with the participation of 40 old individuals of both genders, with age group between 60 and 84 years divided in 2 groups according to the medical diagnosis,dizziness of vascular or metabolic origin. The patients passed over medical examinations, anamnesis, advising, evaluation of quality of life (scale of quantification of dizziness and Brazilian Dizziness Handicap Inventory) and the VR properly stated, what was based on the protocol of Cawthorne and Cooksey. The statistics analysis from the data was done through the t-Student test, to comparisons of parallels samples, using a test of bilateral hypothesis; the coefficients of Pearson and Spearman were used in the study of correlations. It was noticed that the old bearer of labyrinth disease of metabolic or vascular origin, has average age of 70,2 years, prevalent diagnosis in the metabolic group of diabetes mellitus and in the vascular group of arterial high blood pressure. For the used scales we can notice that the aspects evaluated through the DHI (physical, emotional, functional and general) and the scale of quantification of dizziness, improved after the therapeutic intervention by the Vestibular Rehabilitation in the geriatric patients with labyrinth disease of vascular and metabolic origin. Nevertheless significant difference in the scales of the DHI and quantification of dizziness after VR was not observed between the metabolic and vascular groups. Significant correlation was still observed in this study between the scales of quantification of dizziness with the DHI before and after treatment. For the questions boarded in the DHI there was a growth in the quality of life of all the old ones in study. The total time of treatment by means of VR varies of 4-10 therapeutic sessions. So, taking into account the epidemiologist data of the aging in Brazil and knowing that great part of the old ones with vestibular affections has vascular and metabolic origin, it is concluded that the VR based on the protocols of Cawthorne and Cooksey, can be used inbeneficial way in this population, also bringing positive impact in the capacity of life of these individuals.

A tontura é um sintoma que acomete a população mundial, sendo observada maior prevalência em idosos devido ao processo de deterioração funcional dos sistemas auditivo e vestibular com o envelhecimento e também devido à alta sensibilidade destes sistemas a problemas clínicos situados em outras partes do corpo humano, comumente relacionados à etiologia vascular e metabólica. A Reabilitação Vestibular (RV) tem se mostrado uma importante e efetiva estratégia no tratamento de indivíduos com desordens do equilíbrio corporal, proporcionando uma acentuada melhora na qualidade de vida. O objetivo deste trabalho foi avaliar prospectivamente o efeito da RV como forma de tratamento das labirintopatias de origem vascular e metabólica sobre a qualidade de vida de indivíduos idosos. O estudo foi delineado como um ensaio clínico prospectivo, longitudinal, observacional, com a participação de 40 indivíduos idosos de ambos os gêneros, com faixa etária entre 60 e 84 anos, divididos em 2 grupos conforme o diagnóstico médico, tontura de origem vascular ou metabólica. Os pacientes passaram por anamnese, aconselhamento, avaliação da qualidade de vida (escala de quantificação da tontura e Dizziness Handicap Inventory brasileiro) e a RV propriamente dita que se baseou no protocolo de Cawthorne e Cooksey. A análise estatística dos dados foi feita através do teste t-Student, para comparações de amostras pareadas, usando um teste de hipótese bilateral; os coeficientes de Pearson e de Spearman foram usados no estudo de correlações. Observou-se que o idoso portador de labirintopatia de origem metabólica ou vascular, possui idade média de 70,2 anos, diagnóstico prevalente no grupo metabólico de diabetes mellitus e no grupo vascular de hipertensão arterial sistêmica. Pelas escalas utilizadas podemos observar que os aspectos avaliados por meio do DHI (físico, emocional, funcional e geral) e escala de quantificação de tontura, melhoraram após a intervenção terapêutica pela Reabilitação Vestibular nos idosos portadores de labirintopatias de origem vascular e metabólica. Contudo não se observou diferença significativa nas escalas do DHI e quantificação da tontura pós RV entre os grupos metabólico e vascular. Observou-se ainda, neste estudo, correlação significativa entre a escala de quantificação da tontura com o DHI pré e pós-tratamento. Pelas questões abordadas no DHI houve um incremento na qualidade de vida de todos os idosos em estudo. O período de terapia mediante RV variou de quatro a dez sessões terapêuticas. Assim, levando em consideração os dados epidemiológicos do envelhecimento no Brasil e sabendo que a grande parte dos idosos com afecções otoneurológicas tem origem vascular e metabólica, conclui-se que a RV baseada nos protocolos de Cawthorne e Cooksey pode ser utilizada de modo benéfico nesta população, trazendo inclusive impacto positivo na qualidade de vidas destes indivíduos. / The dizziness is a symptom that attacks the world-wide population, being observed bigger predominance in old due to the process of functional deterioration of the hearing and vestibular systems with the aging and also due to the high sensibility of these systems to clinical problems situated in other parts of the human body, usually related to vascular and metabolic etiology. The Vestibular Rehabilitation (VR) has shown an important and effective strategy in the individuals\' treatment with disorders of the physical balance, providing an accented improvement in the quality of life. The objective of this work was evaluate prospectively the effect of the RV as form of treatment of the labyrinth disease of vascular and metabolic origin in the quality of life of geriatric patients. The study was outlined like a clinical prospective test, longitudinal, observed, with the participation of 40 old individuals of both genders, with age group between 60 and 84 years divided in 2 groups according to the medical diagnosis,dizziness of vascular or metabolic origin. The patients passed over medical examinations, anamnesis, advising, evaluation of quality of life (scale of quantification of dizziness and Brazilian Dizziness Handicap Inventory) and the VR properly stated, what was based on the protocol of Cawthorne and Cooksey. The statistics analysis from the data was done through the t-Student test, to comparisons of parallels samples, using a test of bilateral hypothesis; the coefficients of Pearson and Spearman were used in the study of correlations. It was noticed that the old bearer of labyrinth disease of metabolic or vascular origin, has average age of 70,2 years, prevalent diagnosis in the metabolic group of diabetes mellitus and in the vascular group of arterial high blood pressure. For the used scales we can notice that the aspects evaluated through the DHI (physical, emotional, functional and general) and the scale of quantification of dizziness, improved after the therapeutic intervention by the Vestibular Rehabilitation in the geriatric patients with labyrinth disease of vascular and metabolic origin. Nevertheless significant difference in the scales of the DHI and quantification of dizziness after VR was not observed between the metabolic and vascular groups. Significant correlation was still observed in this study between the scales of quantification of dizziness with the DHI before and after treatment. For the questions boarded in the DHI there was a growth in the quality of life of all the old ones in study. The total time of treatment by means of VR varies of 4-10 therapeutic sessions. So, taking into account the epidemiologist data of the aging in Brazil and knowing that great part of the old ones with vestibular affections has vascular and metabolic origin, it is concluded that the VR based on the protocols of Cawthorne and Cooksey, can be used inbeneficial way in this population, also bringing positive impact in the capacity of life of these individuals.

No description available.

No description available.

The purpose of this study was to determine the reliability of two new alternative portable methods for measuring maximal isometric force measures while performing the standard mid-thigh pull. One method, the bar grip method, required the use of the trunk and upper extremity muscles, while the second method, the pelvic belt method, did not. Both methods demonstrated good test-retest reliability via randomized repeated measures over 24-36 hours. Interestingly, the pelvic belt method generally demonstrated average maximal forces up to 65% higher than the bar method. There was a good relationship between both methods. These new alternative methods could provide strength coaches an option for a more efficient, cost-effective, portable means for the mid-thigh pull test.

Excerpt: Recently, clinical vestibular tests have been developed for assessing otolith function. Little is known about treatment for otolith dysfunction, and this case report offers a perspective on using otolith stimulation to treat vestibular loss.

Abstract available through Physical Therapy.

Dizziness and balance problems are common symptoms at all ages. The aims were; to evaluate rehabilitation, static, dynamic balance and recovery in acute unilateral vestibular loss (AUVL), to evaluate the treatment of benign paroxysmal positional vertigo (BPPV) with assessment of static and dynamic balance and to evaluate the prevalence of dizziness and BPPV in a population of 75-year-olds. Study 1: Twenty-seven patients (51years) with AUVL were included and the recovery was followed regarding vestibular function, dizziness, and sick-leave. The recovery was rapid, with disappearance of spontaneous nystagmus and rapid return to work. Study II: Forty two patents (51 years) with AUVL were included and compared with a reference group. Static and dynamic balance were assessed after six months. Significant instability was found both in static and dynamic balance compared to a reference group. Study III: Seventeen patients (52 years) with severe BPPV (> 3 months) were treated with Semonts´s manouver and/or Brandt-Daroff exercises. The recovery was evaluated by Dix-Hallpike test, subjective dizziness, unsteadiness and balance tests, after 1, 6 and 12 months. Semont´s maneouver resolved dizziness but the long term follow up showed impaired balance. Study IV: A large cohort (675) of elderly was assessed regarding dizziness and BPPV. Side lying test and balance tests were applied. A high prevalence of dizziness (36%) and BPPV (11%) was found. Conclusions: Patients with AUVL and BPPV have despite good symptomatic relief, still impaired static and dynamic balance at long term follow up. BPPV in elderly is common and should be examined since it can be treated.

The thesis deals with the evaluation of gait and balance tests in patients after vestibular schwannoma surgery. The experimental part focuses on the evaluation of dynamics of walking tests during hospitalization of patients diagnosed with vestibular schwannoma. The aim of the experimental part is also to analyze statistically significant correlations between measurable parameters of vestibulo-ocular reflex and walking tests and to evaluate the correlation between the subjective scale of fall fear and the objective assessment of walking and dynamic postural stability. A total of 28 patients aged 33 to 68 (14 men and 14 women) were incuded in the research with diagnosed vestibular schwannoma. Measurements were performed three times in patients (before surgery, after surgery and before the end of hospitalization). After the surgery, in addition to standard rehabilitation, training with visual biofeedback was included using the interactive Homebalance system. Gait and balance assessments were performed throug the tests Timed Up and Go, Four Step Square Test and Functional Gait Assessment. Examinations were complemented by a questionnaire of subjective assessment of fear of falling Falls Efficacy Scale. Statistical analysis showed a significant correlation coefficient in the correlation of Four Step...

Summary: The aim of our study was diagnosis and rehabilitation of vestibular loss in patients with vestibular schwannoma. In the first part we focused on analysis of a group of patients before resection of vestibular schwannoma, mainly on evaluation of gain of posturography and on optimalisation of diagnostic algorithm of vestibular pathology. Throughout the second experiment, we studied if rehabilitation of postural gait with visual biofeedback will speed up vestibular compensation in patients after resection of vestibular schwannoma. The group consisted of 44 patients, who underwent surgical removal of vestibular schwannoma. Before surgery each patient underwent clinical vestibular examination, electronystagmographic recordings and posturography. In the second part of the study 17 patients from previous group were chosen. These patients underwent rehabilitation and rehabilitation with biofeedback. For evaluation was used independent samples T-test and cross-tabulation. A great number of variables were reduced by factor analysis. For statistical analysis of the group with rehabilitation was used nonparametric Wilcoxon signed rank test. Statistical analysis revealed that the most typical parameter for vestibular pathology is the time of the step quick turn test, which is a part of posturography. We proved...