Background: Ménières disease is a complex neurological disease that varies greatly from individual to individual with symptoms such as dizziness and tinnitus. There are few studies that examines the differences regarding balance and dizziness related perception of disabilitiy between men and women with Ménière’s disease. Purpose: Investigate self-assessed perception of disability and balance of people with Ménières disease. The study also aimed to investigate whether there were any differences between men and women regarding the above mentioned variables. Method: Retrospective study with quantitative, correlative and comparative design. 41 subjects, 21 women, 20 men were included in the study. Results: No significant difference between men and women regarding scores on DHI-S or result on Romberg’s test could be shown in this study. Neither could any significant connection between self-assessed perception of disability and balance measured with DHI-S and Romberg’s respectively could be made. Conclusion: No relation between self-assessed disability and balance was detected between men and women. The study also did not find any differences between the sexes on how they perform on balance measurement or rate their disability. More studies are needed to further investigate and map this area. / Bakgrund: Ménières sjukdom är en neurologisk sjukdom med symtom som yrsel och tinnitus. I dagsläget finns få studier som undersöker skillnader gällande balans och yrsel relaterad upplevelse av funktionsnedsättning mellan män respektive kvinnor med Ménières sjukdom. Syfte: Syftet med studien var att undersöka eventuella samband mellan självskattad funktionsnedsättning och balans samt skillnader mellan män och kvinnor. Metod: Retrospektiv studie med kvantitativ, korrelerande och komparativ design. 41 antal försökspersoner, 21 kvinnor, 20 män inkluderades i studien. Resultat: Ingen skillnad mellan män och kvinnors värde på DHI-S kunde påvisas. Det förelåg ingen signifikant skillnad mellan män och kvinnor gällande resultat på Rombergs test. Inget samband mellan upplevelse av funktionsnedsättning och balans mätt med DHI-S respektive Rombergs test för kvinnor och män gick att påvisa. Konklusion: Inget samband mellan självskattad funktionsnedsättning och balans kunde påvisas hos män och kvinnor. Studien fann inte heller några skillnader mellan könen gällande hur de presterar på balansmätning eller skattar sin funktionsnedsättning. Vidare studier behövs för att kunna ytterligare undersöka och kartlägga detta område.

Purpose: To determine whether symptoms of dizziness and fall rates change due to routine cataract surgery and to determine the influence of visual and refractive factors on these common problems in older adults. Methods: Self-reported dizziness and falls were determined in 287 subjects (mean age of 76.5±6.3 years, 55% females) before and after routine cataract surgery for the first (81, 28%), second (109, 38%) and both eyes (97, 34%). Six-month falls rates were determined using self-reported retrospective data. Dizziness was determined using the short-form of the Dizziness Handicap Inventory. Results: The number of patients with dizziness reduced significantly after cataract surgery (52% vs. 38%; χ2 = 19.14 , p < 0.001), but the reduction in number of patients who fell in the 6-months post surgery was not significant (23% vs. 20%; χ2= 0.87, p=0.35). Multivariate logistic regression analyses found significant links between post-operative falls and change in spectacle type (increased risk if switched into multifocal spectacles). Post-operative dizziness was associated with changes in best eye visual acuity and changes in oblique astigmatic correction. Conclusions: Dizziness is significantly reduced by cataract surgery and this is linked with improvements in best eye visual acuity, although changes in oblique astigmatic correction increased dizziness. The lack of improvement in falls rate may be associated with switching into multifocal spectacle wear after surgery.

Purpose: To determine whether symptoms of dizziness and fall rates change due to routine cataract surgery and to determine the influence of visual and refractive factors on these common problems in older adults. Methods: Self-reported dizziness and falls were determined in 287 subjects (mean age of 76.5±6.3 years, 55% females) before and after routine cataract surgery for the first (81, 28%), second (109, 38%) and both eyes (97, 34%). Six-month falls rates were determined using self-reported retrospective data. Dizziness was determined using the short-form of the Dizziness Handicap Inventory. Results: The number of patients with dizziness reduced significantly after cataract surgery (52% vs. 38%; χ2 = 19.14 , p<0.001), but the reduction in number of patients who fell in the 6-months post surgery was not significant (23% vs. 20%; χ2= 0.87, p=0.35). Multivariate logistic regression analyses found significant links between post-operative falls and change in spectacle type (increased risk if switched into multifocal spectacles). Post-operative dizziness was associated with changes in best eye visual acuity and changes in oblique astigmatic correction. Conclusions: Dizziness is significantly reduced by cataract surgery and this is linked with improvements in best eye visual acuity, although changes in oblique astigmatic correction increased dizziness. The lack of improvement in falls rate may be associated with switching into multifocal spectacle wear after surgery. / The Dunhill Medical Trust

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.

Bibliographic identification IŠTOKOVÁ, Lucie. The influence of cochlear implant on vestibular function in adult patients. Prague: Charles University, 2nd Faculty of Medicine, Department of Rehabilitation and Sports Medicine, 2020. 58 p., Appendices. Thesis supervisor Mgr. Klára Kučerová. Abstract Severe hearing loss is standardly treated by cochlear implantation. Considering the anatomical proximity and interconnection to the vestibulocochlear nerve, it is possible to influence vestibular functions. The aim of this diploma thesis is to evaluate the effect of unilateral cochlear implantation on postural stability and vestibular function in adult patients with severe hearing loss caused postlingually. Eleven patients aged 28-72 were examined the day before surgery, the day after surgery, and on average 25 days after surgery. The evaluation consisted of short-form Dizziness Handicap Inventory (DHI), Timed Up and Go testing (TUG), static stabilometry and the perception of the subjective visual vertical (SVV) static and dynamic. Significant deterioration of TUG and SVV was recorded particularly immediately after surgery. In dynamic SVV, especially, when the field of view rotated to the left. Considerable results in stabilometry were only when standing on a hard surface with eyes closed. Improvements in TUG, SVV...