Ce travail est constitué de trois études en plus de la revue de la littérature sur le système de l'équilibration, sur les troubles de l'équilibre d'origine vestibulaire périphérique et sur les principes de la rééducation. I. Etude normative et de la reproductibilité des tests vestibulo-spinaux et rotatoires Objectif : déterminer pour chaque tranche d'âge les valeurs normatives aux tests vestibulo-spinaux et rotatoires et vérifier l'effet de la latéralité sur les sens de déviation et de rotation ; et l'effet du sens de déplacement sur l'amplitude de l'angle. Méthodologie : 120 sujets âgés de 20 à 79 ans ont effectué les tests vestibulo-spinaux et rotatoires pour rechercher les valeurs normatives et 31 parmi ces derniers ont refait les épreuves pour vérifier la reproductibilité des résultats. Résultats :- Les tests vestibulo-spinaux augmentent avec l'âge. Il n'y a pas d'effet de la latéralité sur le sens de déviation ou de rotation. Le sens de déviation ou de rotation n'a pas d'influence significative sur l'amplitude de l'angle. Dans les tests rotatoires avec ou sans fixation, les durées de stabilisation dans le sens horaire et anti-horaire ne sont pas significativement différentes. Conclusion : - les résultats augmentent avec l'âge. Les thérapeutes doivent en tenir compte lors de l'évaluation. II. Etude normative et de la reproductibilité d'une échelle du handicap lié aux troubles de l'équilibre et aux vertiges (E.H.T.E.V.) Objectif. - Déterminer les scores normatifs, en fonction de l'âge et vérifier l'effet du sexe sur les résultats et la reproductibilité de l'E.H.T.E.V. Méthodologie : - La recherche des scores normatifs et de l'effet du sexe a été faite sur une population de 120 sujets, âgés de 20 à 79 ans, sans troubles d'équilibre. L'étude de la reproductibilité des résultats a été faite sur 47 sujets. Les résultats.- Les scores à l' E.H.T.E.V augmentent avec l'âge. Il n'y a pas d'influence significative du sexe sur les scores et la reproductibilité est importante. Conclusion.- Les scores sont influencés par l'âge et il n'y a pas d'effet du sexe sur les résultats. La reproductibilité est importante. Cependant la traduction de cette échelle de l'anglais en français nécessite la validation et la vérification de la fiabilité. III. Intérêt du traitement par exercice rotatoire chez les patients atteints du syndrome de Ménière Objectif : L'objectif de notre travail consiste à évaluer l'efficacité du traitement des troubles d'équilibre par des exercices rotatoires chez les patients souffrant du syndrome de Ménière unilatéral. Méthodologie : les patients sont soumis à des stimulations rotatoires visant à symétriser et à diminuer la réponse nystagmique post-rotatoire. Pour évaluer l'efficacité de ce traitement, les résultats pré- et post-thérapeutiques aux épreuves vestibulo-spinales et rotatoires ainsi que l'analyse de la perception des vertiges par les sujets ont été utilisés. Résultats : -Les patients ont eu en moyenne 11 séances de fauteuil rotatoire pour être subjectivement améliorés. Les épreuves objectives et subjectives montrent une amélioration significative. Conclusion : L'étude montre une amélioration des paramètres objectifs et subjectifs./ After literature review on equilibrium system and peripheral vestibular disorders, vestibular and rehabilitation techniques, Three studies are described in this work. I. “Normative and reproductibility study investigating static, dynamic and rotational testing in rehabilitation of peripheral vestibular balance disorders”. Objective: To determine for different age group, the normative values of vestibular rotational and vestibulospinal tests; to verify the effect of handedness on the direction of veering or rotation during dynamic testing ; and to verify the effect of the veering or rotation direction on angle's amplitude. Method: One hundred and twenty healthy volunteers aged from 20 to 79 years underwent vestibulospinal tests and rotational tests. Results:Vestibulospinal and rotational tests results increased significantly with age. We determined the normative values for each age group. The effect of handedness on the direction of the veering or rotation was not significant. The effect of the veering or rotation direction (left, right) on angle's amplitude was also not significant. Response time of stabilization for clockwise and counterclockwise rotational chair testing (with and without optic fixation): all differences were not significant. Conclusion : Age is an important factor in result of vestibulospinal and rotational tests. The handedness (left or right) does not influence vestibulospinal results. II. Normative study and reliability of french version of dizziness handicap inventory. Objective: this prospective study is to determine the normality per age group, secondly to assess the effect of sex on the scores and the reproductibility of the "Echelle du Handicap lié aux Troubles de l'Equilibre et aux Vertiges" (E.H.T.E.V) french version of the "Dizziness Handicap Inventory (D.H.I). Subjects and method.- The normative scores and the effect of the sex have been determined through the study of a group of 120 subjects. without any instability disorder. Reproductibility has been assessed on 47 individuals. The results.- The scores of the instability related handicap increase with age. There is no significant influence of sex. The reproductibility coefficient is higher.Conclusion:- The scores of the E.H.T.E.V increase with age. There is no significant influence of sex on scores and the coefficient of the reproductibility is good. But the translation of this handicap scale, need a study of validity and reliability. III. “ Benefit of rotational exercises for patients with Meniere's syndrome”. Objective: To date, the effectiveness of balance rehabilitation for patients with Meniere's syndrome has not been unanimously acknowledged by all physicians and physiotherapists. The purpose of this study is to assess the therapeutic efficacy of rotational exercises in the treatment of disequilibrium for patients with unilateral Meniere's syndrome. Methodology: Rotational stimuli were used to symmetrize and reduce postrotatory nystagmic response. Three reference sources were used to assess the efficacy of this management: vestibulospinal function tests rotational tests and the self-perceived impact of vertigo. Results: Patients required 11 sessions (mean value) to attain subjective improvement. Rotational tests and dynamic tests of the vestibulospinal function improved. Conclusion: The objective and subjective measures of disequilibrium were significantly improved.

Self-reported health depends on the internal frame of reference and on response styles. One way of studying this dependency is using anchoring vignettes. Response shift effects are assumed to induce a negative correlation between self-reported health and the health assessments attributed to the vignettes. Method: A representative sample of the German adult population (N = 2,409) was selected. Participants were asked to rate their health state and the health states of two rather complex vignettes representing patients with several health complaints on a 0-100 scale. Results: The mean score of self-assessed health was M = 76.20 (SD = 20.6). There was a very small positive correlation between the assessment of the vignettes and the self-assessed health state (r = .12). After controlling for a proxy of objective health, measured in terms of chronic conditions, the relationship remained slightly positive. Chronic conditions were only marginally associated with the assessments of the vignettes (0 conditions: M = 44.8; ≥ 2 conditions: M = 42.2). Conclusions: The lack of the postulated association between self-reported health and vignettes’ ratings means that we cannot derive tools to correct the subjective ratings for differential use of frames of reference.

Abstract available through Journal of Neurologic Physical Therapy.

<p>Lip force has been found to affect the ability to achieve satisfying speech production and swallowing. A normative value for lip force in adults has been measured to 15 Newton (N). Corresponding value for children measured with Lip Force Meter 100 (LF100) does not exist. In the current study lip force was measured in children between the ages of five and ten years. The aim of the study was to obtain normative values for children with typical development in separate age groups. Production of syllable with initial bilabial plosive was further calculated to see if any correlation between lip force and syllable production existed. An examination of learning effect in repeated measures was also executed. The age group 5:0-5:11 only included four participants. This age group was therefore not included in the statistical measurements.</p><p>The common mean for lip force in all children was 14.98 N. The mean for each age group was 12.75 N for 5:0-5:11 year olds, 14.69 N for 6:0-6:11, 16.93 N for 7:0-7:11, 14.97 N for 8:0-8:11 and 14.14 N for the age group 9:0-9:11 years. In the current study no significant differences in lip force was found between age groups.</p><p>The common mean for syllable production in all children was 5.50 syllables/second. A significant difference between the ages six and seven year olds as well as six and nine year olds was found, where the older age groups showed higher values. No significant correlation was found between lip force and syllable production.</p><p>Analysis of the learning effect over three lip force measurements showed tendencies for increased lip force at the last measure. The difference was not significant. In the present study no statistical measurements for gender differences were executed for each separate age group due to small numbers. Measurements in age group 6:0-9:11 showed tendencies for higher values of both lip force and syllable production for girls. These differences were not significant.</p><p><strong> </strong></p><p><strong> </strong></p>

Lip force has been found to affect the ability to achieve satisfying speech production and swallowing. A normative value for lip force in adults has been measured to 15 Newton (N). Corresponding value for children measured with Lip Force Meter 100 (LF100) does not exist. In the current study lip force was measured in children between the ages of five and ten years. The aim of the study was to obtain normative values for children with typical development in separate age groups. Production of syllable with initial bilabial plosive was further calculated to see if any correlation between lip force and syllable production existed. An examination of learning effect in repeated measures was also executed. The age group 5:0-5:11 only included four participants. This age group was therefore not included in the statistical measurements. The common mean for lip force in all children was 14.98 N. The mean for each age group was 12.75 N for 5:0-5:11 year olds, 14.69 N for 6:0-6:11, 16.93 N for 7:0-7:11, 14.97 N for 8:0-8:11 and 14.14 N for the age group 9:0-9:11 years. In the current study no significant differences in lip force was found between age groups. The common mean for syllable production in all children was 5.50 syllables/second. A significant difference between the ages six and seven year olds as well as six and nine year olds was found, where the older age groups showed higher values. No significant correlation was found between lip force and syllable production. Analysis of the learning effect over three lip force measurements showed tendencies for increased lip force at the last measure. The difference was not significant. In the present study no statistical measurements for gender differences were executed for each separate age group due to small numbers. Measurements in age group 6:0-9:11 showed tendencies for higher values of both lip force and syllable production for girls. These differences were not significant.

Self-reported health depends on the internal frame of reference and on response styles. One way of studying this dependency is using anchoring vignettes. Response shift effects are assumed to induce a negative correlation between self-reported health and the health assessments attributed to the vignettes. Method: A representative sample of the German adult population (N = 2,409) was selected. Participants were asked to rate their health state and the health states of two rather complex vignettes representing patients with several health complaints on a 0-100 scale. Results: The mean score of self-assessed health was M = 76.20 (SD = 20.6). There was a very small positive correlation between the assessment of the vignettes and the self-assessed health state (r = .12). After controlling for a proxy of objective health, measured in terms of chronic conditions, the relationship remained slightly positive. Chronic conditions were only marginally associated with the assessments of the vignettes (0 conditions: M = 44.8; ≥ 2 conditions: M = 42.2). Conclusions: The lack of the postulated association between self-reported health and vignettes’ ratings means that we cannot derive tools to correct the subjective ratings for differential use of frames of reference.

Background Since anthropometric variables are critical to the creation of pulmonary nomograms for FVC, FEV1, and other volumes and capacities, it is logical that anthropometric variables also influence the values of the maximal respiratory pressures (MRPs). Since nomograms are race-specific, it is important that tribe-specific tables of normal maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) be developed. To date normal tables for MRPs do not exist for Navajo children. Objective Therefore the purpose of this study was to derive MRP normative reference values for Navajo children in the age range of 6-14 years. Methods - Participants and Measurements A cross-sectional study was undertaken with a representative sample of 534 healthy children, ages 6-14 years, attending Navajo Nation elementary schools in Arizona. MIP and MEP were measured. Results Test results from 275 girls and 259 boys met American Thoracic Society quality control standards and showed that MRPs all increased with height. Mean MIP in cm H2O was 77 for boys and 67 for girls with lower limits of 44 and 40, respectively. Mean MEP in cm H2O was 75 for boys and 66 for girls with the lower limits of 42 and 38, respectively. Conclusion Since the data were collected from the population of interest, the resulting MIP and MEP reference equations should be used when testing Navajo children ages 6-14 years.

Background Since anthropometric variables are critical to the creation of pulmonary nomograms for FVC, FEV1, and other volumes and capacities, it is logical that anthropometric variables also influence the values of the maximal respiratory pressures (MRPs). Since nomograms are race-specific, it is important that tribe-specific tables of normal maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) be developed. To date normal tables for MRPs do not exist for Navajo children. Objective Therefore the purpose of this study was to derive MRP normative reference values for Navajo children in the age range of 6-14 years. Methods - Participants and Measurements A cross-sectional study was undertaken with a representative sample of 534 healthy children, ages 6-14 years, attending Navajo Nation elementary schools in Arizona. MIP and MEP were measured. Results Test results from 275 girls and 259 boys met American Thoracic Society quality control standards and showed that MRPs all increased with height. Mean MIP in cm H2O was 77 for boys and 67 for girls with lower limits of 44 and 40, respectively. Mean MEP in cm H2O was 75 for boys and 66 for girls with the lower limits of 42 and 38, respectively. Conclusion Since the data were collected from the population of interest, the resulting MIP and MEP reference equations should be used when testing Navajo children ages 6-14 years.

This Master Thesis aims to answer the question why the EU foreign policy-makers decided toimplement the Eastern Partnership (EaP). As the EU foreign policy decision-making processis based upon consensus between all EU Member States, an argumentation analysis isconducted to find the arguments that the policy-makers use to convince the others. By usingHabermas’ Theory of Communicative Action, the arguments are categorized into pragmatic(security and economic interests), moral (humanitarian values) or ethical-political (culturalvalues) logics. The research material consists of official documents and statements of the EUinstitutions. Then, the arguments are evaluated as whether they can be said to be legitimate,‘mobilizing’ arguments: intelligible, appropriate and true. The main result is that even if allargumentation categories are used by policy-makers, none of the categories can be said to becompletely legitimate. Therefore, an ideological perspective is a possible complement to thecategories within the Theory of Communicative Action. This perspective would possibly addto the understanding why the EaP was implemented.