Book Summary: This book comprehensively covers the assessment and treatment of balance system impairments. Designed to be used in graduate programs in audiology, and by practicing audiologists, it is also appropriate for those in the fields of physical therapy, otolaryngology, and neurology. Assessment chapters address ocular motility testing, positional/positioning testing, caloric testing, rotational testing, computerized dynamic posturography, and vestibular evoked potentials. Treatment chapters cover non-medical, medical, and surgical treatment of dizziness and vertigo, vestibular rehabilitation and assessment of and intervention for falls risk. Additionally, the book provides background information on the vestibular and ocular motor systems, sample cases, and a final chapter, "Putting It All Together."

Objective: Cervical vestibular evoked myogenic potentials (cVEMPs) are short-latency electromyogram (EMG) evoked by high-level acoustic stimuli recorded from the activated sternocleidomastoid muscle and used to evaluate otolith organ function. The purpose of this study was to investigate the effects of aging on the cVEMP and on the sternocleidomastoid muscle EMG level. Design: A cross-sectional observational study was used to investigate differences in cVEMP and sternocleidomastoid muscle EMG level in a group of 24 younger and 24 older individuals. cVEMPs were recorded during activation of the sternocleidomastoid muscle at target EMG levels ranging from 0 to 90 μV and during maximum voluntary contraction of the sternocleidomastoid muscle. Results: The sternocleidomastoid muscle EMG amplitude increased as a function of target EMG level for both age groups; however, the mean EMG amplitude was greater for the younger group than the older group, and the variability of EMG amplitude was greater for the older group. The EMG amplitude at maximum voluntary contraction ranged from 88 to 279 μV for the younger subjects and from 32 to 230 μV for the older subjects, and the mean EMG amplitude at maximum voluntary contraction was significantly greater for the younger group than the older group. The cVEMP amplitude increased as a function of EMG target level for each age group. Although cVEMP amplitude increased as a function of target EMG level for both groups, the older group exhibited smaller cVEMP amplitudes, overall, compared with the younger group. To separate the influence of EMG level from aging on cVEMP amplitude, only the responses obtained at the 30 μV target EMG level were considered for the statistical analysis because there was no significant difference in EMG level between groups at the 30 μV target level. The mean cVEMP amplitudes at the 30 μV target level were 101 and 51 μV for the younger and older groups, respectively, and a statistical analysis indicated that cVEMP amplitude for the younger group was significantly greater than the older group. Conclusions: The findings suggest that the decrement in cVEMP amplitude is related to both age-related changes in the vestibular system and age-related changes in the sternocleidomastoid muscle.