Objective: To describe the prevalence and impact of vestibular dysfunction and nonspecific dizziness diagnoses and explore their associations with traumatic brain injury (TBI) severity, mechanism, and postconcussive comorbidities among post-9/11 veterans. Setting: Administrative medical record data from the US Departments of Defense and Veterans Affairs (VA). Participants: Post-9/11 veterans with at least 3 years of VA care. Design: Cross-sectional, retrospective, observational study. Main Measures: International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes for TBI, vestibular dysfunction, dizziness, and other commonly associated postconcussive conditions; Neurobehavioral Symptom Inventory. Results: Of the 570 248 post-9/11 veterans in this sample, 0.45% had a diagnosis of vestibular dysfunction and 2.57% had nonspecific dizziness. Those with either condition were more likely to have evidence of TBI (57.11% vs 28.51%) and reported more disruption from neurobehavioral symptoms. Blast and nonblast injuries were associated with greater symptom disruption, particularly in combination. Conclusions: There was a consistent, significant association between TBI and vestibular dysfunction or nonspecific dizziness, after controlling for sociodemographic factors, injury mechanism, and comorbid conditions. Given that most deployed post-9/11 veterans report blast and/or nonblast injuries, the need for prompt identification and management of these conditions and symptoms is clear.

O presente estudo avaliou a eficácia do equipamento de biofeedback eletrotátil lingual (BrainPort®) como substituto sensorial para o aparelho vestibular em pacientes com arreflexia vestibular bilateral (AVB) que não obtiveram boa resposta à terapia convencional de reabilitação vestibular (RV). Sete pacientes com AVB foram treinados a usar o equipamento. A estimulação na superfície da língua foi criada por um padrão dinâmico de pulsos elétricos e o paciente capaz de ajustar a intensidade de estimulação e centralizar o estímulo na placa de eletrodos. Os pacientes foram orientados a continuamente ajustar a orientação do posicionamento da cabeça e a manter o padrão de estímulos no centro da placa. Tarefas posturais que apresentavam dificuldade progressiva foram realizadas durante o uso do equipamento. A distribuição do índice de equilíbrio do teste de integração sensorial (TIS) pré e pós-tratamento mostrou valores médios de 38.3±8.7 e 59.9±11.3, respectivamente, indicando melhora significante estatisticamente (p=0,01). O aparelho de feedback eletrotátil lingual melhorou significantemente o controle postural no grupo de estudo, superando a melhora obtida com a RV convencional. O sistema de biofeedback eletrotátil foi capaz de fornecer informações adicionais sobre o posicionamento da cabeça em relação à orientação vertical gravitacional na ausência da aferência vestibular, melhorando o controle postural. Pacientes com AVB podem integrar a informação eletrotátil no controle da postura com o objetivo de melhorar a estabilidade após a RV convencional. Estes resultados foram obtidos e verificados, não apenas pelo questionário subjetivo, mas também pelo índice de equilíbrio do TIS. As limitações do estudo foram o tamanho reduzido da amostra e a curta duração do seguimento. Os presentes achados mostram que a substituição sensorial mediada pelo feedback eletrotátil lingual pode contribuir para a melhora do equilíbrio nesses pacientes se comparada à RV / The present study evaluated the effectiveness of electrotactile tongue biofeedback (BrainPort®) as a sensory substitute for the vestibular apparatus in patients with bilateral vestibular loss (BVL) who did not have a good response to conventional vestibular rehabilitation (VR). Seven patients with BVL were trained to use the device. Stimulation on the surface of the tongue was created by a dynamic pattern of electrical pulses and the patient was able to adjust the intensity of stimulation and spatially centralize the stimulus on the electrode array. Patients were directed to continuously adjust head orientation and to maintain the stimulus pattern at the center of the array. Postural tasks that present progressive difficulties were given during the use of the device. Pre- and post-treatment distribution of the sensory organization test (SOT) composite score showed an average value of 38.3±8.7 and 59.9±11.3, respectively, indicating a statistically significant improvement (p = 0.01). Electrotactile tongue biofeedback significantly improved the postural control of the study group, even if they had not improved with conventional VR. The electrotactile tongue biofeedback system was able to supply additional information about head position with respect to gravitational vertical orientation in the absence of vestibular input, improving postural control. Patients with BVL can integrate electrotactile information in their postural control in order to improve stability after conventional VR. These results were obtained and verified not only by the subjective questionnaire but also by the SOT composite score. The limitations of the study are the small sample size and short duration of the follow-up. The current findings show that the sensory substitution mediated by electrotactile tongue biofeedback may contribute to the improved balance experienced by these patients compared to VR

O presente estudo avaliou a eficácia do equipamento de biofeedback eletrotátil lingual (BrainPort®) como substituto sensorial para o aparelho vestibular em pacientes com arreflexia vestibular bilateral (AVB) que não obtiveram boa resposta à terapia convencional de reabilitação vestibular (RV). Sete pacientes com AVB foram treinados a usar o equipamento. A estimulação na superfície da língua foi criada por um padrão dinâmico de pulsos elétricos e o paciente capaz de ajustar a intensidade de estimulação e centralizar o estímulo na placa de eletrodos. Os pacientes foram orientados a continuamente ajustar a orientação do posicionamento da cabeça e a manter o padrão de estímulos no centro da placa. Tarefas posturais que apresentavam dificuldade progressiva foram realizadas durante o uso do equipamento. A distribuição do índice de equilíbrio do teste de integração sensorial (TIS) pré e pós-tratamento mostrou valores médios de 38.3±8.7 e 59.9±11.3, respectivamente, indicando melhora significante estatisticamente (p=0,01). O aparelho de feedback eletrotátil lingual melhorou significantemente o controle postural no grupo de estudo, superando a melhora obtida com a RV convencional. O sistema de biofeedback eletrotátil foi capaz de fornecer informações adicionais sobre o posicionamento da cabeça em relação à orientação vertical gravitacional na ausência da aferência vestibular, melhorando o controle postural. Pacientes com AVB podem integrar a informação eletrotátil no controle da postura com o objetivo de melhorar a estabilidade após a RV convencional. Estes resultados foram obtidos e verificados, não apenas pelo questionário subjetivo, mas também pelo índice de equilíbrio do TIS. As limitações do estudo foram o tamanho reduzido da amostra e a curta duração do seguimento. Os presentes achados mostram que a substituição sensorial mediada pelo feedback eletrotátil lingual pode contribuir para a melhora do equilíbrio nesses pacientes se comparada à RV / The present study evaluated the effectiveness of electrotactile tongue biofeedback (BrainPort®) as a sensory substitute for the vestibular apparatus in patients with bilateral vestibular loss (BVL) who did not have a good response to conventional vestibular rehabilitation (VR). Seven patients with BVL were trained to use the device. Stimulation on the surface of the tongue was created by a dynamic pattern of electrical pulses and the patient was able to adjust the intensity of stimulation and spatially centralize the stimulus on the electrode array. Patients were directed to continuously adjust head orientation and to maintain the stimulus pattern at the center of the array. Postural tasks that present progressive difficulties were given during the use of the device. Pre- and post-treatment distribution of the sensory organization test (SOT) composite score showed an average value of 38.3±8.7 and 59.9±11.3, respectively, indicating a statistically significant improvement (p = 0.01). Electrotactile tongue biofeedback significantly improved the postural control of the study group, even if they had not improved with conventional VR. The electrotactile tongue biofeedback system was able to supply additional information about head position with respect to gravitational vertical orientation in the absence of vestibular input, improving postural control. Patients with BVL can integrate electrotactile information in their postural control in order to improve stability after conventional VR. These results were obtained and verified not only by the subjective questionnaire but also by the SOT composite score. The limitations of the study are the small sample size and short duration of the follow-up. The current findings show that the sensory substitution mediated by electrotactile tongue biofeedback may contribute to the improved balance experienced by these patients compared to VR

Diss. (sammanfattning) Linköping : Univ., 2005. / Härtill 6 uppsatser.

Objective: To identify disruption due to dizziness symptoms following deployment-related traumatic brain injury (TBI) and factors associated with receiving diagnoses for these symptoms. Setting: Administrative medical record data from the Department of Veterans Affairs (VA). Participants: Post-9/11 veterans with at least 3 years of VA care who reported at least occasional disruption due to dizziness symptoms on the comprehensive TBI evaluation. Design: A cross-sectional, retrospective, observational study. Main Measures: International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes of dizziness, vestibular dysfunction, and other postconcussive conditions; neurobehavioral Symptom Inventory. Results: Increased access to or utilization of specialty care at the VA was significant predictors of dizziness and/or vestibular dysfunction diagnoses in the fully adjusted model. Veterans who identified as Black non-Hispanic and those with substance use disorder diagnoses or care were substantially less likely to receive dizziness and vestibular dysfunction diagnoses. Conclusions: Access to specialty care was the single best predictor of dizziness and vestibular dysfunction diagnoses, underscoring the importance of facilitating referrals to and utilization of specialized, comprehensive clinical facilities or experts for veterans who report disruptive dizziness following deployment-related TBI. There is a clear need for an evidence-based pathway to address disruptive symptoms of dizziness, given the substantial variation in audiovestibular tests utilized by US providers by region and clinical specialty. Further, the dearth of diagnoses among Black veterans and those in more rural areas underscores the potential for enhanced cultural competency among providers, telemedicine, and patient education to bridge existing gaps in the care of dizziness.

O presente estudo avaliou a eficácia do equipamento de biofeedback Vertiguard®), que utiliza a informação vibrotátil como substituto sensorial (SS) de apoio ao sistema vestibular. Foram selecionados 13 pacientes com comprometimento severo do equilíbrio corporal e não obtiveram resultado satisfatório à terapia de reabilitação vestibular convencional. Os sujeitos foram randomizados entre dois grupos controle (GC), que utilizou o estímulo vibratório e estudo (GE), que treinou com o equipamento desligado. Os indivíduos foram treinados com o equipamento durante dez dias e foram orientados a corrigir o alinhamento corporal sempre que recebessem um estímulo vibrotátil de um cinto com quatro vibradores dispostos em ângulo de 90°entre eles, que informava o desvio corporal para aquele lado e o risco de queda. Para avaliação pré e pós tratamento foi utilizada o protocolo Teste de Integração Sensorial (TIS) da Posturografia Dinâmica Computadorizada (PDC) e duas escalas de auto percepção do equilíbrio: ABC (Activities-specific Balance Confidence) e DHI (Dizziness Handicap Inventory). O GE apresentou melhora estatisticamente significante em C5 (p=0,007) e C6 (p= 0,012) após treinamento. Na escala ABC houve diferença significante entre o início e o final do tratamento apenas no GE (p=0,04). No questionário DHI ocorreu diferença significante no aspecto físico nos GC e GE, e no aspecto funcional (p=0,0427) apenas no grupo GE. Os resultados observados demonstram que o estímulo de substituição sensorial vibratório oferecido pelo sistema Vertiguard®, propicia a melhor integração das redes neurais envolvidas na manutenção da postura, melhorando as estratégias utilizadas na recuperação do equilíbrio corporal / This study evaluated the effectiveness of biofeedback equipment Vertiguard® that uses vibrotactile information as sensory substitution (SS) of the vestibular system. We selected thirteen patients with severe impairment of balance who did not obtain enough improvement from conventional vestibular rehabilitation. A randomization list was used to distribute the patients in Control Group (CG), who received the vibrotactile stimulus and Study Group (SG), who trained without any stimulus. During ten days of training, the patients in both groups used the equipment attached to the waist. They were instructed to correct body alignment when vibrotactile stimulus received from one of the four vibrators arranged at an angle of 90° signaling the risk of f alling. The results of the treatment were evaluated by the protocol sensory organization test (SOT) of the computerized dynamic posturography (CDP), ABC scale (Activities-specific Balance Confidence) and DHI (Dizziness Handicap Inventory). After treatment the SG showed a statistically significant improvement in C5 (p = 0.007) and C6 (p = 0.012). In the ABC scale there was significant difference between the beginning and end of treatment only in the SG (p = 0.04). The Dizziness Handicap Inventory questionnaire (DHI) showed in the after training a significant difference in functional in both CG and SG, and in physical aspects (p = 0.0427) only in SG. The present findings show that sensory substitution using the vibrotactile stimulus of Vertiguard (R) system promotes the improvement of neural networks involved in maintaining posture, improving the strategies used in the recovery of body balance

O presente estudo avaliou a eficácia do equipamento de biofeedback Vertiguard®), que utiliza a informação vibrotátil como substituto sensorial (SS) de apoio ao sistema vestibular. Foram selecionados 13 pacientes com comprometimento severo do equilíbrio corporal e não obtiveram resultado satisfatório à terapia de reabilitação vestibular convencional. Os sujeitos foram randomizados entre dois grupos controle (GC), que utilizou o estímulo vibratório e estudo (GE), que treinou com o equipamento desligado. Os indivíduos foram treinados com o equipamento durante dez dias e foram orientados a corrigir o alinhamento corporal sempre que recebessem um estímulo vibrotátil de um cinto com quatro vibradores dispostos em ângulo de 90°entre eles, que informava o desvio corporal para aquele lado e o risco de queda. Para avaliação pré e pós tratamento foi utilizada o protocolo Teste de Integração Sensorial (TIS) da Posturografia Dinâmica Computadorizada (PDC) e duas escalas de auto percepção do equilíbrio: ABC (Activities-specific Balance Confidence) e DHI (Dizziness Handicap Inventory). O GE apresentou melhora estatisticamente significante em C5 (p=0,007) e C6 (p= 0,012) após treinamento. Na escala ABC houve diferença significante entre o início e o final do tratamento apenas no GE (p=0,04). No questionário DHI ocorreu diferença significante no aspecto físico nos GC e GE, e no aspecto funcional (p=0,0427) apenas no grupo GE. Os resultados observados demonstram que o estímulo de substituição sensorial vibratório oferecido pelo sistema Vertiguard®, propicia a melhor integração das redes neurais envolvidas na manutenção da postura, melhorando as estratégias utilizadas na recuperação do equilíbrio corporal / This study evaluated the effectiveness of biofeedback equipment Vertiguard® that uses vibrotactile information as sensory substitution (SS) of the vestibular system. We selected thirteen patients with severe impairment of balance who did not obtain enough improvement from conventional vestibular rehabilitation. A randomization list was used to distribute the patients in Control Group (CG), who received the vibrotactile stimulus and Study Group (SG), who trained without any stimulus. During ten days of training, the patients in both groups used the equipment attached to the waist. They were instructed to correct body alignment when vibrotactile stimulus received from one of the four vibrators arranged at an angle of 90° signaling the risk of f alling. The results of the treatment were evaluated by the protocol sensory organization test (SOT) of the computerized dynamic posturography (CDP), ABC scale (Activities-specific Balance Confidence) and DHI (Dizziness Handicap Inventory). After treatment the SG showed a statistically significant improvement in C5 (p = 0.007) and C6 (p = 0.012). In the ABC scale there was significant difference between the beginning and end of treatment only in the SG (p = 0.04). The Dizziness Handicap Inventory questionnaire (DHI) showed in the after training a significant difference in functional in both CG and SG, and in physical aspects (p = 0.0427) only in SG. The present findings show that sensory substitution using the vibrotactile stimulus of Vertiguard (R) system promotes the improvement of neural networks involved in maintaining posture, improving the strategies used in the recovery of body balance

INTRODUÇÃO: A literatura é discordante com relação à interferência do IC sobre o equilíbrio corporal. Sendo assim, resolvemos avaliar o equilíbrio corporal de pacientes surdos pós-linguais, submetidos a implante coclear unilateral. OBJETIVO: Observar o equilíbrio corporal pré e pós-implante coclear (IC) ao longo de 1 ano. CASUÍSTICA E METODOLOGIA: Estudo prospectivo observacional realizado com 24 pacientes adultos, surdos pós-linguais submetidos à avaliação vestibular antes e depois da cirurgia de implante coclear unilateral. A avaliação vestibular contou com um questionário sobre vertigem, prova calórica (PC), cadeira rotatória (CR) e posturografia dinâmica computadorizada (PDC) aplicados no pré-operatório, 60, 120, 180 dias e 1 ano após a cirurgia de IC. RESULTADOS: A tontura foi referida por 13 (54,2%) pacientes pré-IC, enquanto 11 (45.8%) não apresentaram a queixa. Ao final do estudo 11 sujeitos (84,6%) referiram melhora da tontura, em 1 (7,7%) permaneceu inalterada e em 1 (7,7%) piorou. Dos 24 pacientes apenas 5 indivíduos (20,8%) desenvolveram tontura no pós-operatório imediato com resolução completa após um mês. A prova calórica identificou 7 (29,2%) sujeitos normorreflexos, 8 (33,3%) com hiporreflexia ou arreflexia unilateral , 3 (12,5%) com hiporreflexia bilateral e 6 (25%) com arreflexia vestibular bilateral (AVB).Houve interferência do estímulo elétrico em ambas as orelhas e na evolução da recuperação postural após ativação do IC, que promoveu a melhora significativa dos índices da PDC ao longo de um ano de acompanhamento. Ao final do estudo, as médias numéricas das condições avaliadas pela PDC mostraram-se superiores nos indivíduos que apresentaram resposta à prova calórica em relação àqueles que possuíam AVB. CONCLUSÃO: Foi decisiva a presença ou não de resposta pós-calórica na evolução do equilíbrio corporal ao longo de 1 ano. A ausência de resposta pós-calórica na avaliação pré-operatória implicou em pior prognóstico na evolução do equilíbrio corporal. No entanto, o melhor desempenho postural dos sujeitos com AVB pode ser explicado pelo melhor aproveitamento da informação visual. É fundamental documentar a presença de função vestibular antes da cirurgia de IC, pois dela depende o prognóstico do individuo em relação às habilidades de aprendizado e recuperação postural ao longo do tempo / INTRODUCTION: There is no consensus in the literature with regard to the effects of cochlear implantation (CI) on vestibular function and balance in patients with deafness. Because of this fact we decided to assess vestibular function before and after unilateral cochlear implantation (CI) in patients with postlingual deafness. OBJECTIVE: To assess balance before and after cochlear implantation (CI) over the course of 1 year. PATIENTS AND METHODS: prospective, observational study sought to assess balance in 24 postlingually deaf adults undergoing vestibular evaluation before and after cochlear implantation (CI). Vestibular assessment consisting of a vertigo questionnaire, caloric tests (CT), rotary chair testing (RC), and computerized dynamic posturography (CDP) was performed preoperatively and at 60, 120, 180 days and 1 year after CI. RESULTS: Overall, 13 patients (54.2%) reported preoperative dizziness and 11 (45.8%) did not have the symptom pre-CI. At the end of the study dizziness ameliorated in 11 (84.6%), remained unchanged in 1 (7.7%) and worsened in 1 (7.7%). Only 5 of the 24 patients (20.8%) developed immediate postoperative dizziness, which resolved within a month. The caloric tests identified 7 (29.2%) patients with normal reflexes, 8 (33.3%) with unilateral areflexia or hyporeflexia, 3 (12.5%) with bilateral hyporeflexia, and 6 (25%) with bilateral vestibular loss (BVL). Electrical stimulation affected both ears and interfered with the progression of postural recovery after CI activation, which led to a significant improvement in CDP values over the course of 1 year of follow-up. At the end of the study, the mean values of the conditions assessed by CDP were higher in individuals who had responded to caloric tests than in individuals with BVL. The better postural performance of subjects with BVL may be due to better use of visual information. CONCLUSION: The presence or absence of CT response was a decisive determinant of balance outcomes over the year after surgery. The absence of post-caloric response in preoperative assessment resulted in a worse prognosis in the evolution of body balance. However, patients with BVL were able to use the visual information for postural stabilization with improvement in the Composite Score. It is essential that vestibular assessment findings be documented before CI surgery because a patient\'s prognosis in terms of learning skills and postural recovery over time depends on this information

INTRODUÇÃO: A literatura é discordante com relação à interferência do IC sobre o equilíbrio corporal. Sendo assim, resolvemos avaliar o equilíbrio corporal de pacientes surdos pós-linguais, submetidos a implante coclear unilateral. OBJETIVO: Observar o equilíbrio corporal pré e pós-implante coclear (IC) ao longo de 1 ano. CASUÍSTICA E METODOLOGIA: Estudo prospectivo observacional realizado com 24 pacientes adultos, surdos pós-linguais submetidos à avaliação vestibular antes e depois da cirurgia de implante coclear unilateral. A avaliação vestibular contou com um questionário sobre vertigem, prova calórica (PC), cadeira rotatória (CR) e posturografia dinâmica computadorizada (PDC) aplicados no pré-operatório, 60, 120, 180 dias e 1 ano após a cirurgia de IC. RESULTADOS: A tontura foi referida por 13 (54,2%) pacientes pré-IC, enquanto 11 (45.8%) não apresentaram a queixa. Ao final do estudo 11 sujeitos (84,6%) referiram melhora da tontura, em 1 (7,7%) permaneceu inalterada e em 1 (7,7%) piorou. Dos 24 pacientes apenas 5 indivíduos (20,8%) desenvolveram tontura no pós-operatório imediato com resolução completa após um mês. A prova calórica identificou 7 (29,2%) sujeitos normorreflexos, 8 (33,3%) com hiporreflexia ou arreflexia unilateral , 3 (12,5%) com hiporreflexia bilateral e 6 (25%) com arreflexia vestibular bilateral (AVB).Houve interferência do estímulo elétrico em ambas as orelhas e na evolução da recuperação postural após ativação do IC, que promoveu a melhora significativa dos índices da PDC ao longo de um ano de acompanhamento. Ao final do estudo, as médias numéricas das condições avaliadas pela PDC mostraram-se superiores nos indivíduos que apresentaram resposta à prova calórica em relação àqueles que possuíam AVB. CONCLUSÃO: Foi decisiva a presença ou não de resposta pós-calórica na evolução do equilíbrio corporal ao longo de 1 ano. A ausência de resposta pós-calórica na avaliação pré-operatória implicou em pior prognóstico na evolução do equilíbrio corporal. No entanto, o melhor desempenho postural dos sujeitos com AVB pode ser explicado pelo melhor aproveitamento da informação visual. É fundamental documentar a presença de função vestibular antes da cirurgia de IC, pois dela depende o prognóstico do individuo em relação às habilidades de aprendizado e recuperação postural ao longo do tempo / INTRODUCTION: There is no consensus in the literature with regard to the effects of cochlear implantation (CI) on vestibular function and balance in patients with deafness. Because of this fact we decided to assess vestibular function before and after unilateral cochlear implantation (CI) in patients with postlingual deafness. OBJECTIVE: To assess balance before and after cochlear implantation (CI) over the course of 1 year. PATIENTS AND METHODS: prospective, observational study sought to assess balance in 24 postlingually deaf adults undergoing vestibular evaluation before and after cochlear implantation (CI). Vestibular assessment consisting of a vertigo questionnaire, caloric tests (CT), rotary chair testing (RC), and computerized dynamic posturography (CDP) was performed preoperatively and at 60, 120, 180 days and 1 year after CI. RESULTS: Overall, 13 patients (54.2%) reported preoperative dizziness and 11 (45.8%) did not have the symptom pre-CI. At the end of the study dizziness ameliorated in 11 (84.6%), remained unchanged in 1 (7.7%) and worsened in 1 (7.7%). Only 5 of the 24 patients (20.8%) developed immediate postoperative dizziness, which resolved within a month. The caloric tests identified 7 (29.2%) patients with normal reflexes, 8 (33.3%) with unilateral areflexia or hyporeflexia, 3 (12.5%) with bilateral hyporeflexia, and 6 (25%) with bilateral vestibular loss (BVL). Electrical stimulation affected both ears and interfered with the progression of postural recovery after CI activation, which led to a significant improvement in CDP values over the course of 1 year of follow-up. At the end of the study, the mean values of the conditions assessed by CDP were higher in individuals who had responded to caloric tests than in individuals with BVL. The better postural performance of subjects with BVL may be due to better use of visual information. CONCLUSION: The presence or absence of CT response was a decisive determinant of balance outcomes over the year after surgery. The absence of post-caloric response in preoperative assessment resulted in a worse prognosis in the evolution of body balance. However, patients with BVL were able to use the visual information for postural stabilization with improvement in the Composite Score. It is essential that vestibular assessment findings be documented before CI surgery because a patient\'s prognosis in terms of learning skills and postural recovery over time depends on this information

Objective:The purpose of this study was to determine factors associated with rehabilitation outcomes following vestibular rehabilitation (VR). Methods:In this prospective cohort study, 116 patients who completed at least 2 supervised sessions participated. Patient characteristics and comorbidities were recorded. Initial and discharge measures included symptom intensity, balance confidence, quality of life, time symptoms interfere with life, perceived benefits of VR, gait speed, fall risk, visual acuity during head movement, and anxiety/depression. Intention-to-treat analyses were performed to determine outcomes at discharge. Bivariate correlations between independent (group characteristics and baseline measures) and dependent (discharge measures) variables were determined. Logistic regressions were performed to identify factors associated with whether a patient would have a normal score or meaningful change at discharge. Results:There was a large effect of VR with significant improvement for the group as a whole on each outcome measure. For each outcome measure most patients improved. Based on preliminary logistic regression, 2 patient characteristics were associated with outcome: number of therapy visits predicted meaningful improvement in gait speed and falls after the onset of the UVH predicted meaningful change in the percent of time symptoms interfered with life. Initial Activities-based Balance Confidence (ABC) scale and Dynamic Gait Index (DGI) scores predicted normal ABC scores at discharge, and initial ABC scores predicted recovery of DGI scores. Preliminary prediction models were generated for balance confidence, impact of dizziness on life, dynamic visual acuity, gait speed, and fall risk. Conclusions:Therapists may use these findings for patient education or the need for adjunct therapy such as counseling. Impact:Not all people with UVH improve following VR, but there is little research examining why. This study looked at multiple factors and identified number of visits and falls after onset of UVH as patient characteristics associated with outcomes following VR, which will help therapists create better predictive models.