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Visual scale to document acute dizziness in the hospital 在医院记录急性头晕的视觉量表
Pub Date : 2024-07-01 DOI: 10.3233/ves-240040
Bela Büki, Jaqueline Irsigler, Heinz Jünger, Christine Harrer, Michael C. Schubert
BACKGROUND:Managing acute vertigo/dizziness for inpatients requires valid communication between the various healthcare professionals that triage such life-threatening presentations, yet there are no current scaling methods for managing such acute vertigo symptoms for inpatients. OBJECTIVE:To describe the development and validation of the Krems Acute Vertigo/Dizziness Scale (KAVEDIS), a new instrument for tracking subjective symptoms (vertigo, dizziness) and gait impairment across four unique vestibular diagnoses (Menière’s disease, benign paroxysmal positional vertigo, peripheral vestibular hypofunction, and vestibular migraine) over a one-year period after inpatient hospital admission. METHODS:Retrospective data collection study from KAVEDIS scale and chart documentation. RESULTS:The KAVEDIS scale can significantly distinguish scores from admission to discharge in three of four vestibular diagnoses. The documented course of subjective vestibular symptoms and gait disturbances were correlated in all four groups. CONCLUSION:We suggest that KAVEDIS documentation among inpatients admitted with acute vertigo/dizziness may improve communication between the various intervening clinicians and help to raise concern in cases of symptomprogression.
背景:管理住院病人的急性眩晕/头晕需要分流此类危及生命症状的不同医护人员之间进行有效的沟通,但目前还没有管理住院病人急性眩晕症状的量表方法。目的:描述克雷姆斯急性眩晕/头晕量表(Krems Acute Vertigo/Dizziness Scale,KAVEDIS)的开发和验证情况,该量表是一种新工具,用于追踪住院病人入院后一年内四种独特前庭诊断(梅尼埃病、良性阵发性位置性眩晕、外周前庭功能减退和前庭性偏头痛)的主观症状(眩晕、头晕)和步态障碍。方法:通过 KAVEDIS 量表和病历记录进行回顾性数据收集研究。结果:KAVEDIS量表能显著区分四种前庭诊断中三种诊断从入院到出院的评分。所有四组患者的主观前庭症状和步态障碍的病程记录都是相关的。结论:我们认为,对因急性眩晕/头晕而入院的住院患者进行 KAVEDIS 记录可改善不同临床医生之间的沟通,并有助于在症状加重时引起关注。
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引用次数: 0
Recovery of turning speed in patients after vestibular schwannoma resection 前庭分裂瘤切除术后患者转弯速度的恢复
Pub Date : 2024-04-21 DOI: 10.3233/ves-230097
Angela R. Weston, Leland Dibble, Peter Fino, Rich Lisonbee, Carrie Hoppes, Brian Loyd
BACKGROUND: Individuals after a vestibular schwannoma resection (VSR) experience significant vestibular symptoms that can be provoked with turning. Vestibular rehabilitation assists in recovery of function and symptom relief, however turning response is unknown. OBJECTIVE: Examine peak turning speed response to surgery and rehabilitation. METHODS: Eight participants with a vestibular schwannoma (PwVS) and five healthy controls (HC) participated in this study. Peak turning speed (PTS) was captured with inertial measurement units (IMU) at the head and/or trunk during turning tasks at a pre-operative, post-operative and post-treatment assessment. Vestibular rehabilitation was provided twice weekly for six weeks. Linear mixed models were used to assess change in PTS across time points. RESULTS: PwVS performed slower PTS than HC prior to surgery. PTS was significantly slower post-operatively compared to pre-operative during walking with head turns (B = –61.03, p = 0.004), two-minute walk test (B = –37.33, p = 0.015), 360° turn (B range from 50.05 to –57.4, p <  0.05) and complex turning course (CTC) at the trunk (B = –18.63, p = 0.009). Post-treatment PTS was significantly faster than pre-operative during CTC at the head (B = 18.46, p = 0.014) and trunk (B = 15.99, p = 0.023). CONCLUSION: PwVS may have turning deficits prior to surgical resection. PTS was significantly affected post-operatively, however improved with rehabilitation.
背景:前庭分裂瘤切除术(VSR)后的患者会出现明显的前庭症状,翻身时可引起这些症状。前庭康复有助于功能恢复和症状缓解,但转弯反应尚不清楚。目的:研究峰值转弯速度对手术和康复的反应。方法:8 名前庭分裂瘤患者(PwVS)和 5 名健康对照组(HC)参加了这项研究。在进行术前、术后和治疗后评估时,使用惯性测量单元(IMU)捕捉头部和/或躯干在完成转弯任务时的峰值转弯速度(PTS)。前庭康复治疗每周两次,为期六周。采用线性混合模型评估各时间点 PTS 的变化。结果:术前,PwVS 的 PTS 比 HC 慢。与术前相比,术后在头部转体行走(B = -61.03,p = 0.004)、两分钟步行测试(B = -37.33,p = 0.015)、360°转体(B 范围从 50.05 到 -57.4,p <0.05)和躯干复杂转体过程(CTC)(B = -18.63,p = 0.009)时的 PTS 明显较慢。在头部(B = 18.46,p = 0.014)和躯干(B = 15.99,p = 0.023)的 CTC 期间,治疗后的 PTS 明显快于手术前。结论:PwVS 在手术切除前可能存在翻身障碍。PTS 在术后受到明显影响,但在康复治疗后会有所改善。
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引用次数: 0
Psychometrics of inertial heading perception 惯性航向感知的心理测量学
Pub Date : 2024-04-16 DOI: 10.3233/ves-230077
Olivia Geno, Kyle Critelli, Cesar Arduino, Benjamin T. Crane, Eric Anson
BACKGROUND:Inertial self-motion perception is thought to depend primarily on otolith cues. Recent evidence demonstrated that vestibular perceptual thresholds (including inertial heading) are adaptable, suggesting novel clinical approaches for treating perceptual impairments resulting from vestibular disease. OBJECTIVE:Little is known about the psychometric properties of perceptual estimates of inertial heading like test-retest reliability. Here we investigate the psychometric properties of a passive inertial heading perceptual test. METHODS:Forty-seven healthy subjects participated across two visits, performing in an inertial heading discrimination task. The point of subjective equality (PSE) and thresholds for heading discrimination were identified for the same day and across day tests. Paired t-tests determined if the PSE or thresholds significantly changed and a mixed interclass correlation coefficient (ICC) model examined test-retest reliability. Minimum detectable change (MDC) was calculated for PSE and threshold for heading discrimination. RESULTS:Within a testing session, the heading discrimination PSE score test-retest reliability was good (ICC = 0. 80) and did not change (t(1,36) = –1.23, p = 0.23). Heading discrimination thresholds were moderately reliable (ICC = 0.67) and also stable (t(1,36) = 0.10, p = 0.92). Across testing sessions, heading direction PSE scores were moderately correlated (ICC = 0.59) and stable (t(1,46) = –0.44, p = 0.66). Heading direction thresholds had poor reliability (ICC = 0.03) and were significantly smaller at the second visit (t(1,46) = 2.8, p = 0.008). MDC for heading direction PSE ranged from 6–9 degrees across tests. CONCLUSION:The current results indicate moderate reliability for heading perception PSE and provide clinical context for interpreting change in inertial vestibular self-motion perception over time or after an intervention.
背景:惯性自我运动感知被认为主要依赖于耳石线索。最近的证据表明,前庭知觉阈值(包括惯性航向)具有适应性,这为治疗前庭疾病导致的知觉障碍提供了新的临床方法。目的:人们对惯性航向感知估计值的心理测量特性(如测试-再测可靠性)知之甚少。在此,我们研究了被动惯性航向感知测试的心理测量特性。方法:47 名健康受试者参加了两次惯性航向辨别任务。确定了同日和跨日测试的主观相等点(PSE)和航向辨别阈值。配对 t 检验确定主观相等点或阈值是否发生了显著变化,混合类间相关系数 (ICC) 模型检验了测试-再测可靠性。计算了PSE和航向辨别阈值的最小可检测变化(MDC)。结果:在一次测试中,航向辨别 PSE 分数的重测可靠性良好(ICC = 0.80),且没有变化(t(1,36) = -1.23, p = 0.23)。方向辨别力阈值的可靠性为中等(ICC = 0.67),也很稳定(t(1,36) = 0.10,p = 0.92)。在各次测试中,航向方向 PSE 分数具有中度相关性(ICC = 0.59)和稳定性(t(1,46) = -0.44,p = 0.66)。标题方向阈值的可靠性较差(ICC = 0.03),并且在第二次访问时明显变小(t(1,46) = 2.8,p = 0.008)。各次测试中,航向 PSE 的 MDC 在 6-9 度之间。结论:目前的结果表明,航向感知 PSE 具有适度的可靠性,并为解释惯性前庭自我运动感知随时间或干预后的变化提供了临床背景。
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引用次数: 0
Sense of direction in vestibular disorders 前庭障碍的方向感
Pub Date : 2024-03-10 DOI: 10.3233/ves-230082
Alexander I.G. Moore, John F. Golding, Anastasia Alenova, Patricia Castro, Adolfo M. Bronstein
BACKGROUND:Our sense of direction (SOD) ability relies on the sensory integration of both visual information and self-motion cues from the proprioceptive and vestibular systems. Here, we assess how dysfunction of the vestibular system impacts perceived SOD in varying vestibular disorders, and secondly, we explore the effects of dizziness, migraine and psychological symptoms on SOD ability in patient and control groups. METHODS:87 patients with vestibular disorder and 69 control subjects were assessed with validated symptom and SOD questionnaires (Santa Barbara Sense of Direction scale and the Object Perspective test). RESULTS:While patients with vestibular disorders performed significantly worse than controls at the group level, only central and functional disorders (vestibular migraine and persistent postural perceptual dizziness), not peripheral disorders (benign-paroxysmal positional vertigo, bilateral vestibular failure and Meniere’s disease) showed significant differences compared to controls on the level of individual vestibular groups. Additionally, orientational abilities associated strongly with spatial anxiety and showed clear separation from general dizziness and psychological factors in both patient and control groups. CONCLUSIONS:SOD appears to be less affected by peripheral vestibular dysfunction than by functional and/or central diagnoses, indicating that higher level disruptions to central vestibular processing networks may impact SOD more than reductions in sensory peripheral inputs. Additionally, spatial anxiety is highly associated with orientational abilities in both patients and control subjects.
背景:我们的方向感(SOD)能力依赖于本体感觉系统和前庭系统对视觉信息和自身运动线索的感觉整合。在此,我们将评估前庭系统功能障碍如何影响不同前庭疾病患者的方向感;其次,我们将探讨头晕、偏头痛和心理症状对患者组和对照组方向感能力的影响。方法:87 名前庭功能紊乱患者和 69 名对照组受试者接受了有效症状和 SOD 问卷(圣巴巴拉方向感量表和物体透视测试)的评估。结果:虽然前庭功能紊乱患者在群体水平上的表现明显差于对照组,但只有中枢性和功能性紊乱(前庭性偏头痛和持续性姿势知觉性眩晕),而非外周性紊乱(良性阵发性位置性眩晕、双侧前庭功能衰竭和梅尼埃病)与对照组相比,在单个前庭群体水平上存在显著差异。此外,在患者组和对照组中,定向能力与空间焦虑密切相关,并与一般眩晕和心理因素明显分离。结论:与功能性和/或中枢性诊断相比,SOD 受外周前庭功能障碍的影响似乎较小,这表明中枢前庭处理网络的高层次破坏可能比外周感觉输入的减少对 SOD 的影响更大。此外,在患者和对照组受试者中,空间焦虑与定向能力高度相关。
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引用次数: 0
Evaluation of the reliability and validity of the upright head roll test for lateral semicircular canal benign paroxysmal positional vertigo 评估侧半规管良性阵发性位置性眩晕的直立头部滚动测试的可靠性和有效性
Pub Date : 2024-03-04 DOI: 10.3233/ves-230127
Jae Sang Han, Dong-Hee Lee, Shi Nae Park, Kyoung Ho Park, Tae Ho Kim, Jae Hong Han, Min Ju Kang, So-Hyun Kim, Jae-Hyun Seo
BACKGROUND: The upright head roll test (UHRT) is a recently introduced diagnostic maneuver for lateral semicircular canal benign paroxysmal positional vertigo (LSC-BPPV). OBJECTIVE: This study aimed to evaluate the reliability and validity of the UHRT. METHODS: Two separate studies were conducted.Study 1 analyzed 827 results of videonystagmography (VNG) to assess UHRT reliability, and Study 2 analyzed 130 LSC-BPPV cases to evaluate UHRT validity. RESULTS: The inter-test reliability between UHRT and the supine head roll test (SHRT) showed substantial agreement (Cohen’s kappa = 0.753) in direction-changing positional nystagmus (DCPN) and almost perfect agreement (Cohen’s kappa = 0.836) in distinguishing the direction of DCPN. The validity assessment of UHRT showed high accuracy in diagnosing LSC-BPPV (80.0% ) and in differentiating the variant types (74.6% ). UHRT was highly accurate in diagnosing the canalolithiasis type in LSC-BPPV patients (Cohen’s kappa = 0.835); however, it showed only moderate accuracy in diagnosing the cupulolithiasis type (Cohen’s kappa = 0.415). The intensity of nystagmus in UHRT was relatively weaker than that in SHRT (P < 0.05). CONCLUSION: UHRT is a reliable test for diagnosing LSC-BPPV and distinguishing subtypes. However, UHRT has a limitation in discriminating the affected side owing to a weaker intensity of nystagmus than SHRT.
背景:直立滚头试验(UHRT)是最近推出的一种诊断外侧半规管良性阵发性位置性眩晕(LSC-BPPV)的方法。目的:本研究旨在评估 UHRT 的可靠性和有效性。研究 1 分析了 827 例视频震颤成像(VNG)结果,以评估 UHRT 的可靠性;研究 2 分析了 130 例 LSC-BPPV 病例,以评估 UHRT 的有效性。结果:UHRT 和仰卧头部滚动测试(SHRT)在改变方向的位置性眼球震颤(DCPN)方面的测试间可靠性显示出很大的一致性(Cohen's kappa = 0.753),在区分 DCPN 的方向方面几乎完全一致(Cohen's kappa = 0.836)。UHRT 的有效性评估显示,其诊断 LSC-BPPV 的准确率很高(80.0%),区分变异类型的准确率也很高(74.6%)。UHRT 在诊断 LSC-BPPV 患者的管结石类型时准确率很高(Cohen's kappa = 0.835);但在诊断杯状结石类型时仅显示出中等准确率(Cohen's kappa = 0.415)。与 SHRT 相比,UHRT 的眼震强度相对较弱(P < 0.05)。结论:UHRT 是诊断 LSC-BPPV 和区分亚型的可靠测试。然而,由于 UHRT 的眼震强度弱于 SHRT,因此在区分患侧方面存在局限性。
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引用次数: 0
Erratum to: Abstracts of the 31st Bárány Society Meeting, Madrid, Spain, May 9-11, 2022 勘误:第 31 届巴拉尼学会会议摘要,西班牙马德里,2022 年 5 月 9-11 日
Pub Date : 2024-02-16 DOI: 10.3233/ves-249001
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引用次数: 0
Normalization of the Suppression Head Impulse Test (SHIMP) and its correlation with the Head Impulse Test (HIMP) in healthy adults 健康成人抑制性头脉冲测试(SHIMP)的正常化及其与头脉冲测试(HIMP)的相关性
Pub Date : 2024-01-11 DOI: 10.3233/ves-230063
Suheda Baran, Gulce Kirazli, Pelin Pistav Akmese, Nese Celebisoy, Tayfun Kirazli
OBJECTIVE:In our study, it was aimed to compare vestibulo-ocular reflex (VOR) gain and saccade parameters in HIMP and SHIMP tests between gender, right and left ears, and age groups in healthy adults and to examine the correlation between the tests regarding these parameters. METHODS:The study included a total of 100 healthy participants aged 18–65 and without complaints of hearing loss, dizziness, lightheadedness, and/or imbalance. Participants underwent HIMP and SHIMP tests, respectively. RESULTS:No significant difference was found in HIMP and SHIMP VOR gain values according to gender and age groups. SHIMP duration was significantly longer in women. VOR gain values were lower in the right ear. HIMP amplitude values were higher and SHIMP amplitude values were lower with increasing age. In older age groups, SHIMP peak velocity and duration values were significantly decreased, while HIMP duration value increased and latency value was longer. In the 1st saccade, a significant difference was obtained between HIMP and SHIMP tests for all saccade parameters. There was a statistically significant positive correlation between the VOR gain values of HIMP and SHIMP tests. CONCLUSIONS:The present study showed that VOR gain and saccade parameters obtained in different age groups will be important in determining clinical outcomes in vestibular pathologies.
目的:我们的研究旨在比较健康成年人在HIMP和SHIMP测试中的前庭眼反射(VOR)增益和囊状移动参数在性别、左右耳和年龄组之间的差异,并研究这些参数在测试之间的相关性。方法:研究共包括 100 名年龄在 18-65 岁之间、无听力损失、头晕、头重脚轻和/或失衡症状的健康参与者。参与者分别接受了 HIMP 和 SHIMP 测试。结果:不同性别和年龄组的 HIMP 和 SHIMP VOR 增益值无明显差异。女性的 SHIMP 持续时间明显更长。右耳的 VOR 增益值较低。随着年龄的增长,HIMP 振幅值越高,SHIMP 振幅值越低。在老年组中,SHIMP 峰值速度和持续时间值明显降低,而 HIMP 持续时间值增加,潜伏期值延长。在第 1 次囊回中,HIMP 和 SHIMP 测试的所有囊回参数均有显著差异。在统计学上,HIMP 和 SHIMP 测试的 VOR 增益值呈显著正相关。结论:本研究表明,不同年龄组的 VOR 增益和囊状移动参数对确定前庭病变的临床结果非常重要。
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引用次数: 0
期刊
Journal of Vestibular Research
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