Renata Coelho Scharlach

Resultados do Balance Rehabilitation Unit na Vertigem Posicional Paroxística Benigna

UNLABELLEDnPosturography is a useful new tool to study the influence of vestibular diseases on balance.nnnAIMnto compare the results from the Balance Rehabilitation Unit (BRU) static posturography in elderly patients with Benign Paroxysmal Positional Vertigo (BPPV), before and after Epleys maneuver.nnnMATERIALS AND METHODSna prospective study of 20 elderly patients with a diagnosis of BPPV. The patients underwent static posturography and the limit of stability (LE) and ellipse area were measured. We also applied the Dizziness Handicap Inventory (DHI) questionnaire to study treatment effectiveness.nnnRESULTSn80% were females, with a mean age of 68.15 years. After the maneuver, the LE increased significantly (p=0.001). The elliptical area of somatosensory, visual and vestibular conflicts (2,7,8,9 situations) in BRU and the DHI scores decreased significantly (p<0.05) after treatment.nnnCONCLUSIONnthe study suggests that elderly patients with BPPV may present static postural control impairment and that the maneuver is effective for the remission of symptoms, to increase in the stability and improvement in postural control in situations of visual, somatosensory and vestibular conflicts.

Postural Control in Older Patients with Benign Paroxysmal Positional Vertigo

Objective. To evaluate the effectiveness of a canalith-repositioning procedure in postural control of older patients with idiopathic benign paroxysmal positional vertigo (BPPV). Study Design. Prospective clinical trial. Setting. A tertiary referral center. Methods. A 9-month follow-up survey with a prospective design was conducted among 33 older patients with BPPV. Patients underwent static posturography (Balance Rehabilitation Unit [BRU]) and were administered the Dizziness Handicap Inventory (DHI) before and after the maneuver. After the treatment, they were compared with 33 healthy older subjects. The posturography parameters were the limit of stability (LOS), the center of body-pressure area (COP), and the velocity of oscillation (VOS) under conditions of visual, somatosensory, and visual-vestibular conflict. Results. One canalith-repositioning procedure relieved most patients’ complaints (54.5%), and 100% were relieved with 1 to 3 maneuvers. Total DHI score and all subscales improved after treatment (P < .01). The LOS values pretreatment (mean [SD] 134.27 [55.32] cm2) and posttreatment (181.03 [47.79] cm2) were significantly different (P < .01). Comparative analysis of COP values showed a relevant statistical difference in 8 of 10 postmaneuver conditions (P < .01). The postmaneuver VOS showed a significant difference under 7 conflict conditions. There were no differences between the healthy older subjects and treated patients for all VOS values under all conditions and for COP values under 9 conditions. Conclusion. The canalith-repositioning procedure promotes remission of symptoms, an increase in LOS, and improvement in postural control under conditions of somatosensory and visual conflict and visual-vestibular interaction.

Body balance in elderly patients, 12 months after treatment for BPPV

UNLABELLEDnBenign Paroxysmal Positional Vertigo is highly prevalent in the elderly population, triggering major changes in body balance.nnnOBJECTIVEnTo compare the results obtained from static posturography in the elderly before and after otoliths repositioning maneuvers and 12 months after treatment onset.nnnDESIGNnlongitudinal, descriptive and analytical study.nnnMETHODnElderly patients with clinical diagnosis of BPPV submitted to Balance Rehabilitation Unit static posturography in 10 sensory conditions at three time intervals: before and after the repositioning maneuver and12 months after the treatmentnnnRESULTSnWe studied 23 subjects with a mean age of 68.74 years. Posturography revealed that the stability limit was not significantly different when the three time intervals were compared (p = 0.405). The center of pressure (CoP) showed a significant change in condition 2 (stable surface and closed eyes), because after the repositioning maneuver, the CoP significantly differed vis-à-vis the results before and 12 months after the treatment (p = 0.003). The values of body velocity sway (BVS) were significantly different in six sensory conditions in these three time intervals.nnnCONCLUSIONn12 months after the treatment for BPPV, the static posturography showed balance abnormalities similar to those found before treatment.

Uma abordagem interdisciplinar na avaliação e reabilitação do idoso com disfunção vestibular crônica

Introducao: disturbios auditivos como zumbido, perda de audicao e hiperacusia podem comprometer o desenvolvimento da linguagem nas criancas. Objetivo: verificar a ocorrencia de queixas auditivas (zumbido, desconforto a sons e dificuldades auditivas) em criancas de sete a 10 anos e relacionar a presenca ou nao dessas queixas ao desempenho escolar. Metodo: 31 criancas com idade entre nove a 12 anos, com media etaria de 10,22 anos, de ambos os generos. Os pacientes foram submetidos a entrevistas fechadas, por meio da aplicacao de um questionario pre-estabelecido baseado no trabalho de Coelho (2006). De acordo com a avaliacao realizada pela coordenacao pedagogica da escola quanto as dificuldades escolares, as criancas foram divididas em dois grupos, Grupo controle –G1(n=14) e Grupo de estudo-G2 (n=17). A analise dos resultados utilizada foi descritiva. Resultado: do total de pacientes (n=31), 38,70% apresentaram zumbido; 29,03% desconforto a sons e 29,03 dificuldades auditivas. Entre os pacientes com queixa de zumbido, 33,33% eram do G1 1 e 66,67,% do Grupo 2. Entre os pacientes com desconforto a sons, 33,33,% apresentavam a queixa no G1 e 66,67%, no G2. Discussao: O estudo encontrou maior ocorrencia da queixa de zumbido e de desconforto a sons, em criancas com dificuldade escolar. Conclusao: 38,70% das criancas estudadas referiram percepcao de zumbido e 29,03% referiram desconforto a sons. As queixas de zumbido e desconforto a sons foram mais frequentes nas criancas com dificuldade escolar.

Hatha yoga on body balance

Background: A good body balance requires a proper function of vestibular, visual, and somatosensory systems which can be reach with exercise practice and/or yoga. Aim: To determine the effects of a 5-month hatha yoga training program on body balance in young adults. Materials and Methods: This study used a controlled, nonrandomized design, where the experimental group underwent a 5-month training program and were then compared with the control group that had a sedentary lifestyle. A convenience sample of 34 out of 40 men aged 25-55 years old (34.0 ± 0.9) were deemed eligible for this study. They were randomly divided into two groups: Experimental and control groups. Subjects in the experimental group were engaged in 60 min sessions of hatha yoga three times a week for 5 months. We evaluated postural control by measuring the limit of stability and velocity of oscillation (VOS) in three conditions of the balance rehabilitation unit (BRU) and through field procedures (four position, plane, flamingo, hopscotch, and dynamic test). Results: We observed differences (P < 0.05) in postintervention scores between the groups regardless of BRU parameters and field procedures (except for flamingo) even after adjusting for preintervention scores, suggesting that these changes were induced by hatha yoga training. The partial eta squared on BRU parameters ranged from 0.78 (VOS1)-0.97 (COP2), and from 0.00 (flamingo)-0.94 (four position) for the field procedures. Conclusions: Our results provide substantial evidence that postural control in healthy young adults can be improved through practicing hatha yoga.

Ocorrência de queixas auditivas em escolares com e sem dificuldade de aprendizagem

Introducao: disturbios auditivos como zumbido, perda de audicao e hiperacusia podem comprometer o desenvolvimento da linguagem nas criancas. Objetivo: verificar a ocorrencia de queixas auditivas (zumbido, desconforto a sons e dificuldades auditivas) em criancas de sete a 10 anos e relacionar a presenca ou nao dessas queixas ao desempenho escolar. Metodo: 31 criancas com idade entre nove a 12 anos, com media etaria de 10,22 anos, de ambos os generos. Os pacientes foram submetidos a entrevistas fechadas, por meio da aplicacao de um questionario pre-estabelecido baseado no trabalho de Coelho (2006). De acordo com a avaliacao realizada pela coordenacao pedagogica da escola quanto as dificuldades escolares, as criancas foram divididas em dois grupos, Grupo controle –G1(n=14) e Grupo de estudo-G2 (n=17). A analise dos resultados utilizada foi descritiva. Resultado: do total de pacientes (n=31), 38,70% apresentaram zumbido; 29,03% desconforto a sons e 29,03 dificuldades auditivas. Entre os pacientes com queixa de zumbido, 33,33% eram do G1 1 e 66,67,% do Grupo 2. Entre os pacientes com desconforto a sons, 33,33,% apresentavam a queixa no G1 e 66,67%, no G2. Discussao: O estudo encontrou maior ocorrencia da queixa de zumbido e de desconforto a sons, em criancas com dificuldade escolar. Conclusao: 38,70% das criancas estudadas referiram percepcao de zumbido e 29,03% referiram desconforto a sons. As queixas de zumbido e desconforto a sons foram mais frequentes nas criancas com dificuldade escolar.

Body Stabilization in Benign Paroxysmal Positional Vertigo

Objective: Evaluate the influence of Benign Paroxysmal Positional Vertigo (BPPV) in the balance control of the elderly after Epley’s maneuver and understand whether a reposition maneuver is enough to recover balance control. Method: Prospective study of 33 elderly patients with vertical canal BPPV seen in a tertiary center. Dizziness Handicap Inventory (DHI) and static posturography were determined before and after Epley’s maneuver. The parameters of the Balance Rehabilitation Unit (BRU) static posturography analyzed were: the limit of stability (LOS) and body sway velocity (VOS). Results: The DHI total and the subscale scores improved (P = .001) after the treatment in all aspects. There was statistically significant improvement of the LOS pre- and posttreatment (P = .001). Eight of 10 visual-vestibular stimuli had statistically significant improvement after treatment: with eyes closed (P = .001); over foam and eyes closed (P = .002); saccadic stimulation (P = . 043); horizontal optokinetic stimulation (P = .015); 2 different verticaloptokinetic stimulations (P = . 003, P = . 009); two different visual-vestibular stimulations (P = .003, P = .047). The VOS showed statistical significance after treatment for eyes closed (P = .001); on foam and eyes closed (P = .005); horizontal optokinetic stimulus (P = .042); vertical optokinetic stimulus (P = .027); horizontal visual vestibular stimulus (P = .002); vertical visual vestibular stimulus (P = .018). Conclusion: Elderly patients with BPPV present impairment of static postural control in vestibular conflicts. The maneuver promotes remission of symptoms, increases the limit of stability, and improves the control of postural balance in the conditions of somatosensory, visual, and visual-vestibular conflicts.