Journal of Vestibular Research - Volume 34, issue 4

Authors: Büki, Bela | Irsigler, Jaqueline | Jünger, Heinz | Harrer, Christine | Schubert, Michael C.

Article Type: Research Article

Abstract: 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. Show more

Keywords: Acute vertigo, intensity score, Menière’s disease, benign paroxysmal positional vertigo, migraine

DOI: 10.3233/VES-240040

Citation: Journal of Vestibular Research, vol. 34, no. 4, pp. 169-175, 2024

Authors: Nascimento, Joana | Araújo, Pedro | Moreira, Inês | Henriques, Maria Manuel | Amorim, Margarida | Machado, Eugénia | Monteiro, Conceição

Article Type: Research Article

Abstract: BACKGROUND: Visual vertigo occurs after vestibular and non-vestibular pathology and can be present in children and adolescents. It can be assessed by “the Visual Vertigo Analogue Scale” (VVAS), a questionnaire with a Portuguese version for adults. OBJECTIVES: To perform the adaptation to pediatric age and validation of VVAS in European Portuguese. METHODS: This prospective study involved the pediatric adaptation of the Portuguese VVAS, according to recognized guidelines. It was then completed by 30 healthy controls and 18 children with vestibulopathy. Patient caregivers also completed the Dizziness Handicap Inventory - Patient Caregivers (DHI-PC) to further explore the …link between questionnaires. Groups were compared for severity of visual vertigo and VVAS test-retest reliability was tested. RESULTS: The VVAS score was significantly higher in vestibular group (p  < 0.001). No statistically significant differences were found between VVAS initial and re-test scores (p  = 0.33). VVAS severity scores showed a positive correlation with DHI-PC (r = 0.598, p  = 0.009). CONCLUSION: The present Pediatric adaptation of VVAS in European Portuguese shows good psychometric properties for the assessment of visual vertigo. A positive correlation with the DHI-PC was showed, establishing the potential use of both questionnaires in the evaluation of vertigo children. Show more

Keywords: Visual vertigo, visual analog scale, child, validity, reliability

DOI: 10.3233/VES-230140

Citation: Journal of Vestibular Research, vol. 34, no. 4, pp. 177-184, 2024

Authors: Östlind, Elin | Ekstrand, Elisabeth | Axén, Iben | Brogårdh, Christina | Fänge, Agneta Malmgren | Stigmar, Kjerstin | Ekvall Hansson, Eva

Article Type: Research Article

Abstract: BACKGROUND: Dizziness is a common symptom in post-COVID condition (PCC) which may have a large impact on several life domains. However, knowledge on dizziness-severity and disability in PCC is sparse. OBJECTIVE: The aim was to describe the severity of dizziness-related disability in individuals with PCC, and how it is manifested in daily life. METHODS: A questionnaire regarding symptoms of PCC, health, and dizziness-related handicap was administered online, and 524 persons with PCC and dizziness were included. RESULTS: Mean score of the Dizziness Handicap Inventory was 35.2 (24.0) and 51.8%, were classified as having moderate/severe …dizziness-related disability. The percentage of maximum value for the subscales were: Physical manifestation, 48%, Emotional Impact, 36% and Catastrophic Impact , 17%. The greatest influence on physical movements was when bending forward, head shaking or doing strenuous physical activities or household chores. CONCLUSIONS: Half had moderate or severe dizziness-related disability and the physical manifestations occurred mostly during specific or strenuous body movements. This indicate a vestibular impairment that may be effectively managed with vestibular rehabilitation. Assessment and treatment of dizziness might be an essential part in PCC rehabilitation and future research should continue to explore the potential causal pathways of dizziness in PCC. Show more

Keywords: Post-covid condition, dizziness, dizziness-related disability, activities of daily living

DOI: 10.3233/VES-230064

Citation: Journal of Vestibular Research, vol. 34, no. 4, pp. 185-193, 2024

Authors: Lindell, Ellen | Finizia, Caterina | Davidsson, Hugo | Kollen, Lena | Kern, Silke | Skoog, Ingmar | Rydén, Lina

Article Type: Research Article

Abstract: BACKGROUND: Benign paroxysmal positional vertigo (BPPV) is one of the most frequently diagnosed cause of dizziness among older adults. OBJECTIVE: To investigate the prevalence of BPPV and positional symptoms of dizziness and nystagmus among 75-year-olds and to identify factors associated with BPPV and positional dizziness and nystagmus. METHODS: In this cross-sectional population-based study of 75-78-year-olds in Gothenburg, 887 participants were examined with questions regarding dizziness and health and social factors. A total of 681 participants underwent the Dix-Hallpike test or the side-lying test for BPPV using Video Frenzel goggles. RESULTS: In total 32% reported …problems with dizziness (n  = 887). The prevalence of BPPV was 4% in the unweighted and 4.5% in the weighted analyses, compensating for selective attrition of women and participants with previous positional dizziness. Positional dizziness without nystagmus was found in 2% and nystagmus without dizziness was found in 9%. Individuals with BPPV and positional dizziness experienced more dizziness in everyday life compared with those with normal tests, while those with positional nystagmus did not. CONCLUSIONS: The estimated prevalence of BPPV among 75-year-olds was 4.5%. Despite weighted analyses, the true prevalence may be higher since many participants with dizziness refused testing. Dizziness was associated with fear and discomfort so strong that around 20% of the participants declined testing. Show more

Keywords: Dizziness, older adults, BPPV, positional symptoms

DOI: 10.3233/VES-240027

Citation: Journal of Vestibular Research, vol. 34, no. 4, pp. 195-204, 2024

Authors: Wellons, Rachel D. | Duhe, Sydney E. | MacDowell, Sara G. | Oxborough, Sara | KC, Madhav

Article Type: Research Article

Abstract: BACKGROUND: Health disparities (HD) impact care delivery and health outcomes in individuals with vestibular disorders (IVD). OBJECTIVE: The purpose of this study is to identify whether health disparities (HD) exist in Vestibular Rehabilitation (VR) between individuals identifying as Caucasians or racial or ethnic minorities (REM). METHODS: This study was a retrospective chart review of IVD who attended outpatient VR between 1/2014 and 9/2020. Data recorded included age, gender, race/ethnicity, vestibular diagnosis, VR interventions, and pre-post outcome measures such as Dizziness Handicap Inventory (DHI), and Activities-Specific Balance Confidence Scale (ABC), Gait speed (GS), and …Functional Gait Assessment (FGA). Chi-squared tests, one-tailed, and two-tailed t -tests (α= 0.05) were utilized to compare Caucasian and REM groups. RESULTS: Three hundred and forty-three charts (N  = 343) met inclusion/exclusion criteria. REM demonstrated higher median DHI scores (46 vs. 38, p  = 0.008) and lower ABC scores (53.10% vs. 66.30%, p  < 0.001) at VR evaluation compared to Caucasians. There were no statistically significant differences in DHI, ABC, FGA, and GS scores between Caucasians and REM at discharge. CONCLUSIONS: VR was able to equalize HD in DHI and ABC which initially existed between REM and Caucasians. VR therapists should work with public health and policy researchers to improve access to VR. Show more

Keywords: Vestibular rehabilitation, health disparities

DOI: 10.3233/VES-240002

Citation: Journal of Vestibular Research, vol. 34, no. 4, pp. 205-214, 2024

Authors: Kriz, Morgan | Conover, Sarah | Cameron, Nicholas | Conover, Meg | Simon, Janet | Prueter, James | Samy, Ravi | Backous, Douglas

Article Type: Research Article

Abstract: BACKGROUND: Vestibular rehabilitation (VR) is a commonly employed treatment method for disorders of dizziness and imbalance. Access to a clinic for rehabilitation appointments can be challenging for a person experiencing dizziness. Telehealth may offer a comparable alternative to clinic-based VR for some patients. OBJECTIVE: The objective of this study was to determine the efficacy of telehealth-based VR compared to traditional clinic-based VR, as measured with the Dizziness Handicapped Inventory (DHI) in a retrospective sample of patients with vestibular conditions. METHODS: This is a retrospective, multi-institutional review from May 2020 to January 2021. Three study groups were …analyzed: a telehealth group, a hybrid group, and a clinic based control group. Treatment efficacy was measured using the DHI. A repeated measures ANCOVA was performed to compare changes between the groups and across timepoints. RESULTS: The repeated measures ANCOVA was not significant for the interaction of groups (control, telehealth, and hybrid) by time (pre and post) (p  > 0.05). However, there was a significant main effect for time (pre and post) (p  < 0.05). Specifically, all groups improved DHI scores from pre to post treatment with mean differences of control: 31.85 points, telehealth: 18.75 points, and hybrid: 21.45 points. CONCLUSION: Findings showed that in-clinic, telehealth, and hybrid groups demonstrated a decrease in DHI scores, indicating self-reported improvements in the impact of dizziness on daily life. Continued research is recommended to explore the efficacy of using telehealth in assessing and treating vestibular conditions. Show more

Keywords: Vestibular rehabilitation, dizziness, telehealth, Dizziness Handicap Inventory

DOI: 10.3233/VES-220094

Citation: Journal of Vestibular Research, vol. 34, no. 4, pp. 215-222, 2024