Title

Comparison of subjective complaints, postural control impairments, and balance deficits among adults with semicircular canal versus otolith vestibular dysfunction

Date of Award

2006

Availability

Article

Degree Name

Doctor of Philosophy (Ph.D.)

Department

Physical Therapy

First Committee Member

Rose Marie Rine, Committee Chair

Abstract

Recently, otolith function has been tested clinically in individuals who report dizziness and imbalance due to chronic peripheral vestibulopathy (P-VeD). However, subjective complaints, postural control impairments, and balance deficits due to canal versus otolith vestibular dysfunction have not been clarified. This hinders the diagnostic process and the selection of appropriate intervention. The purpose of this study was to examine and compare these problems in adults with chronic canal versus otolith dysfunction.Methods. Fourteen adults with reports of dizziness and imbalance due to chronic P-VeD were grouped based on results of canal and otolith function testing. Two studies were completed to compare group differences with: (1) subjective complaints and (2) postural control impairments and balance deficits. Descriptives as well as non-parametric and parametric statistics were used.Results. Vestibular function testing revealed distinct vestibular pathologies' with the majority of subjects having otolith dysfunction. While differences between groups were not always significant, due to low power and small sample size, trends were evident. Reports of dizziness symptoms were more often different between those with canal versus otolith dysfunction. All subjects reported imbalance and other non-distinct symptoms, however, only those with otolith dysfunction reported falls. Those with otolith dysfunction had worse Dizziness Handicap Inventory scores, greater balance deficit scores with the Dynamic Gait Index, and took fewer steps with heel-toe walking (eyes closed) as compared to those with canal only dysfunction. The majority of subjects who had abnormal Sensory Organizational Testing scores, as well as took a step under conditions 4--6, were those with otolith dysfunction. During Dynamic Perturbation Testing, the pattern of muscle activation was different in those with P-VeD as compared to healthy subjects and all but one subject that took a step had otolith dysfunction.Conclusion. The symptoms were more severe, and the persistence of postural control impairments and balance deficits were more predominant, in subjects with otolith dysfunction. Understanding differences between canal versus otolith dysfunction can help with patient management. Future research should examine whether the type of P-VeD involved affects treatment outcome.

Keywords

Health Sciences, Rehabilitation and Therapy

Link to Full Text

http://access.library.miami.edu/login?url=http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3243104