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Automated romberg testing in patients with benign paroxysmal positional vertigo and healthy subjects


Adelsberger, Rolf; Valko, Yulia; Straumann, Dominik; Troester, Gerhard (2015). Automated romberg testing in patients with benign paroxysmal positional vertigo and healthy subjects. IEEE Transactions on Bio-Medical Engineering, 62(1):373-381.

Abstract

Objective: Benign paroxysmal positional vertigo (BPPV) is the most common cause of dizziness. The underlying pathomechanism responsible for the recurrent vertigo attacks has been elucidated in detail, and highly effective treatment strategies (liberation maneuvers) have been developed. However, many BPPV patients complain about problems of balance especially following liberation maneuvers. Aim: To objectively demonstrate differences in balance performance in BPPV patients compared to healthy subjects both prior and after BPPV liberation maneuvers. Methods: Seven patients with BPPV of the posterior semicircular canal and 9 healthy subjects participated. To assess balance while standing, we analyzed the location and temporal stability of the center of pressure recorded by pressure-sensitive electronic soles during Romberg testing (on stable ground and on foam) and tandem stand. To assess regularity of gait, we analyzed the step frequency during walking of 50m. All tests were performed prior and after liberation maneuvers in both groups. Results: Healthy subjects and patients differ significantly in their balance performance and use different stabilization strategies both prior and after liberation maneuvers. Both Romberg tests indicated poorer balance in BPPV patients (mean COP shifted towards toes), especially in the post-treatment tests, while tandem stand appeared unaltered. We did not observe differences in escorted (by an experimenter) walking regularities between patients and healthy subjects and between pre- and post-maneuver testing. Conclusion and significance: Our findings confirm the typical clinical observation of a further post-treatment deterioration of already impaired postural performance in BPPV patients. While the etiology and the time course of this peculiar problem warrants further studies, the treating physician should be familiar with this transient side effect of therapeutic maneuvers to provide adequate counseling of patients. Finally, we successfully demonstrated the pressure-sensitive electronic soles as a new and potentially useful tool for both clinical and research purposes.

Abstract

Objective: Benign paroxysmal positional vertigo (BPPV) is the most common cause of dizziness. The underlying pathomechanism responsible for the recurrent vertigo attacks has been elucidated in detail, and highly effective treatment strategies (liberation maneuvers) have been developed. However, many BPPV patients complain about problems of balance especially following liberation maneuvers. Aim: To objectively demonstrate differences in balance performance in BPPV patients compared to healthy subjects both prior and after BPPV liberation maneuvers. Methods: Seven patients with BPPV of the posterior semicircular canal and 9 healthy subjects participated. To assess balance while standing, we analyzed the location and temporal stability of the center of pressure recorded by pressure-sensitive electronic soles during Romberg testing (on stable ground and on foam) and tandem stand. To assess regularity of gait, we analyzed the step frequency during walking of 50m. All tests were performed prior and after liberation maneuvers in both groups. Results: Healthy subjects and patients differ significantly in their balance performance and use different stabilization strategies both prior and after liberation maneuvers. Both Romberg tests indicated poorer balance in BPPV patients (mean COP shifted towards toes), especially in the post-treatment tests, while tandem stand appeared unaltered. We did not observe differences in escorted (by an experimenter) walking regularities between patients and healthy subjects and between pre- and post-maneuver testing. Conclusion and significance: Our findings confirm the typical clinical observation of a further post-treatment deterioration of already impaired postural performance in BPPV patients. While the etiology and the time course of this peculiar problem warrants further studies, the treating physician should be familiar with this transient side effect of therapeutic maneuvers to provide adequate counseling of patients. Finally, we successfully demonstrated the pressure-sensitive electronic soles as a new and potentially useful tool for both clinical and research purposes.

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Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurology
04 Faculty of Medicine > Neuroscience Center Zurich
04 Faculty of Medicine > Center for Integrative Human Physiology
Dewey Decimal Classification:570 Life sciences; biology
610 Medicine & health
Language:English
Date:2015
Deposited On:06 Nov 2014 11:34
Last Modified:05 Apr 2016 18:28
Publisher:Institute of Electrical and Electronics Engineers
ISSN:0018-9294
Additional Information:© 2013 IEEE. Personal use of this material is permitted. Permission from IEEE must be obtained for all other uses, in any current or future media, including reprinting/republishing this material for advertising or promotional purposes, creating new collective works, for resale or redistribution to servers or lists, or reuse of any copyrighted component of this work in other works.
Publisher DOI:https://doi.org/10.1109/TBME.2014.2354053
PubMed ID:25203981

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