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| 2. |
- Johansson, Rolf, et al.
(författare)
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Discrimination of Patients with Acoustic Neuroma and Peripheral Vestibular Lesions with Human Posture Dynamics
- 1995
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Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 1651-2251 .- 0001-6489. ; 115:S520, s. 27-28
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Tidskriftsartikel (refereegranskat)abstract
- A group of normal subjects (n = 17) was compared with groups of patients with a diagnosis of vestibular neuritis (n = 18), and acoustic neuromas (n = 35). Fisher linear discriminant analysis was applied to distinguish clusters of parameters characteristic for each disease. Hence it was possible to distinguish the vestibular neuritis patients from the normal group with statistical significance (p < 0.01). Also the patients with an acoustic neuroma could be distinguished from the normal subjects with statistical significance (p < 0.05).
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| 4. |
- Karlberg, Mikael, et al.
(författare)
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Asymmetric optokinetic after-nystagmus induced by active or passive sustained head rotations
- 1996
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Ingår i: Acta Oto-Laryngologica. - 1651-2251. ; 116:5, s. 647-651
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Tidskriftsartikel (refereegranskat)abstract
- Asymmetric vestibular function affects optokinetic after-nystagmus (OKAN) in man, but little is known about the involvement of cervical proprioception in the visual-vestibular interaction reflected as OKAN. We studied the effect of asymmetric cervical proprioception induced by active maximal, or passive 70 degrees sustained horizontal head rotations on OKAN in 16 healthy subjects. We evoked optokinetic nystagmus (OKN) by means of a whole-field optokinetic drum rotated at a velocity of 90 degrees/s for 60 s. Following left- and right-beating OKN, we recorded OKAN in complete darkness for 60 s by DC electro-oculography. Both passively and actively sustained head rotations significantly reduced the intensity of OKAN beating in the direction opposite to the head rotation, while OKAN beating in the direction of the head rotation remained unchanged. This resulted in significant asymmetry between OKAN beating in the direction of the head rotation vs. that in the opposite direction. The findings show that in normal subjects neck proprioception converges with visual and vestibular signals and affects subcortical OKN. Asymmetric neck proprioception from neck disorders may be hypothesized to induce dizziness or vertigo in situations where OKN is evoked.
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| 6. |
- Karlberg, Mikael, et al.
(författare)
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Dizziness of Suspected Cervical Origin Distinguished by Posturographic Assessment of Human Postural Dynamics
- 1996
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Ingår i: Journal of Vestibular Research. - 1878-6464. ; 6:1, s. 37-47
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Tidskriftsartikel (refereegranskat)abstract
- Useful clinical tests are lacking for the controversial entity "cervical vertigo". In earlier studies patients assumed to suffer from cervical vertigo or dizziness manifested disturbed postural control as compared to healthy subjects, but were hard to distinguish from patients with other balance disorders. Using posturography in which stance was perturbed by a vibratory stimulus applied towards the calf muscles, we studied 16 consecutive patients with recent onset of neck pain and concomitant complaints of vertigo or dizziness, but normal findings at otoneurological examination and electronystagmography; 18 patients with recent vestibular neuritis; and 17 healthy subjects. We performed system identification of a model of the control of upright human stance, using the vibratory stimulus as input and the recorded body sway as output. According to values for the three normalized parameters of the transfer function of the model (i.e., swiftness, stiffness, and damping), cervical vertigo patients were distinguished both from healthy subjects (P < 0.001), and from vestibular neuritis patients (P < 0.001). It was also possible to distinguish the vestibular neuritis group from the group of healthy subjects (P < 0.01). The results show disturbed postural control in patients with cervical vertigo to differ from that in patients with recent vestibular neuritis, and indicate posturographic assessment of human posture dynamics to be a possible future tool for use in diagnosing cervical vertigo.
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| 7. |
- Karlberg, Mikael, et al.
(författare)
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Head movement restriction and postural stability in patients with compensated unilateral vestibular loss
- 1998
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Ingår i: Archives of Physical Medicine and Rehabilitation. - 0003-9993. ; 79:11, s. 1448-1450
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study whether restriction of head-neck movements improves postural performance in patients with compensated unilateral total vestibular loss. DESIGN: Randomized controlled experimental study. SETTING: Laboratory for clinical and experimental vestibular testing at a tertiary referral center. PATIENTS: Fifteen consecutive patients (seven men, eight women, mean age 53 years) at routine follow-up, 6 months after translabyrinthine extirpation of acoustic neurinomas (mean tumor size 13.5mm, range 5 to 25mm). None of the patients had signs or symptoms of central nervous system dysfunction. INTERVENTION: Posturographic tests comparing patients with and without a semirigid neck collar. Test order was randomized between patients to reduce training effects. MAIN OUTCOME MEASURE: Posturography measuring velocity and variance of quiet stance and measuring body sway induced by vibration at 60, 80, and 100Hz to the calf muscles. Tests were conducted with eyes open and closed. RESULTS: In tests with vibration at 100Hz to the calf muscles and with eyes open, body sway velocity was significantly higher when patients were wearing a neck collar. No significant difference was found in any other test. CONCLUSION: Restricting head-neck movements with a neck collar does not improve postural stability in patients with compensated unilateral total vestibular loss. A tendency toward impaired postural performance leads to the conclusion that it is not appropriate to treat such patients with neck collars to improve their balance.
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| 8. |
- Karlberg, Mikael, et al.
(författare)
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Impaired postural control in patients with cervico-brachial pain
- 1995
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Ingår i: Acta Oto-Laryngologica. Supplement. - 0365-5237. ; 115:S520, s. 440-442
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Tidskriftsartikel (refereegranskat)abstract
- Dizziness and subjective balance disturbances are common complaints in cervical pain syndromes. We assessed balance function with posturography using vibration-induced and galvanically-induced body sway in consecutive patients (n = 116) with cervico-brachial pain syndrome of more than 3 months' duration. A total of 83% of the patients showed signs of cervical root compression on MRT scans. The incidence of complaints of vertigo was 50%. The patients manifested significantly poorer postural control than sex- and age-matched controls (n = 20). Disorders of the neck should be considered when assessing patients complaining of dizziness, vertigo and balance disturbances.
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| 9. |
- Karlberg, Mikael, et al.
(författare)
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Postural and symptomatic improvement after physiotherapy in patients with dizziness of suspected cervical origin
- 1996
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Ingår i: Archives of Physical Medicine and Rehabilitation. - 0003-9993. ; 77:9, s. 874-882
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To assess postural performance in patients with dizziness of suspected cervical origin in whom extracervical causes had been excluded, and to assess the effects of physiotherapy on postural performance and subjective complaints of neck pain and dizziness. DESIGN: Prospective, randomized, controlled trial. SETTING: Primary care centers and a tertiary referral center. PATIENTS AND SUBJECTS: Of 65 referrals, 43 patients were excluded because extracervical etiology was suspected. Of the remaining 22 patients, 17 completed the study (15 women, 2 men, x age 37 yr, range 26-49). The controls were 17 healthy subjects (15 women, 2 men, x age 36 yr, range 25-55). INTERVENTION: Physiotherapy based on analysis of symptoms and findings, and aimed to reduce cervical discomfort. Patients were randomized either to receive immediate physiotherapy (n = 9), or to wait 2 months, undergo repeat measurements, and then receive physiotherapy (n = 8). MAIN OUTCOME MEASURES: Posturography, measuring velocity and variance of vibration-induced body sway and variance of galvanically induced body sway. Subjective intensity of neck pain (Visual Analog Scale ratings, 0-100), intensity and frequency of dizziness (subjective score 0-4). RESULTS: The patients manifested significantly poorer postural performance than did healthy subjects (.05 > p > .0001). Physiotherapy significantly reduced neck pain and intensity and the frequency of dizziness (p < .01), and significantly improved postural performance (.05 > p > .0007). CONCLUSIONS: Patients with dizziness of suspected cervical origin are characterized by impaired postural performance. Physiotherapy reduces neck pain and dizziness and improves postural performance. Neck disorders should be considered when assessing patients complaining of dizziness, but alternative diagnoses are common.
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