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A Comparison of Dizziness Handicap Inventory Scores with Stability Index and Fourier Harmony Index in Healthy Individuals

  • Sang-Seok Yeo (Department of Physical Therapy, College of Health and Welfare Sciences, Dankook University) ;
  • Heun-Jae Ryu (Department of Public Health Sciences, Graduate School, Dankook University)
  • Received : 2023.07.13
  • Accepted : 2023.08.24
  • Published : 2023.08.31

Abstract

Purpose: The purpose of this study was to determine whether the degree of dizziness affects static balance due to the disruption or absence of the senses involved in balance. To this end, the correlation between the Dizziness Handicap Inventory (DHI), which objectively evaluates dizziness, the Fourier Index (FI; Frequency bands of postural oscillation, F1, F2-4, F5-6, F7-8) and the Stability Index (ST), which evaluates static balance ability, were examined. Methods: This study investigated balance and dizziness issues in 30 healthy young adults. Participants underwent multiple tests like the DHI and tetra-ataxiometric posturography (Tetrax) under different conditions (eyes open/closed, standing on a foam-rubber pillow, and with the head in various orientations). Results: We found that F1 exhibited a weak positive correlation with dizziness under normal conditions, as well as when the eyes were closed (r=0.396, p<0.05) and the head was tilted back (r=0.375, p<0.05). Meanwhile, F5-6 showed a moderate positive correlation with dizziness in both head-back (HB: r=0.471, p<0.05) and head-forward postures (r=0.404, p<0.05). Lastly, both F7-8 and ST demonstrated a moderate positive correlation with dizziness when the head was in a forward posture (F7-8: r=0.483; ST: r=0.403, p<0.05). Conclusion: The study results indicate that the severity of dizziness affects sensory systems and balance. It also suggests that head movements, especially forward and backward, further stimulate the vestibular system, intensifying dizziness, and balance problems in affected individuals.

Keywords

References

  1. Horak FB. Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? age ageing. 2006;35(suppl_2):ii7-11.  https://doi.org/10.1093/ageing/afl077
  2. Shumway-Cook A, Woollacott MH. Motor control: translating research into clinical practice. 5th ed. Philadelphia, Lippincott Williams & Wilkins, 2016:153-82, 198-204. 
  3. Lesinski M, Hortobagyi T, Muehlbauer T et al. Effects of balance training on balance performance in healthy older adults: a systematic review and meta-analysis. Sports Med. 2015;45:1721-38.  https://doi.org/10.1007/s40279-015-0375-y
  4. Cadore EL, Rodriguez-Manas L, Sinclair A et al. Effects of different exercise interventions on risk of falls, gait ability, and balance in physically frail older adults: a systematic review. Rejuvenation Res. 2013;16(2):105-14.  https://doi.org/10.1089/rej.2012.1397
  5. Sherrington C, Tiedemann A, Fairhall N et al. Exercise to prevent falls in older adults: an updated meta-analysis and best practice recommendations. NSW Public Health Bull. 2011;22(4):78-83.  https://doi.org/10.1071/NB10056
  6. Neuhauser H, Von Brevern M, Radtke A et al. Epidemiology of vestibular vertigo: a neurotologic survey of the general population. Neurology. 2005;65(6):898-904.  https://doi.org/10.1212/01.wnl.0000175987.59991.3d
  7. Kerber KA, Baloh RW. The evaluation of a patient with dizziness. Neurol Clin Pract. 2011;1(1):24-33.  https://doi.org/10.1212/CPJ.0b013e31823d07b6
  8. Denny-Brown DE. Neurologic aspects of vertigo. New Engl J Med. 1949;241(4):144-5.  https://doi.org/10.1056/NEJM194907282410403
  9. Bronstein AM. Multisensory integration in balance control. Handb Clin Neurol. 2016;137:57-66.  https://doi.org/10.1016/B978-0-444-63437-5.00004-2
  10. Lee H. Neuro-otological aspects of cerebellar stroke syndrome. J Clin Neurol. 2009;5(2):65-73.  https://doi.org/10.3988/jcn.2009.5.2.65
  11. Angelaki DE, Cullen KE. Vestibular system: the many facets of a multimodal sense. Annu Rev Neurosci. 2008;31:125-50.  https://doi.org/10.1146/annurev.neuro.31.060407.125555
  12. Brandt T, Brandt T. Vestibular cortex: its locations, functions, and disorders. Ann N Y Acad Sci. 2003:219-31. 
  13. Hain TC, Uddin M. Pharmacological treatment of vertigo. CNS Drugs. 2003;17:85-100.  https://doi.org/10.2165/00023210-200317020-00002
  14. Baloh RW. Differentiating between peripheral and central causes of vertigo. Otolaryngol Head Neck Surg. 1998;119(1):55-9.  https://doi.org/10.1016/S0194-5998(98)70173-1
  15. Newman-Toker DE, Edlow JA. Titrate: a novel, evidence-based approach to diagnosing acute dizziness and vertigo. Neurol Clin. 2015;33(3):577-99.  https://doi.org/10.1016/j.ncl.2015.04.011
  16. Shepard NT, Telian SA. Programmatic vestibular rehabilitation. Otolaryngol Head Neck Surg. 1995;112(1):173-82.  https://doi.org/10.1016/S0194-59989570317-9
  17. Halmagyi GM. Diagnosis and management of vertigo. Clin Med. 2005;5(2):159. 
  18. Agrawal Y, Carey JP, Della Santina CC et al. Disorders of balance and vestibular function in us adults: data from the national health and nutrition examination survey. Arch Intern Med. 2001-2004. 2009;169(10):938-44.  https://doi.org/10.1001/archinternmed.2009.66
  19. Le TN, Westerberg BD, Lea J. Vestibular neuritis: recent advances in etiology, diagnostic evaluation, and treatment. Adv Otorhinolaryngol. 2019;82:87-92.  https://doi.org/10.1159/000490275
  20. Bhattacharyya N, Gubbels SP, Schwartz SR et al. Clinical practice guideline: benign paroxysmal positional vertigo (update). Otolaryngol Head Neck Surg. 2017;156(3_suppl):S1-47.  https://doi.org/10.1177/0194599816689667
  21. Muncie Jr HL, Sirmans SM, James E. Dizziness: approach to evaluation and management. Am Fam Phys. 2017;95(3):154-62. 
  22. Dunlap PM, Holmberg JM, Whitney SL. Vestibular rehabilitation: advances in peripheral and central vestibular disorders. Curr Opin Neurol. 2019;32(1):137-44.  https://doi.org/10.1097/WCO.0000000000000632
  23. Zingler VC, Cnyrim C, Jahn K et al. Causative factors and epidemiology of bilateral vestibulopathy in 255 patients. Ann Neurol. 2007;61(6):524-32.  https://doi.org/10.1002/ana.21105
  24. Alhabib SF, Saliba I. Video head impulse test: a review of the literature. Eur Arch Otorhinolaryngol. 2017;274:1215-22.  https://doi.org/10.1007/s00405-016-4157-4
  25. Jacobson GP, Newman CW. The development of the dizziness handicap inventory. Arch Otolaryngol Head Neck Surg. 1990;116(4):424-7.  https://doi.org/10.1001/archotol.1990.01870040046011
  26. Diracoglu D, Cihan C, Issever H et al. Servikal radikulopatili hastalarda postural performans. Turk Fiz Tip Rehab Derg. 2009;55(4). 
  27. Friedrich M, Grein HJ, Wicher C et al. Influence of pathologic and simulated visual dysfunctions on the postural system. Exp Brain Res. 2008;186:305-14.  https://doi.org/10.1007/s00221-007-1233-4
  28. Morad Y, Azaria B, Avni I et al. Posturography as an indicator of fatigue due to sleep deprivation. Aviat Space Environ Med. 2007;78(9):859-63. 
  29. Niederer I, Kriemler S, Zahner L et al. Influence of a lifestyle intervention in preschool children on physiological and psychological parameters (ballabeina): Study design of a cluster randomized controlled trial. BMC Public Health. 2009;9(1):1-11.  https://doi.org/10.1186/1471-2458-9-1
  30. Sartorio A, Lafortuna C, Conte G et al. Changes in motor control and muscle performance after a short-term body mass reduction program in obese subjects. J Endocrinol Invest. 2001;24(6):393-8.  https://doi.org/10.1007/BF03351039
  31. Schwartz S, Segal O, Barkana Y et al. The effect of cataract surgery on postural control. Invest Ophthalmol Vis Sci. 2005;46(3):920-4.  https://doi.org/10.1167/iovs.04-0543
  32. Schwesig R, Goldich Y, Hahn A et al. Postural control in subjects with visual impairment. Eur J Ophthalmol. 2011;21(3):303-9.  https://doi.org/10.5301/EJO.2010.5504
  33. Steinberg N, Eliakim A, Pantanowitz M et al. The effect of a weight management program on postural balance in obese children. Eur J Pediatr. 2013;172:1619-26.  https://doi.org/10.1007/s00431-013-2090-8
  34. Woollacott MH, Shumway-Cook A, Nashner LM. Aging and posture control: changes in sensory organization and muscular coordination. Int J Aging Hum Dev. 1986;23(2):97-114.  https://doi.org/10.2190/VXN3-N3RT-54JB-X16X
  35. Fernandez C, Goldberg JM. Physiology of peripheral neurons innervating otolith organs of the squirrel monkey. Ii. Directional selectivity and force-response relations. J Neurophysiol. 1976;39(5):985-95.  https://doi.org/10.1152/jn.1976.39.5.985
  36. Kim HS, Yun DH, Yoo SD et al. Balance control and knee osteoarthritis severity. Ann Rehabil Med 2011;35(5):701-9.  https://doi.org/10.5535/arm.2011.35.5.701
  37. Shotwell S, Jacobs R, Hudspeth AJ. Directional sensitivity of individual vertebrate hair cells to controlled deflection of their hair bundles. Ann NY Acad Sci. 1981;374(1):1-10.  https://doi.org/10.1111/j.1749-6632.1981.tb30854.x
  38. Okumura T, Horii A, Kitahara T et al. Somatosensory shift of postural control in dizzy patients. Acta Otolaryngol. 2015;135(9):925-30.  https://doi.org/10.3109/00016489.2015.1040172
  39. Ezure K, Graf W. A quantitative analysis of the spatial organization of the vestibulo-ocular reflexes in lateral-and frontal-eyed animals I. Orientation of semicircular canals and extraocular muscles. Neuroscience. 1984;12(1):85-93.  https://doi.org/10.1016/0306-4522(84)90140-4
  40. Wilson V, Boyle R, Fukushima K et al. The vestibulocollic reflex. J Vest Res.1995;5(3):147-70.  https://doi.org/10.3233/VES-1995-5301
  41. Grossman GE, Leigh RJ. Instability of gaze during locomotion in patients with deficient vestibular function. Ann Neurol. 1990;27(5):528-32.  https://doi.org/10.1002/ana.410270512
  42. Black FO, Wall C, Nashner LM. Effects of visual and support surface orientation references upon postural control in vestibular deficient subjects. Acta Otolaryngol. 1983;95(1-4):199-210.  https://doi.org/10.3109/00016488309130936
  43. Kim TH, Yi JH, Oh SG. Staticposture stability evaluation of female elderly using stability evaluation device. J Kor Academia Industrial. 2011;12(12):5518-24.  https://doi.org/10.5762/KAIS.2011.12.12.5518
  44. Peterson BW, Goldberg J, Bilotto G et al. Cervicocollic reflex: its dynamic properties and interaction with vestibular reflexes. J Neurophysiol. 1985;54(1):90-109.  https://doi.org/10.1152/jn.1985.54.1.90
  45. Dieterich M. Dizziness. Neurologist. 2004;10(3):154-64.  https://doi.org/10.1097/01.nrl.0000126586.29463.c8
  46. Hirasawa K, Otsuka K, Yoshino K et al. Efficacy of chotosan in dizziness induced by head rotation or extension in the standing position: a retrospective study. Int Medical J. 2022;29(2). 
  47. Paloski WH, Wood SJ, Feiveson AH et al. Destabilization of human balance control by static and dynamic head tilts. Gait posture. 2006;23(3):315-23.  https://doi.org/10.1016/j.gaitpost.2005.04.009
  48. Buckley JG, Anand V, Scally A et al. Does head extension and flexion increase postural instability in elderly subjects when visual information is kept constant? gait posture. 2005;21(1):59-64.  https://doi.org/10.1016/j.gaitpost.2003.11.005
  49. Takahashi S. Importance of cervicogenic general dizziness. J Rural Med. 2018;13(1):48-56. https://doi.org/10.2185/jrm.2958