• 대한물리의학회지
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• 제14권1호
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• pp.35-41
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• 2019

PURPOSE: This study examined the effects of a vestibular stimulation training program on the walking ability of chronic stroke patients over a six month period. METHODS: Forty stroke patients were enrolled in this study. The patients were divided randomly into a control group (n=20) and experimental group (n=20). A general exercise program was applied to Group I and vestibular stimulation training was applied to Group II(30 min, three times a week for six weeks). The changes in straight walking ability, curved walking ability, and functional walking ability were measured using a 10 m walking test figure-of-eight-walking test, and dynamic gait index, respectively. The measures before and after the program were compared using a paired t-test for a comparison of each group and an independent t-test for a comparison between groups. RESULTS: The changes in each group were examined according to the measurement period. The Experimental group showed significant functional improvement in all three tests after the vestibular stimulation training program, but the control group did not show significant improvement in any of the tests after the general exercise program. A comparison of the changes between groups revealed the experimental group to show significantly higher improvement than the control group in all tests. CONCLUSION: The vestibular stimulation training program helps improve the gait function of stroke patients. Based on the results of this study, it is expected that various vestibular stimulation training programs will be developed and applied in a range of places.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• 제61권11호
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• pp.580-587
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• 2018

Background and Objectives We evaluated the clinical characteristics and vestibular function of patients with direction changing vibration induced nystagmus (DC VIN) and unilateral vestibular hypofunction and suggest clinical implication and a proposed mechanism of DC VIN. Subjects and Method The records of 315 patients who underwent the VIN test were reviewed retrospectively. Among these, 18 patients (5.7%) showed DC VIN, and out of whom, 15 patients (4.8%) were diagnosed as unilateral vestibular hypofunction by caloric, rotation chair (RCT), and video head impulse test (vHIT). We analyzed the relationship between DC VIN and the dizziness characteristics, duration of disease, and the outcome of the vestibular function test. Results The mean age of 15 patients was $67.4{\pm}10.7years$ and the mean duration of dizziness was $13.6{\pm}29.7months$. The caloric test revealed 25% of the patients to have significant canal paresis [Caloric vestibular neuritis (VN)], while 75% showed normal caloric response. However, unilateral vestibular hypofunction was observed by abnormal results in RCT or vHIT (Non-caloric VN). Seven patients showed ipsilateral DC VIN (nystagmus to vibrated side) and eight patients contralateral DC VIN (nystagmus to opposite side of vibration). Patients with ipsilateral DC VIN were shown to have a significant longer duration of dizziness than those with contralateral DC VIN. Conclusion Although rare, DC VIN can also be found in patients with unilateral vestibular hypofunction. Patients with DC VIN had a mild vestibular asymmetry with Non-caloric VN or Caloric VN in the process of compensation. The mechanism of ipsilateral DC VIN seems to be due to the small amount of vestibular asymmetry, which is smaller than the interaural attenuation of vibration.

• Journal of Audiology & Otology
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• 제25권2호
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• pp.89-97
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• 2021

Background and Objectives: Bilateral sequential vestibular neuritis (BSVN) is a rare condition in which an inflammation or an ischemic damage of the vestibular nerve occurs bilaterally in a sequential pattern. We described four cases of BSVN. Subjects and Methods: Every patient underwent video-head impulse test during the first and the second episode of vestibular neuritis (VN), furthermore they have been studied with radiological imaging. Results: Contralateral VN occurred after a variable period from prior event. Vestibular function recovered from the first episode in one case. The other three patients developed contralateral VN. One case was due to a bilateral VN in association with a Ramsay-Hunt syndrome, in another patient clinical records strongly suggested an ischemic etiology, whereas in two cases aetiology remained uncertain. Two patients subsequently developed a benign paroxysmal positional vertigo involving the posterior canal on the side of the latest VN (Lindsay-Hemenway syndrome). Conclusions: Instrumental vestibular assessment represents a pivotal tool to confirm the diagnosis of VN and BSVN.

• 대한청각학회지
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• 제25권2호
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• pp.89-97
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• 2021

Background and Objectives: Bilateral sequential vestibular neuritis (BSVN) is a rare condition in which an inflammation or an ischemic damage of the vestibular nerve occurs bilaterally in a sequential pattern. We described four cases of BSVN. Subjects and Methods: Every patient underwent video-head impulse test during the first and the second episode of vestibular neuritis (VN), furthermore they have been studied with radiological imaging. Results: Contralateral VN occurred after a variable period from prior event. Vestibular function recovered from the first episode in one case. The other three patients developed contralateral VN. One case was due to a bilateral VN in association with a Ramsay-Hunt syndrome, in another patient clinical records strongly suggested an ischemic etiology, whereas in two cases aetiology remained uncertain. Two patients subsequently developed a benign paroxysmal positional vertigo involving the posterior canal on the side of the latest VN (Lindsay-Hemenway syndrome). Conclusions: Instrumental vestibular assessment represents a pivotal tool to confirm the diagnosis of VN and BSVN.

• The Journal of Korean Physical Therapy
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• 제25권5호
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• pp.288-296
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• 2013

Purpose: This study was conducted in order to determine whether mechanical horseback-riding training depending on velocity can improve vestibular function and static postural balance on standing in healthy adults. Methods: For evaluation of vestibular function, electrooculography (EOG) of vertical and horizontal was performed for identification of the motion of eyes. For evaluation of static postural balance, COP distance, time spent on the sharpened Romberg test with neck extension (SRNE) were measured. Measurements were performed three times before training, three weeks after training, and six weeks after training. Participants were randomly assigned to three groups: fast velocity-mechanical horse -riding training (FV-MHRT, n=12), moderate velocity-mechanical horse-riding training (MV-MHRT, n=12), and slow velocity-mechanical horse-riding training (SV-MHRT, n=12). Results: According to the result for vertical, horizontal EOG, there was significant interaction in each group in accordance with the experiment time (p<0.05). The FV-MHRT group showed a significant decrease compared with the MV- MHRT, SV-MHRT groups (p<0.05). According to the result for static postural balance, the time spent, COP distance in SRNE showed significant interaction in each group in accordance with the experiment time (p<0.05). The time spent on the SRNE showed a significant increas in FV-MHRT, SV-MHRT (p<0.05). The COP distance of SRNE showed a significant increase in MV-MHRT (p<0.05). Conclusion: The MHRT velocity activated mechanism of vestibular spinal reflex (VSR), vestibular ocular reflex (VOR), also helped to strengthen vestibular function and static postural balance. In addition, it should be applied to different velocity of MHRT according to the specific purpose.

• 한국운동역학회지
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• 제22권2호
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• pp.209-217
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• 2012

The purpose of this study was to develop a turn-type treatment program which applies the principle of spotting and a roll-type treatment program that induces off-vertical axis. 29 collegiate students volunteered for this study. 12-week treatment programs were applied to both 15 students for turn-type treatment group and 14 students for roll-type treatment group. As an analytic tool, eye camera was employed to verify the treatment programs for a stimulus upon a turn, recovery after a stimulus upon a turn, and nystagmus that affects a vestibular system. Two-way ANOVA with repeated measures was applied to see the significant differences between the treatment groups, and between the test periods. For Post-Hoc Test, paired t-test was used to within the group and independent t-test was used to between the groups. The results indicated that roll-type treatment training has maximized a stimulus on nystagmyus during the stimulus by a roll. Turn-type treatment training has maximized a stimulus on nystagmyus right after a stimulus by a roll and significantly decreased the intensity of nystagmyus during the recovery. Both turn and roll type treatments have reduced the recovery time which from nystagmyus to a normal status. Roll-type treatment has showed a much shorter recovery time for nystagmyus than the roll-type treatment has. Based on the results of treatment programs developed in this study, we expect the treatment programs can be applied to treat dizziness and to improve the function of vestibular system as a rehabilitation tool.

• 대한전기학회:학술대회논문집
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• 대한전기학회 1996년도 하계학술대회 논문집 B
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• pp.1027-1030
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• 1996

The purpose of this study was to develop systematic diagnostic system testing easily, rapidly vestibular function of patients suffered from vestibular syndrome such as nausea vomiting, dizzness, ataxia. Diagnostic system composed of rotatory chair system which rotated sinusoidally patients against their vertical axis for purpose of invoking eye movement by vestibulo-ocular reflex and the softwares which storaged eye movement into computer and analyzed eye movement. Rotatory chair system consisted of comfortable chair and DC servomotor with reducer(1:80) by controlled servo in field of nonlinear motor control, double feedback loops system containing velocity feedback loop and position feedback loop was applied to this sever controlled rotatory chair system. Maximum rotatory velocity of rotatory chair was upto 60 degree per second and frequency range was 0.01 to 0.64 Hz. These above results suggest that clinical rotatory chair system may test easily, rapidly vestibular function and diagnose etiology of dizziness, thus giving effective assistance on the treatment of dizziness patients.

• Annals of Clinical Neurophysiology
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• 제7권2호
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• pp.80-82
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• 2005

Background: Idiopathic Parkinson's disease (IPD) is closely related to Lewy body pathology. Pathological changes in medullar oblongata and pontine tegmentum have been reported in patients with subclinical motor symptom. Vestibular evoked myogenic potential (VEMP) is mediated by vestibular nuclei in lower brainstem and reflects the function of lower brainstem. The purpose of our study is to estimate the lower brainstem function in IPD patients. Methods: Ten patients with idiopathic Parkinson's disease underwent VEMP test. The patients were divided into Hohn-Yahr (H-Y) stage I (unilateral motor involvement) group and H-Y stage II or more severe (bilateral motor involvement) group. VEMP results were compared between groups using Mann-Whitney U test. Results: Among patients, 6 patients showed abnormal VEMP (unilateral abnormality 2, bilateral abnormalities 4). Between H-Y stage I group and H-Y II,III group, there was no statistical difference in the results of VEMP. Conclusions: We concluded that the lower brainstem dysfunction reflected in VEMP could occur in IPD regardless of the progression of the disease.

• Annals of Clinical Neurophysiology
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• 제8권1호
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• pp.1-5
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• 2006

The head thrust maneuver is a simple bedside test of the higher frequency vestibulo-ocular reflex, which is based on Ewald's second law. It is performed by grasping the patient's head and applying a brief, small-amplitude, high-acceleration head turn, first to one side and then to the other. The patient fixates on the examiner's nose and the examiner watches for corrective rapid eye movements (saccades), which are a sign of decreased vestibular response. The "catch-up" saccades after a head thrust in one direction indicate a peripheral vestibular lesion on that side (in the labyrinth or the $8^{th}$ nerve including the root's entry zone in the brain stem). An individual pair of vertical semicircular canals can also be stimulated by turning the head to the right or left by $45^{\circ}$ and then by rotating the head in the pitch plane relative to the body. Recent studies have suggested that assessment of individual semicircular canal function by head thrust test may provide useful information for anatomical and functional details of a variety of peripheral vestibulopathies and for predicting the prognosis of vestibular neuritis. In central vestibulopathy, the head thrust test may also be valuable sign to determine dysfunction of the central pathways from individual semicircular canals and its role for the development of diverse central nystagmus.

• 한국전문물리치료학회지
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• 제5권3호
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• pp.21-33
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• 1998

The purposes of this study were to ascertain differences of the sensory system, central processing system, effector system, and balance ability according to general characteristics (sex, fall experience, and age), and to identify the contributions of the sensory, central processing, and effector system to balance ability in 83 healthy elderly subjects. The subjects were elderly (over 60 years) who live in Wonju City. All subjects participated in six tests (position sense test, visual acuity, vestibular stepping test, Mini-Mental Status Exam-Korea, strength of dorsiflexors, and Berg Balance Test). Collected data were analyzed by the independent t-test, one-way ANOVA, and stepwise multiple regression. The results were as follows: 1. The results of the six tests according to sex showed that vestibular function was significantly better in women than in men. But visual acuity, cognitive function, strength of dorsiflexors, and balance ability were significantly better in men than in women (p<0.05). 2. There were no significant differences in position sense, visual acuity, vestibular function, cognitive function, strength of dorsiflexors, and balance ability between fallers and non-fallers (p>0.05). 3. However, the results of the six tests according to age (group A: 60-69 years, group B: 70-79 years, group C: 80-89 years) showed significant differences in five tests. In the Scheff$\acute{e}$ test, position sense, visual acuity, and cognitive function showed significantly different results between in group A and group C: the strength of the dorsiflexors was significantly different between in group A and group B, and balance ability was significantly different between in group A and group C, and between in group B and group C (p<0.05). 4. Cognitive function and position sense were positively associated with balance ability. Their power of explanation regarding balance ability was 38% (p<0.05). These results suggest that cognitive function and position sense play an important role in balance ability. This would seem to suggest that programs for evaluation or improvement of elderly's balance ability in the elderly should consider cognitive function and position sense.