• Journal of Korean Academy of Nursing
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• v.46 no.5
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• pp.710-719
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• 2016

Purpose: In this study an examination was done of the effect of self-efficacy promoting vestibular rehabilitation (S-VR) on dizziness, exercise self-efficacy, adherence to vestibular rehabilitation (VR), subjective and objective vestibular function, vestibular compensation and the recurrence of dizziness in patients with vestibular hypofunction. Methods: This was a randomized controlled study. Data were collected 3 times at baseline, 4 and 8 weeks after beginning the intervention. Outcome measures were level of dizziness, exercise self-efficacy, and level of adherence to VR. Subjective and objective vestibular function, vestibular compensation and the recurrence of dizziness were also obtained. Data were analyzed using Windows SPSS 21.0 program. Results: After 4 weeks of S-VR, there was no difference between the groups for dizziness, subjective and objective vestibular functions. However, exercise self-efficacy and adherence to VR were higher in the experimental group than in the control group. After 8 weeks of S-VR, dizziness (p =.018) exercise self-efficacy (p <.001), adherence to VR (p <.001), total-dizziness handicap inventory (DHI) (p =.012), vision analysis ratio (p =.046) in the experimental group differ significantly from that of the control group. The number of patients with recurring dizziness were higher in the control group than in the experimental group (p <.001). Conclusion: The results indicate that continuous 8 weeks of S-VR is effective in reducing dizziness, and improving exercise self-efficacy, subjective vestibular function and adherence to VR. Objective vestibular function and vestibular compensation were also improved in the experimental group at the end of 8 weeks of S-VR.

• The Journal of Korean Physical Therapy
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• v.29 no.6
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• pp.316-323
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• 2017

Effort to improve balance ability in the field of rehabilitation has been constantly issued and developed up to now. A variety of subcomponent of postural control including function and cognition should be needed in many body systems and be complicatedly linked to each system. In South Korea, although decreased postural dysfunction due to neurological or musculoskeletal disorders has been well documented, we do not have many experience and knowledge of vestibular rehabilitation for maintain and improve balance function. In the United States, vestibular physical therapy is already acknowledged as clinical subspecialty by American Physical Therapy Association. However, there is no curriculum subject related to vestibular rehabilitation in standard education of physical therapy and no specialist who has clinical experience and knowledge of this realm. Therefore, we reviewed general information and basic knowledge of vestibular rehabilitation such as current state of vestibular disorder in South Korea, pathology, major causes of vestibular dysfunction including peripheral vestibular disorders, vestibular neuritis, benign paroxysmal positional vertigo, and central disorder, evaluation of vestibular dysfunction, and treatment for vestibular dysfunction new approaches. We expect that physical therapist in South Korea recognize clinical significance of vestibular exercise and that clinical concern and research will be begun in near future.

• Research in Vestibular Science
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• v.17 no.4
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• pp.160-166
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• 2018

Objectives: This study was conducted to assess the current management status of the vestibular function test laboratories in Korea. Methods: Questionnaire about the management status of the vestibular function test laboratories was sent by email to the entire members of the Korean Balance Society. The contents of questionnaire included situation of employees who perform the tests, the types of vestibular function tests and equipment, frequency of the test and types of dizziness related questionnaires. Results: Forty-nine hospitals and clinics responded. All the 49 respondents answered that they have videonystagmography. Spontaneous nystagmus analysis by videonystagmogrphy was the most frequently tests for patients with dizziness. Questionnaires for dizziness were used by 27 respondents (55.1%) for initial evaluation of the dizziness patients. The Korean version of dizziness handicap inventory was the most frequently used dizziness related questionnaire. Conclusions: We analyzed the current management status of vestibular function test laboratories to comprehend the present condition of the vestibular function test. We think that these results will help to provide a standard for laboratory operations and prepare for the education, focusing on high-demand tests.

• Korean Journal of Audiology
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• v.25 no.1
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• pp.36-42
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• 2021

Background and Objectives: Globally, the human immunodeficiency virus (HIV) is responsible for one of the most serious pandemics to date. The vulnerability of the vestibular system in individuals with HIV has been confirmed, and central vestibular impairments have been frequently reported. However, there are disagreements on the impact of HIV on peripheral vestibular function. Thus, the current study aimed to determine the prevalence of peripheral vestibular impairment, specifically related to the semi-circular canals (SCCs), in HIV-positive individuals receiving antiretroviral (ARV) treatment. Subjects and Methods: A total of 92 adults between the ages of 18 and 50 years (divided into two groups) participated in the study. The first group comprised HIV-positive individuals receiving ARV treatment (n₁=60), and the second group comprised HIV-negative participants (n₂=32). The video head impulse test was used to conduct the head impulse paradigm (HIMP). Results: Bilateral normal HIMP results were obtained in 95% of the HIV-positive participants and all HIV-negative participants. The gain of the left posterior SCCs was significantly lower in the HIV-positive group, while the gains of all other canals between the two groups were comparable. Conclusions: The prevalence of peripheral vestibular impairment in the HIV-positive group was not significantly different from that of the HIV-negative group. The reduced prevalence in the current study may be attributed to participant characteristics, the test battery employed, and the central compensation of the vestibular dysfunctions at the later stages of infection.

• Journal of Audiology & Otology
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• v.25 no.1
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• pp.36-42
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• 2021

Background and Objectives: Globally, the human immunodeficiency virus (HIV) is responsible for one of the most serious pandemics to date. The vulnerability of the vestibular system in individuals with HIV has been confirmed, and central vestibular impairments have been frequently reported. However, there are disagreements on the impact of HIV on peripheral vestibular function. Thus, the current study aimed to determine the prevalence of peripheral vestibular impairment, specifically related to the semi-circular canals (SCCs), in HIV-positive individuals receiving antiretroviral (ARV) treatment. Subjects and Methods: A total of 92 adults between the ages of 18 and 50 years (divided into two groups) participated in the study. The first group comprised HIV-positive individuals receiving ARV treatment (n₁=60), and the second group comprised HIV-negative participants (n₂=32). The video head impulse test was used to conduct the head impulse paradigm (HIMP). Results: Bilateral normal HIMP results were obtained in 95% of the HIV-positive participants and all HIV-negative participants. The gain of the left posterior SCCs was significantly lower in the HIV-positive group, while the gains of all other canals between the two groups were comparable. Conclusions: The prevalence of peripheral vestibular impairment in the HIV-positive group was not significantly different from that of the HIV-negative group. The reduced prevalence in the current study may be attributed to participant characteristics, the test battery employed, and the central compensation of the vestibular dysfunctions at the later stages of infection.

• Journal of Audiology & Otology
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• v.23 no.1
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• pp.33-38
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• 2019

Background and Objectives: Determination of the lesion side based on the direction of the nystagmus could result in confusions to the clinicians due to mismatch between the vestibular function tests and also between vestibular and audiologic features. To minimize these mistakes, we elucidated the clinical manifestation and vestibular function test results in cases with recovery spontaneous nystagmus (rSN). Subjects and Methods: Patients who visited ENT clinic of tertiary referral hospital for acute onset continuous vertigo from January 2008 to December 2011 were enrolled. In these patients, we assessed onset time of vertigo, time point of paralytic spontaneous nystagmus (SN) and time point of rSN. At each time point of SN, vestibular function tests and hearing function tests were performed. Results: We confirmed the rSN among patients with unilateral vestibulopathy and demonstrated that high gain of the rotatory chair test (slow harmonic acceleration) and/or mismatch of the SN direction and contralateral caloric weakness could indicate the recovery state of patients and nystagmus observed in this stage is recovery phase nystagmus. Conclusions: In acute vestibulopathy patients, recovery phase nystagmus was observed and on this stage of disease vestibular function tests shows several features that could predict recovery state.

• Korean Journal of Audiology
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• v.23 no.1
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• pp.33-38
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• 2019

Background and Objectives: Determination of the lesion side based on the direction of the nystagmus could result in confusions to the clinicians due to mismatch between the vestibular function tests and also between vestibular and audiologic features. To minimize these mistakes, we elucidated the clinical manifestation and vestibular function test results in cases with recovery spontaneous nystagmus (rSN). Subjects and Methods: Patients who visited ENT clinic of tertiary referral hospital for acute onset continuous vertigo from January 2008 to December 2011 were enrolled. In these patients, we assessed onset time of vertigo, time point of paralytic spontaneous nystagmus (SN) and time point of rSN. At each time point of SN, vestibular function tests and hearing function tests were performed. Results: We confirmed the rSN among patients with unilateral vestibulopathy and demonstrated that high gain of the rotatory chair test (slow harmonic acceleration) and/or mismatch of the SN direction and contralateral caloric weakness could indicate the recovery state of patients and nystagmus observed in this stage is recovery phase nystagmus. Conclusions: In acute vestibulopathy patients, recovery phase nystagmus was observed and on this stage of disease vestibular function tests shows several features that could predict recovery state.

• The Journal of Korean Physical Therapy
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• v.25 no.5
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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.

• PNF and Movement
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• v.18 no.3
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• pp.383-392
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• 2020

Purpose: Balance and gait dysfunction caused by aging affect elderly individuals' independent life, which, in turn, can reduce their overall quality of life. The purpose of this study is to compare the differences in the vestibular function of healthy elderly and young adults based on the subjective visual vertical (SVV) test as well as to compare and analyze the gait ability between these two groups to study the differences and association between vestibular, dizziness, and balance ability. Methods: The subjects were 18 young and 16 elderly adults with no neurological or musculoskeletal damage. To evaluate vestibular function, a subjective visual vertical test was performed. To evaluate the gait function, the step time, step length, stride length, stance phase ratio, and swing phase ratio were measured. Balance was evaluated using the Berg Balance Scale (BBS), and dizziness was evaluated using a dizziness handicap inventory (DHI). Results: There were significant differences in the SVV, BBS, and DHI between the young and elderly adults (p < 0.05). The gait variables of the older adults were all significantly different (except for the swing phase ratio) than those of the young adults (p < 0.05). As the result of correlation analysis, the SVV values of the young adults showed a significant negative correlation with step length and stride length (p < 0.05), while the SVV values of the elderly adults only showed a significant positive correlation with the DHI (p < 0.05). Conclusion: The elderly appeared to show a decrease in vestibular function when compared to the young adults, and it is thought that walking and balance function declined, while dizziness increased. Moreover, it is believed that these results can be used as basic data for vestibular rehabilitation in the future.

• Research in Vestibular Science
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• v.17 no.4
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• pp.134-141
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• 2018

Objectives: We aimed to study the role of vestibular input on spatial memory performance in mice that had undergone bilateral surgical labyrinthectomy, semicircular canal (SCC) occlusion and 4G hypergravity exposure. Methods: Twelve to 16 weeks old ICR mice (n=30) were used for the experiment. The experimental group divided into 3 groups. One group had undergone bilateral chemical labyrinthectomy, and the other group had performed SCC occlusion surgery, and the last group was exposed to 4G hypergravity for 2 weeks. The movement of mice was recorded using camera in Y maze which had 3 radial arms (35 cm long, 7 cm high, 10 cm wide). We counted the number of visiting arms and analyzed the information of arm selection using program we developed before and after procedure. Results: The bilateral labyrinthectomy group which semicircular canal and otolithic function was impaired showed low behavioral performance and spacial memory. The semicircular canal occlusion with $CO_2$ laser group which only semicircular canal function was impaired showed no difference in performance activity and spatial memory. However the hypergravity exposure group in which only otolithic function impaired showed spatial memory function was affected but the behavioral performance was spared. The impairment of spatial memory recovered after a few days after exposure in hypergravity group. Conclusions: This spatial memory function was affected by bilateral vestibular loss. Space-related information processing seems to be determined by otolithic organ information rather than semicircular canals. Due to otolithic function impairment, spatial learning was impaired after exposure to gravity changes in animals and this impaired performance was compensated after normal gravity exposure.