Biomedical subjects

Susan L Whitney

Publications and source records attributed to Susan L Whitney.

23 records · Page 2Linked to original sources

PubMed2004

Reliability, internal consistency, and validity of data obtained with the functional gait assessment.

BACKGROUND AND PURPOSE: The Functional Gait Assessment (FGA) is a 10-item gait assessment based on the Dynamic Gait Index. The purpose of this study was to evaluate the reliability, internal consistency, and validity of data obtained with the FGA when used with people with vestibular disorders. SUBJECTS: Seven physical therapists from various practice settings, 3 physical therapist students, and 6 patients with vestibular disorders volunteered to participate. METHODS: All raters were given 10 minutes to review the instructions, the test items, and the grading criteria for the FGA. The 10 raters concurrently rated the performance of the 6 patients on the FGA. Patients completed the FGA twice, with an hour's rest between sessions. Reliability of total FGA scores was assessed using intraclass correlation coefficients (2,1). Internal consistency of the FGA was assessed using the Cronbach alpha and confirmatory factor analysis. Concurrent validity was assessed using the correlation of the FGA scores with balance and gait measurements. RESULTS: Intraclass correlation coefficients of.86 and.74 were found for interrater and intrarater reliability of the total FGA scores. Internal consistency of the FGA scores was.79. Spearman rank order correlation coefficients of the FGA scores with balance measurements ranged from.11 to.67. DISCUSSION AND CONCLUSION: The FGA demonstrates what we believe is acceptable reliability, internal consistency, and concurrent validity with other balance measures used for patients with vestibular disorders.

Adult↗

PubMed2004

The sensitivity and specificity of the Timed "Up & Go" and the Dynamic Gait Index for self-reported falls in persons with vestibular disorders.

The purpose of this study was to determine the sensitivity and specificity of the Timed "Up & Go" (TUG) and Dynamic Gait Index in identifying self-reported fallers among persons with vestibular dysfunction. One hundred three patient charts were included from a tertiary vestibular physical therapy practice. The patients ranged in age from 14-90 years and had vestibular diagnoses, falls reported in the patient chart, and completed the TUG and/or the Dynamic Gait Index (DGI). Thirty-one persons reported falling one or more times in the previous 6 months during their initial assessment. Persons who took longer than 13.5 seconds to perform the TUG test were 3.7 times more likely to have reported a fall in the previous 6 months. Those persons with scores less than or equal to 18 on the DGI were 2.7 times (p = 0.03) more likely to have reported a fall in the previous 6 months. The sensitivity of the DGI at 18 or less was 70% and the specificity was 51%. People who scored greater than 11.1 seconds on the TUG were 5 times (p = 0.001) more likely to have reported a fall in the previous 6 months. Sensitivity (80%) and specificity (56%) were calculated for TUG scores of greater than 11.1 seconds. The TUG and the DGI appear to be helpful in identifying fall risk in persons with vestibular dysfunction. Slower scores on the TUG (> 11.1 seconds) and lower scores on the DGI (18) correlated with reports of falls in persons with vestibular dysfunction.

Accidental Falls↗

PubMed2003

Otolith-ocular responses in patients with surgically confirmed unilateral peripheral vestibular loss.

The chronic effects of unilateral peripheral vestibular loss (UPVL) are influenced by vestibular compensation. This study documents the balance-related symptoms and quantitative vestibular laboratory testing of 20 patients with surgically confirmed UPVL. Included are measures of the semicircular canal-ocular reflex, the otolith-ocular reflex, and both static and dynamic semicircular canal-otolith-interaction. This study differs from previous studies of patients with UPVL in that a large number of patients with surgically confirmed lesions were tested with three types of off-vertical axis rotation, several of the patients had anatomically preserved superior vestibular nerves, and self-perceived level of disability related to dizziness and imbalance were available. Results confirmed previously reported changes in the vestibulo-ocular reflex of patients with UPVL. Also, there was no apparent effect of anatomically preserving the superior vestibular nerve during surgical resection of vestibular schwannomas based on either subjective or objective measures of vestibular dysfunction. Further, there were no apparent correlations between subjective measures of dizziness and imbalance and objective measures of vestibulo-ocular function. These results have clinical implications for the management of patients with unilateral vestibular loss and provide insights into the process of vestibular compensation especially with respect to the otolith-ocular reflex.

Adult↗

PubMed2002

The effect of age on vestibular rehabilitation outcomes.

OBJECTIVE: The purpose of the retrospective chart review was to compare vestibular rehabilitation outcomes in young versus older adults. STUDY DESIGN: Retrospective matched design. METHODS: Twenty-three persons with vestibular disorders aged 20 to 40 years were matched by gender, vestibular diagnosis, and vestibular function test results to 23 older adults aged 60 to 80 years. The patients were treated with a custom-designed physical therapy exercise program. Patients completed the Dizziness Handicap Inventory, the Activities-Specific Balance Confidence (ABC) scale, and the Dynamic Gait Index; number of falls; and rated the severity of their dizziness. The two-sample test, the Mann-Whitney test, and McNemar's test for correlated proportions were used to determine whether there was a difference in scores between the two age groups at the beginning and end of physical therapy. RESULTS: During the initial evaluation, older adults reported having statistically greater space and motion discomfort and more severe symptoms on a scale of 0 to 100. Younger adults had more impaired DGI scores and a higher proportion of caloric testing abnormalities. After rehabilitation, overall improvement was seen in both the younger and older populations. There were no statistical differences between the two groups on the DHI, the DGI, reported symptoms at discharge, or number of falls. When only the complete matched-pair data were analyzed, there were no statistically significant differences between the age groups in the proportion of patients demonstrating clinical improvement. CONCLUSION: Age does not significantly influence the beneficial effects of vestibular rehabilitation for persons with vestibular disorders.

Adult↗

PubMed2002

Vestibular rehabilitation outcomes in patients with a history of migraine.

OBJECTIVES: The purpose of this study was to assess the efficacy of physical therapy for patients with vestibular disorders with and without a history of migraine headaches. STUDY DESIGN: Retrospective case series. SETTING: Outpatient physical therapy clinic. PATIENTS: Thirty patients with both a history of migraine and a diagnosis of vestibular/balance disorder considered unrelated to migraine were identified by retrospective chart review. Thirty patients without a history of migraine, matched retrospectively by diagnosis, vestibular function, and age (+/-5 years), were used as a comparison group. INTERVENTIONS: Both groups were treated with a custom-designed physical therapy program for a mean of 4.1 visits over a mean of 3.3 months. MAIN OUTCOME MEASURES: Patients completed the Dizziness Handicap Inventory, the Activities-Specific Balance Confidence Scale, the Dynamic Gait Index, and the Timed Up & Go Test and rated the severity of their dizziness on an analog scale of 0 to 100. RESULTS: Significant differences were demonstrated within both groups between initial evaluation and discharge in each of the assessment measures used. Patients with a history of migraine demonstrated worse scores on all outcome measures than did the patients without a history of migraine. There were no statistically significant differences between the two groups' scores before and after therapy except for the total Dizziness Handicap Inventory score at discharge (p < 0.05). CONCLUSIONS: Patients with vestibular disorders with or without a history of migraine demonstrated improvements in both subjective and objective measures of balance after physical therapy. Patients with a history of migraine perceived a greater handicap from dizziness than did patients without a history of migraine that was greater than the difference in physical function performance measures between groups.

Aged↗