Development and Preliminary Findings of the Dizziness Symptom Profile

Objectives: Dizziness, vertigo, and unsteadiness are common complaints of patients who present to primary care providers. These patients often are referred to otology for assessment and management. Unfortunately, there are a small number of specialists to manage these patients. However, there are several dizziness disorders that can be successfully managed by primary care providers if the disorder is properly identified. To assist in the identification of several of the most common dizziness disorders, we developed the dizziness symptom profile (DSP). The DSP is a self-report questionnaire designed to generate one or more differential diagnoses that can be combined with the patient’s case history and physical examination. Design: This report describes three investigations. Investigations 1 and 2 (i.e., exploratory and confirmatory investigations, N = 514) describe the development of the DSP. Investigation 3 (N = 195) is a validation study that describes the level of agreement between the DSP completed by the patient, and, the differential diagnosis of the otologist. Results: The final version of the DSP consists of 31 items. Preliminary findings suggest that the DSP is in agreement with the differential diagnoses of ear specialists for Meniere’s disease (100% agreement), vestibular migraine (95% agreement), and benign paroxysmal positional vertigo (82% agreement). Conclusions: Early results suggest that DSP may be useful in the creation of differential diagnoses for dizzy patients that can be evaluated and managed locally. This has the potential to reduce the burden on primary care providers and reduce delays in the diagnosis of common dizziness and vertigo disorders. ACKNOWLEDGMENTS: The primary author acknowledges the significant contributions of the following co-authors: Gary P. Jacobson: conceptualization and design of the investigation, data acquisition, data analysis, authorship of the manuscript, revision of the manuscript, and final approval for submission. Erin G. Piker: conceptualization and design of the investigation, data acquisition, data analysis, authorship of the manuscript, revision of the manuscript, and final approval for submission. Kelsey Hatton: data acquisition, authorship of the manuscript, revision of the manuscript, and final approval for submission. Kenneth E. Watford: design of the investigation, data acquisition, authorship of the manuscript, revision of the manuscript, and final approval for submission. Timothy Trone: data acquisition, authorship of the manuscript, revision of the manuscript, and final approval for submission. Devin L. McCaslin: conceptualization of the study, data acquisition, authorship of the manuscript, revision of the manuscript, and final approval for submission. Marc L. Bennett: data acquisition, authorship of the manuscript, revision of the manuscript, and final approval for submission. Alejandro Rivas: data acquisition, authorship of the manuscript, revision of the manuscript, and final approval for submission. David S. Haynes: data acquisition, authorship of the manuscript, revision of the manuscript, and final approval for submission. Richard A. Roberts: data acquisition, authorship of the manuscript, revision of the manuscript, and final approval for submission. The authors have no conflicts of interest to disclose. Address for correspondence: Gary P. Jacobson, Division of Audiology, Vanderbilt Bill Wilkerson Center, Medical Center East, South Tower, Suite 9302, Nashville, TN 37232. E-mail: gary.jacobson@vanderbilt.edu Received December 19, 2017; accepted May 14, 2018. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Development and Preliminary Findings of the Dizziness Symptom Profile

Objectives: Dizziness, vertigo, and unsteadiness are common complaints of patients who present to primary care providers. These patients often are referred to otology for assessment and management. Unfortunately, there are a small number of specialists to manage these patients. However, there are several dizziness disorders that can be successfully managed by primary care providers if the disorder is properly identified. To assist in the identification of several of the most common dizziness disorders, we developed the dizziness symptom profile (DSP). The DSP is a self-report questionnaire designed to generate one or more differential diagnoses that can be combined with the patient’s case history and physical examination. Design: This report describes three investigations. Investigations 1 and 2 (i.e., exploratory and confirmatory investigations, N = 514) describe the development of the DSP. Investigation 3 (N = 195) is a validation study that describes the level of agreement between the DSP completed by the patient, and, the differential diagnosis of the otologist. Results: The final version of the DSP consists of 31 items. Preliminary findings suggest that the DSP is in agreement with the differential diagnoses of ear specialists for Meniere’s disease (100% agreement), vestibular migraine (95% agreement), and benign paroxysmal positional vertigo (82% agreement). Conclusions: Early results suggest that DSP may be useful in the creation of differential diagnoses for dizzy patients that can be evaluated and managed locally. This has the potential to reduce the burden on primary care providers and reduce delays in the diagnosis of common dizziness and vertigo disorders. ACKNOWLEDGMENTS: The primary author acknowledges the significant contributions of the following co-authors: Gary P. Jacobson: conceptualization and design of the investigation, data acquisition, data analysis, authorship of the manuscript, revision of the manuscript, and final approval for submission. Erin G. Piker: conceptualization and design of the investigation, data acquisition, data analysis, authorship of the manuscript, revision of the manuscript, and final approval for submission. Kelsey Hatton: data acquisition, authorship of the manuscript, revision of the manuscript, and final approval for submission. Kenneth E. Watford: design of the investigation, data acquisition, authorship of the manuscript, revision of the manuscript, and final approval for submission. Timothy Trone: data acquisition, authorship of the manuscript, revision of the manuscript, and final approval for submission. Devin L. McCaslin: conceptualization of the study, data acquisition, authorship of the manuscript, revision of the manuscript, and final approval for submission. Marc L. Bennett: data acquisition, authorship of the manuscript, revision of the manuscript, and final approval for submission. Alejandro Rivas: data acquisition, authorship of the manuscript, revision of the manuscript, and final approval for submission. David S. Haynes: data acquisition, authorship of the manuscript, revision of the manuscript, and final approval for submission. Richard A. Roberts: data acquisition, authorship of the manuscript, revision of the manuscript, and final approval for submission. The authors have no conflicts of interest to disclose. Address for correspondence: Gary P. Jacobson, Division of Audiology, Vanderbilt Bill Wilkerson Center, Medical Center East, South Tower, Suite 9302, Nashville, TN 37232. E-mail: gary.jacobson@vanderbilt.edu Received December 19, 2017; accepted May 14, 2018. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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P 054 - Evaluation of ground reaction forces by inverse dynamics analysis

Publication date: Available online 4 July 2018
Source:Gait & Posture
Author(s): R. Van Hulle, C. Schwartz, V. Denoël, J.L. Croisier, B. Forthomme, O. Brüls




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O 087 - Neurobiomechanical differences between successful and unsuccessful sit to stand movements performed by acute stroke patients

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): A. Kerr, A. Clark, V. Pomeroy




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P 036 - Pressure mapping analysis for forward and backward gait

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): A. Mosiołek, A. Hadamus, M. Selegrat, M. Wąsak, S. Wójtowicz, Z. Wroński, K. Wiśniewska, M. Grabowicz, A. Bugalska, D. Białoszewski




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P 042 - Gait complexity quantified using inertial measurement units in children with cerebral palsy

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): H. Piitulainen, T. Rantalainen, J.P. Kulmala, H. Mäenpää




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P 043 - Center of Pressure Progression and Ground Reaction Forces Are Altered in Cerebral Palsy Crouch Gait

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): A. Salehi, A. Khandan, M. Arab Baniasad, S. Baghdadi, F. Farahmand, H. Zohoor




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Editorial Board

Publication date: July 2018
Source:Gait & Posture, Volume 64





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O 104 - MRI-based musculoskeletal models for the quantification of gait in children with Juvenile Idiopathic Arthritis

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): E. Montefiori, L. Modenese, R. Di Marco, S. Magni-Manzoni, C. Malattia, M. Petrarca, A. Ronchetti, P. van Dijkhuizen, M. Viceconti, C. Mazzà




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P 052 - Detection of lower extremity asymmetries in slow and dynamic bilateral tasks. Inertial Sensor system vs Optical Motion Capture System

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): W. Teufl, M. Miezal, B. Taetz, M. Fröhlich, G. Bleser




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P 097 - Metabolic cost of transport in over-ground and treadmill walking of healthy elderly and effects of a treadmill familiarization protocol

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): S. Das Gupta, H. Faber, D. Kistemaker, M. Bobbert




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P 037 - Prediction of moments from movements without force platforms using artificial neural networks a pilot test

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): P. Osateerakun, G. Barton, R. Foster, S. Bennett, R. Lakshminarayan




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O 102 - How does load transfer with weight reduction in obese children: A 3-year follow-up study

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): L. Yang, R. Li, H. Fan




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P 025 - Lower limb muscles activity during imagination of gait

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): B. Kolářová, M. Tomsa, J. Richards, P. Kolář, O. Hana




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P 031 - Kinematics of Lateral Step Down is the best discriminator of women with patellofemoral pain

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): Ferreira C., Barton G., Delgado L., Rabelo N., Politti F., Lucareli P.




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O 075 - Exploration of the role of forearm muscles during activities of daily living

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): N. Jarque-Bou, A. Adkins, V. Darhbe, V. Gracia-Ibañez, W. Murray, M. Vergara, J.L. Sancho-Bru




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P 061 – Determination of biomechanical influences of increased femoral anteversion (twisted leg) on running for developing individual

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): A. Apti, N.E. Akalan, S. Kuchimov, Y. Temelli, Ö.İ. Kılıçoğlu, A. Kurt, F. Miller




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P 054 - Evaluation of ground reaction forces by inverse dynamics analysis

Publication date: Available online 4 July 2018
Source:Gait & Posture
Author(s): R. Van Hulle, C. Schwartz, V. Denoël, J.L. Croisier, B. Forthomme, O. Brüls




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O 087 - Neurobiomechanical differences between successful and unsuccessful sit to stand movements performed by acute stroke patients

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): A. Kerr, A. Clark, V. Pomeroy




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P 036 - Pressure mapping analysis for forward and backward gait

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): A. Mosiołek, A. Hadamus, M. Selegrat, M. Wąsak, S. Wójtowicz, Z. Wroński, K. Wiśniewska, M. Grabowicz, A. Bugalska, D. Białoszewski




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P 042 - Gait complexity quantified using inertial measurement units in children with cerebral palsy

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): H. Piitulainen, T. Rantalainen, J.P. Kulmala, H. Mäenpää




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P 043 - Center of Pressure Progression and Ground Reaction Forces Are Altered in Cerebral Palsy Crouch Gait

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): A. Salehi, A. Khandan, M. Arab Baniasad, S. Baghdadi, F. Farahmand, H. Zohoor




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Editorial Board

Publication date: July 2018
Source:Gait & Posture, Volume 64





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O 104 - MRI-based musculoskeletal models for the quantification of gait in children with Juvenile Idiopathic Arthritis

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): E. Montefiori, L. Modenese, R. Di Marco, S. Magni-Manzoni, C. Malattia, M. Petrarca, A. Ronchetti, P. van Dijkhuizen, M. Viceconti, C. Mazzà




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P 052 - Detection of lower extremity asymmetries in slow and dynamic bilateral tasks. Inertial Sensor system vs Optical Motion Capture System

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): W. Teufl, M. Miezal, B. Taetz, M. Fröhlich, G. Bleser




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P 097 - Metabolic cost of transport in over-ground and treadmill walking of healthy elderly and effects of a treadmill familiarization protocol

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): S. Das Gupta, H. Faber, D. Kistemaker, M. Bobbert




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P 037 - Prediction of moments from movements without force platforms using artificial neural networks a pilot test

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): P. Osateerakun, G. Barton, R. Foster, S. Bennett, R. Lakshminarayan




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O 102 - How does load transfer with weight reduction in obese children: A 3-year follow-up study

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): L. Yang, R. Li, H. Fan




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P 025 - Lower limb muscles activity during imagination of gait

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): B. Kolářová, M. Tomsa, J. Richards, P. Kolář, O. Hana




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P 031 - Kinematics of Lateral Step Down is the best discriminator of women with patellofemoral pain

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): Ferreira C., Barton G., Delgado L., Rabelo N., Politti F., Lucareli P.




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via IFTTT

O 075 - Exploration of the role of forearm muscles during activities of daily living

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): N. Jarque-Bou, A. Adkins, V. Darhbe, V. Gracia-Ibañez, W. Murray, M. Vergara, J.L. Sancho-Bru




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P 061 – Determination of biomechanical influences of increased femoral anteversion (twisted leg) on running for developing individual

Publication date: Available online 3 July 2018
Source:Gait & Posture
Author(s): A. Apti, N.E. Akalan, S. Kuchimov, Y. Temelli, Ö.İ. Kılıçoğlu, A. Kurt, F. Miller




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Development of electrophysiological and behavioural measures of electrode discrimination in adult cochlear implant users

Publication date: Available online 4 July 2018
Source:Hearing Research
Author(s): Rajeev Mathew, Deborah Vickers, Patrick Boyle, Azhar Shaida, David Selvadurai, Dan Jiang, Jaime Undurraga
The plasticity of the auditory system enables it to adjust to electrical stimulation from cochlear implants (CI). Whilst speech perception may develop for many years after implant activation, very little is known about the changes in auditory processing that underpin these improvements. Such an understanding could help guide interventions that improve hearing performance. In this longitudinal study, we examine how electrode discrimination ability changes over time in newly implanted adult CI users. Electrode discrimination was measured with a behavioural task as well as the spatial auditory change complex (ACC), which is a cortical response to a change in place of stimulation. We show that there was significant improvement in electrode discrimination ability over time, though in certain individuals the process of accommodation was slower and more limited. We found a strong relationship between objective and behavioural measures of electrode discrimination using pass-fail rules. In several cases, the development of the spatial ACC preceded accurate behavioural discrimination. These data provide evidence for plasticity of auditory processing in adult CI users. Behavioural electrode discrimination score but not spatial ACC amplitude was found to be a significant predictor of speech perception. We suggest that it would be beneficial to measure electrode discrimination in CI users and that interventions that exploit the plastic capacity of the auditory system to improve basic auditory processing, could be used to optimize performance in CI users.



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Development of electrophysiological and behavioural measures of electrode discrimination in adult cochlear implant users

Publication date: Available online 4 July 2018
Source:Hearing Research
Author(s): Rajeev Mathew, Deborah Vickers, Patrick Boyle, Azhar Shaida, David Selvadurai, Dan Jiang, Jaime Undurraga
The plasticity of the auditory system enables it to adjust to electrical stimulation from cochlear implants (CI). Whilst speech perception may develop for many years after implant activation, very little is known about the changes in auditory processing that underpin these improvements. Such an understanding could help guide interventions that improve hearing performance. In this longitudinal study, we examine how electrode discrimination ability changes over time in newly implanted adult CI users. Electrode discrimination was measured with a behavioural task as well as the spatial auditory change complex (ACC), which is a cortical response to a change in place of stimulation. We show that there was significant improvement in electrode discrimination ability over time, though in certain individuals the process of accommodation was slower and more limited. We found a strong relationship between objective and behavioural measures of electrode discrimination using pass-fail rules. In several cases, the development of the spatial ACC preceded accurate behavioural discrimination. These data provide evidence for plasticity of auditory processing in adult CI users. Behavioural electrode discrimination score but not spatial ACC amplitude was found to be a significant predictor of speech perception. We suggest that it would be beneficial to measure electrode discrimination in CI users and that interventions that exploit the plastic capacity of the auditory system to improve basic auditory processing, could be used to optimize performance in CI users.



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