Evaluation of a bedside test of utricular function – the bucket test – in older individuals

Sun, Daniel Q.; Zúñiga, M. Geraldine; Davalos-Bichara, Marcela; Carey, John P.; Agrawal, Yuri

doi:10.3109/00016489.2013.867456

Cited by 31 publications

(23 citation statements)

References 20 publications

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“…In our subjects, there was also a tendency for older adults to rely on vision more heavily than proprioception, compared to younger adults. This is consistent with studies of visuo-vestibular perception of the vertical in older adults (Alberts et al, 2019;Kobayashi et al, 2002;Sun et al, 2014). In brightly lit surroundings, we might expect most people to favor vision over proprioception.…”

Section: Weight Of Vision Vs Proprioceptionsupporting

confidence: 90%

Visuo-proprioceptive control of the hand in older adults

Block

Sexton

2020

Preprint

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To control hand movement, we have both vision and proprioception, or position sense. The brain is known to integrate these to reduce variance. Here we ask whether older adults integrate vision and proprioception in a way that minimizes variance as young adults do, and whether older subjects compensate for an imposed visuo-proprioceptive mismatch as young adults do. Ten healthy older adults (mean age 69) and 10 healthy younger adults (mean age 19) participated.Subjects were asked to estimate the position of visual, proprioceptive, and combined targets, with no direct vision of either hand. After a veridical baseline block, a spatial visuoproprioceptive misalignment was gradually imposed by shifting the visual component forward from the proprioceptive component without the subject's awareness. Older subjects were more variable than young subjects at estimating both visual and proprioceptive target positions (F 1,18 = 6.14, p = 0.023). Older subjects tended to rely more heavily on vision than proprioception compared to younger subjects. However, the weighting of vision vs. proprioception was correlated with minimum variance predictions for both older (r = 0.71, p = 0.021) and younger (r = 0.81, p = 0.0047) adults, suggesting that variance-minimizing mechanisms are present to some degree in older adults. Visual and proprioceptive realignment were similar for young and older subjects in the misalignment block, suggesting older subjects are able to realign as much as young subjects. These results suggest that intact multisensory processing in older adults should be explored as a potential means of mitigating degradation in individual sensory systems.

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Section: Weight Of Vision Vs Proprioceptionsupporting

confidence: 90%

Visuo-proprioceptive control of the hand in older adults

Block

Sexton

2020

Preprint

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“…In summary, in order to maintain balance, the brain uses all available sensorial cues from vestibular, visual, and proprioceptive inputs, which in turn are integrated by the central nervous system to execute adequate motor responses. In this manner, age-related balance deterioration does not appear to behave as a unique standardized phenomenon, but the opposite, it seems to be extremely variable from patient to patient ( 17 , 18 , 20 , 27 ). Moreover, minor new or acute impairments can affect disproportionately their capacity to cope difficult equilibrium scenarios, as every sensory modality may already be partially deteriorated.…”

Section: Pathophysiology Of Balance In the Elderlymentioning

confidence: 94%

“…Similarly, elderly patients with chronic pathological asymmetric vestibular evoked myogenic potentials (VEMPs) or deviated subjective visual vertical (SVV) tests, do not report dizziness or vertigo as significant symptoms, which may relate to central compensation occurring from the beginning of this slow onset of vestibular function ( 18 , 19 , 26 , 27 ). This scenario leads to no pathological symptoms at all.…”

Section: Pathophysiology Of Balance In the Elderlymentioning

confidence: 99%

Vertigo and Dizziness in the Elderly

2015

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The prevalence of vertigo and dizziness in people aged more than 60 years reaches 30%, and due to aging of world population, the number of patients is rapidly increasing. The presence of dizziness in the elderly is a strong predictor of falls, which is the leading cause of accidental death in people older than 65 years. Balance disorders in the elderly constitute a major public health problem, and require an adequate diagnosis and management by trained physicians. In the elderly, common causes of vertigo may manifest differently, as patients tend to report less rotatory vertigo and more non-specific dizziness and instability than younger patients, making diagnosis more complex. In this mini review, age-related degenerative processes that affect balance are presented. Diagnostic and therapeutic approaches oriented to the specific impaired system, including visual, proprioceptive, and vestibular pathways, are proposed. In addition, presbystasis – the loss of vestibular and balance functions associated with aging – benign paroxysmal positional vertigo, and stroke (in acute syndromes) should always be considered.

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“…Before each trial, the patients were instructed to state when the line was vertical while the examiner moved the bucket. The angle gaps outside of the range of −2.0° (left) to +2.0° (right) were considered positive …”

Section: Methodsmentioning

confidence: 99%

“…The angle gaps outside of the range of −2.0 (left) to +2.0 (right) were considered positive. 12 IMAGING. Performing ieMRI at 4 hours after intravenous administration of Gadolinium was previously reported to be useful for imaging of endolymphatic hydrops (EH).…”

Section: Evaluationsmentioning

confidence: 99%

Head‐Up Sleep May Cure Patients With Intractable Benign Paroxysmal Positional Vertigo: A six‐Month Randomized Trial

Horinaka

Kitahara

Shiozaki

et al. 2019

Laryngoscope Investig Oto

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Objectives The aim of the present study was to assess head‐position management for intractable idiopathic benign paroxysmal positional vertigo (BPPV) when lying down. We hypothesized that head‐up sleep (HUS) could prevent free‐floating otoliths from entering the semicircular canals. Study Design A prospective two‐arm multicenter randomized controlled trial. Methods BPPV was diagnosed in 611 patients (611/1,520; 40.2%) according to the 2015 diagnostic guidelines issued by the International Classification of Vestibular Disorders. Among them, 201 patients were intractable (201/611; 32.9%), 88 of whom were idiopathic and subsequently enrolled in the study. Patients randomly received intervention with HUS at greater than 45° (n = 44) or head‐down sleep (HDS; n = 44) when lying down. Before treatment, they completed several examinations, including subjective visual vertical (SVV). The specific diagnoses for the 88 patients with BPPV included horizontal type cupula (n = 40), horizontal type canal (n = 13), posterior type (n = 26), and probable and/or atypical BPPV (n = 9). Results Patient backgrounds did not differ significantly between the HUS and HDS groups. Visual analog scale (VAS) scores of vertiginous sensation were significantly lower in the HUS group than in the HDS group at both the third month and sixth month post‐treatment. Positional/positioning nystagmus observed just before treatment disappeared significantly more often in the HUS group than in the HDS group until the sixth post‐treatment month. Further, especially in HUS group, VAS scores in SVV− group (n = 24) were significantly lower than those in the SVV+ group (n = 20) sixth month post‐treatment. Conclusions Controlling free‐floating otoliths is not easy due to aging of the otolith organs. Repeatedly returning the endless free‐floating debris from the canals to the utricle through physical means is not a good strategy. Therefore, HUS when lying down at home could be recommended as an initial treatment for patients with intractable idiopathic BPPV. Level of Evidence 1b

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Evaluation of a bedside test of utricular function – the bucket test – in older individuals

Cited by 31 publications

References 20 publications

Visuo-proprioceptive control of the hand in older adults

Visuo-proprioceptive control of the hand in older adults

Vertigo and Dizziness in the Elderly

Head‐Up Sleep May Cure Patients With Intractable Benign Paroxysmal Positional Vertigo: A six‐Month Randomized Trial

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